임신부의 철분 섭취 실태와 임신결과

Abstract

It is known that Korean pregnant women take iron supplement higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with various individual factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102-item food frequency questionnaire, and information on types and amount of nutritional supplement intakes was also attained. While dietary intake levels of most nutrients exceeded the KDRIs(Korea Dietary Reference Intakes:EAR:Estimated Average Requirements), folate fell short of the KDRIs. The mean levels of iron supplement significantly increased as pregnancy duration aged (1st trimester: 10.2 ± 27.1 mg/day, 2nd trimester: 50.2 ± 42 mg/day, 3rd trimester: 66.8 ± 40.2 mg/day, p<0.05). A total of 428 women (83.9%) reported to take iron supplement. The mean dietary intake of iron was 24% of the total iron intake for pregnancy women. Iron intake from food were not significantly different among Ⅰ,Ⅱ, and Ⅲ. In case of, iron intake from supplement the most frequent dose (34.1%) was 90-100mg/day, and the mean iron supplement intake was 304% of the EAR. The pregnant women were divided into the three groups(groupⅠ: Fe supplement intake ≤ EAR, groupⅡ: EAR〈 Fe supplement intake ≤ 3 times of EAR, groupⅢ: 3 times of EAR〈 Fe supplement intake). The study findings showed that those with higher levels of iron supplement had better meal quality measured by NAR(Nutrient Adequacy Ratio) and INQ(Index of Nutrient Quality). In addition iron supplement intake levels were positively associated with age (20s: 66.5 ± 38.6 mg/day, 30s: 77.3 ± 47.8 mg/day, p<0.0116) and experience of childbirth (1st pregnancy: 70.9 ± 41.2 mg/day, 2nd pregnancy: 64.5 ± 39.5 mg/day, ≥3rd pregnancy: 94.4 ± 63.8 mg/day, p<0.005). However, no significant association was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use much exceeded the EAR, suggesting need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition.