Does intravenous iron administration in pregnancy change blood vessel and heart function?

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Iron deficiency is a common nutritional deficiency among women of childbearing age. Iron deficiency during the third-trimester of pregnancy is associated with premature birth, foetal growth restriction, stillbirth and infection. Women with iron deficiency are at risk of needing red blood cell transfusion, and having cardiovascular problems like enlarged heart or high blood pressure, reduced immune function, tiredness and depressive episodes. Iron infusion increases iron levels in the body and reduces the risk of the problems described above, but it remains unclear how the blood vessels and the heart respond to the increased iron levels. The aim of this study is to find out whether pregnant women with iron-deficiency or iron-deficiency anaemia display impaired heart and blood vessel function, and, whether this improves after iron infusion of ferric carboxymaltose. We will compare results with a group of age– and gestation-matched healthy pregnant women. We will make 2 or 3 one-hour appointments for participants to come into the Lyell McEwin Hospital: First : on the day or week before the iron infusion Second : two - four days post infusion (Third : two weeks from the first visit depending on the stage of pregnancy) 4 non-invasive tests will be performed: Laser Doppler studies — Small probes sit on the skin and measure blood flow through the very small blood vessels. We measure the way the blood vessels dilate when a drug or mild heat is applied to a small area of the skin. Arteriograph — This is a special blood pressure cuff that also measures how stiff blood vessels are. USCOM — A small ultrasonic probe rests on the skin surface of the neck and measures heart function using sound waves. Retinal photograph — We will take a photo of the blood vessels at the back of the eyes.

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