title: Hepcidin and iron homeostasis during pregnancy.
abstract: Hepcidin is the master regulator of systemic iron bioavailability in humans. This review examines primary research articles that assessed hepcidin during pregnancy and postpartum and report its relationship to maternal and infant iron status and birth outcomes; areas for future research are also discussed. A systematic search of the databases Medline and Cumulative Index to Nursing and Allied Health returned 16 primary research articles including 10 human and six animal studies. Collectively, the results indicate that hepcidin is lower during pregnancy than in a non-pregnant state, presumably to ensure greater iron bioavailability to the mother and fetus. Pregnant women with undetectable serum hepcidin transferred a greater quantity of maternally ingested iron to their fetus compared to women with detectable hepcidin, indicating that maternal hepcidin in part determines the iron bioavailability to the fetus. However, inflammatory states, including preeclampsia, malaria infection, and obesity were associated with higher hepcidin during pregnancy compared to healthy controls, suggesting that maternal and fetal iron bioavailability could be compromised in such conditions. Future studies should examine the relative contribution of maternal versus fetal hepcidin to the control of placental iron transfer as well as optimizing maternal and fetal iron bioavailability in pregnancies complicated by inflammation.
authors.affiliation: Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago 845 S. Damen Ave., Room 814 (MC802), Chicago, IL 60612, USA. marydh@uic.edu.
authors.forename: Mary Dawn
authors.initials: MD
authors.lastname: Koenig
authors.affiliation: Division of Health Promotion Research, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60608, USA. ltussing@uic.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Tussing-Humphreys
authors.affiliation: Sumter Family Health Center, 1278 N Lafayette Drive Sumter, SC 29150, USA. jday@sumterfhc.com.
authors.forename: Jessica
authors.initials: J
authors.lastname: Day
authors.affiliation: School of Nursing, Yale University, 100 Church Street South, New Haven, CT 06519, USA. brooke.cadwell@yale.edu.
authors.forename: Brooke
authors.initials: B
authors.lastname: Cadwell
authors.affiliation: UCLA, Department of Medicine, Center for Iron Disorders, University of California Los Angeles, CHS 52-239, 10833 Le Conte Ave. Los Angeles, CA 90095-1690, USA. enemeth@mednet.ucla.edu.
authors.forename: Elizabeta
authors.initials: E
authors.lastname: Nemeth
mesh_terms: D000818:Animals; D001682:Biological Availability; D016208:Databases, Factual; D004195:Disease Models, Animal; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D064451:Hepcidins / Q000097:blood*; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D008431:Maternal-Fetal Exchange; D049590:Postpartum Period; D011247:Pregnancy
chemical_list: D064451:Hepcidins; D007501:Iron
references.citation: Proc Natl Acad Sci U S A. 2002 Apr 2;99(7):4596-601
references.pmid: 11930010
references.citation: World J Surg. 2012 Apr;36(4):800-6
references.pmid: 22350482
references.citation: Proc Natl Acad Sci U S A. 2002 Feb 19;99(4):2264-9
references.pmid: 11854522
references.citation: J Obstet Gynaecol Res. 2011 Nov;37(11):1620-4
references.pmid: 21733041
references.citation: Reprod Biol Endocrinol. 2013 May 01;11:32
references.pmid: 23635304
references.citation: Biomed Pharmacother. 2001 Jul;55(6):324-32
references.pmid: 11478585
references.citation: Br J Obstet Gynaecol. 1991 Sep;98(9):886-91
references.pmid: 1911607
references.citation: Am J Hematol. 2012 Oct;87(10):977-83
references.pmid: 22886770
references.citation: Blood Cells Mol Dis. 2010 Oct 15;45(3):238-45
references.pmid: 20800515
references.citation: Am J Physiol Regul Integr Comp Physiol. 2009 Apr;296(4):R1063-70
references.pmid: 19176888
references.citation: Am J Clin Nutr. 2000 May;71(5 Suppl):1280S-4S
references.pmid: 10799402
references.citation: Best Pract Res Clin Haematol. 2005 Jun;18(2):171-82
references.pmid: 15737883
references.citation: J Nutr Health Aging. 2009 Oct;13(8):666-70
references.pmid: 19657548
references.citation: Nutr Rev. 1992 Nov;50(11):329-31
references.pmid: 1488157
references.citation: Am J Trop Med Hyg. 2007 Oct;77(4):623-6
references.pmid: 17978060
references.citation: J Hepatol. 2009 Feb;50(2):394-401
references.pmid: 19070914
references.citation: Obstet Gynecol Annu. 1972;1:219-44
references.pmid: 4591070
references.citation: Proteome Sci. 2008 Oct 14;6:28
references.pmid: 18854031
