Iron deficiency is common during pregnancy and increases the risk of adverse outcomes such as pre-term delivery, preeclampsia and intrauterine growth restriction. The most common treatment for iron deficiency is oral iron supplementation using ferrous salts. However, such supplements often have gastrointestinal side effects that can reduce compliance. Thus, there is a need for a well-tolerated, safe and effective oral iron supplement.
We are involved in the development and testing of novel iron supplements which we believe will have advantages over ferrous salts. The first of these is IHAT (iron hydroxide adipate tartrate) which consists of nanoparticles of iron oxo-hydroxide coated with organic acids. IHAT is currently being tested in clinical trials, however, due to a lack of preclinical data, these trials exclude pregnant women. To provide this data, we administered either IHAT or ferrous sulfate to pregnant mice and examined iron levels in late pregnancy. Our results show that oral IHAT is equally as effective as ferrous sulfate at increasing both maternal and fetal iron status. While ferrous sulfate triggered an increase in the expression of the stress induced haem oxygenase 1 gene in both intestinal cells and the placenta, no such increase was observed in mice treated with IHAT. These studies suggest that IHAT is an effective iron supplement that may have fewer detrimental effects than ferrous based supplements in pregnant women.
We have also examined the use of carbonyl iron as a potential oral supplement. Carbonyl iron consists of 5μm particles of elemental iron and has an exceptional safety profile. Interestingly, we found that mice fed diets containing high levels of carbonyl iron where able to absorb iron independent of the normal intestinal iron uptake pathway, suggesting that it may be a useful oral supplement in patients with compromised intestinal absorption.