Blunted erythropoietin production and decreased erythropoiesis in early
pregnancy [see comments]
Y Beguin, G Lipscei, H Thoumsin and G Fillet
Department of Hematology, University of Liege, Belgium.
After decreasing in the first trimester of pregnancy, the total red blood
cell mass increases in the second and third trimesters to peak at term at
about 120% to 125% of nonpregnant values, but how this is brought about by
changes in the rate of erythropoiesis is not known. We evaluated
erythropoiesis by measuring serum transferrin receptor (TfR) levels in 406
women during normal pregnancy (N = 317), at delivery (N = 63), or in the
early postpartum (N = 27). Despite the presence of the placenta and the
frequent occurrence of iron deficiency, TfR levels remained low in the
first two trimesters and increased in the third trimester and at delivery.
To explain why erythropoiesic activity was relatively low in early
pregnancy, we also measured serum immunoreactive erythropoietin (Epo) in
relation to the degree of anemia. There was a very strong correlation
between serum TfR and Epo levels in the entire group (r = .59, P less than
.0001) as well as in each period of pregnancy. Epo levels remained low for
the degree of anemia and did not correlate with hematocrit in the first two
trimesters, but recovered afterwards. In the early postpartum, Epo
production and erythropoiesis were normal. We conclude that: (1)
erythropoiesis is decreased in the first part of pregnancy but increases
afterwards; and (2) blunted Epo production in early pregnancy could be
responsible for that observation.
Volume 78,
Issue 1,
pp. 89-93,
07/01/1991
Copyright © 1991 by The American Society of Hematology