references.citation: MMWR Recomm Rep. 1998 Apr 3;47(RR-3):1-29
references.pmid: 9563847
references.citation: J Matern Fetal Neonatal Med. 2014 Jan;27(1):75-9
references.pmid: 23662610
references.citation: Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):724-7
references.pmid: 7573233
references.citation: J Nutr. 2008 Nov;138(11):2284-8
references.pmid: 18936232
references.citation: Blood. 2010 Dec 2;116(23):4754-61
references.pmid: 20826717
references.citation: Blood. 2007 Aug 1;110(3):1048-54
references.pmid: 17435114
references.citation: Anal Biochem. 2009 Jun 15;389(2):124-9
references.pmid: 19341701
references.citation: Blood. 2003 Aug 1;102(3):783-8
references.pmid: 12663437
references.citation: Exp Physiol. 1998 Nov;83(6):771-81
references.pmid: 9782187
references.citation: Am J Trop Med Hyg. 2011 Jan;84(1):148-51
references.pmid: 21212218
references.citation: Eur J Haematol. 2010 Oct;85(4):345-52
references.pmid: 20528904
references.citation: J Cell Physiol. 1984 Aug;120(2):225-32
references.pmid: 6746749
references.citation: Lancet. 1998 Nov 28;352(9142):1747-9
references.pmid: 9848351
references.citation: N Engl J Med. 1999 Dec 23;341(26):1986-95
references.pmid: 10607817
references.citation: Fertil Steril. 2012 Jul;98(1):228-34
references.pmid: 22494925
references.citation: Blood Cells Mol Dis. 2012 Apr 15;48(4):233-7
references.pmid: 22365732
references.citation: Nutr Rev. 1997 Apr;55(4):91-101
references.pmid: 9197129
references.citation: N Engl J Med. 2005 Mar 10;352(10):1011-23
references.pmid: 15758012
references.citation: Gut. 2004 May;53(5):655-60
references.pmid: 15082582
references.citation: Br J Haematol. 2009 Mar;144(5):789-93
references.pmid: 19120353
references.citation: Am J Physiol Regul Integr Comp Physiol. 2013 Jun 15;304(12):R1121-9
references.pmid: 23594612
references.citation: Clin Chem Lab Med. 2013 Jul;51(7):1395-401
references.pmid: 23241678
references.citation: J Perinat Med. 1996;24(6):687-91
references.pmid: 9120753
references.citation: Biometals. 2009 Feb;22(1):77-87
references.pmid: 19130266
references.citation: Nutr Rev. 2011 Nov;69 Suppl 1:S17-22
references.pmid: 22043877
references.citation: Clin Chem Lab Med. 2010 Oct;48(10):1423-6
references.pmid: 20626300
references.citation: Br J Obstet Gynaecol. 1993 Jun;100(6):587-92
references.pmid: 8334096
references.citation: Br J Nutr. 2007 Mar;97(3):544-9
references.pmid: 17313717
references.citation: Br J Nutr. 2001 May;85 Suppl 2:S75-80
references.pmid: 11509093
references.citation: Nutr Metab (Lond). 2011 Feb 03;8:9
references.pmid: 21291567
references.citation: J Neuroendocrinol. 2008 Apr;20(4):427-31
references.pmid: 18266949
references.citation: MCN Am J Matern Child Nurs. 1995 Jul-Aug;20(4):234
references.pmid: 7658937
references.citation: Hematology Am Soc Hematol Educ Program. 2006;:29-35, 507
references.pmid: 17124036
references.citation: Semin Hematol. 2009 Oct;46(4):387-93
references.pmid: 19786207
references.citation: J Nutr. 2010 Oct;140(10):1728-35
references.pmid: 20685892
references.citation: Cell Metab. 2005 Mar;1(3):191-200
references.pmid: 16054062
references.citation: Asia Pac J Clin Nutr. 2008;17(3):451-6
references.pmid: 18818166
references.citation: Eur J Haematol. 2013 Jan;90(1):37-44
references.pmid: 23110713
references.citation: Blood. 2008 Nov 15;112(10):4292-7
references.pmid: 18689548
references.citation: Baillieres Clin Haematol. 1994 Dec;7(4):829-49
references.pmid: 7881156
references.citation: Clin Chem. 2010 Oct;56(10):1570-9
references.pmid: 20739637
references.citation: J Nutr. 2003 May;133(5 Suppl 2):1700S-1708S
references.pmid: 12730487
references.citation: Am J Clin Nutr. 2000 Jul;72(1 Suppl):257S-264S
references.pmid: 10871591
references.citation: Curr Opin Hematol. 1999 Mar;6(2):65-70
references.pmid: 10088634
references.citation: Int J Gynaecol Obstet. 2002 Nov;79(2):93-100
references.pmid: 12427391
references.citation: Am J Clin Nutr. 2003 Oct;78(4):773-81
references.pmid: 14522736
references.citation: Clin Chim Acta. 2012 Apr 11;413(7-8):696-701
references.pmid: 22222553
references.citation: Clin Chem. 2007 Apr;53(4):620-8
references.pmid: 17272487
references.citation: J Perinatol. 2013 Mar;33(3):177-81
references.pmid: 22722675
references.citation: J Nutr. 2001 Feb;131(2S-2):581S-589S
references.pmid: 11160591
references.citation: Annu Rev Nutr. 2006;26:323-42
references.pmid: 16848710
references.citation: Free Radic Biol Med. 2000 Feb 15;28(4):514-9
references.pmid: 10719232
references.citation: Am J Physiol Gastrointest Liver Physiol. 2010 Apr;298(4):G525-9
references.pmid: 20110460