Metabolism of hepcidin and iron in pregnant women: pathophysiology and research results

Pregnancy is characterized by changes in iron metabolism due to the needs of the growing fetus, placenta and increased circulating blood volume. Hepcidin, the main hormone regulating systemic iron metabolism, plays a key role in maintaining the balance between iron intake, storage and transport. This pathophysiological review reviews the current understanding of hepcidin regulation during pregnancy, including our own studies. The study included 33 pregnant women in whom hemoglobin, serum iron and hepcidin levels were determined. Descriptive statistics, correlation and regression analyses were used for the analysis (p < 0.05 was considered significant). A statistically significant positive association was found between hemoglobin and hepcidin levels: Hepc = –23. 87 + 0. 25 × Hb (r = 0.62; p = 0.0003). A moderate inverse correlation was also observed between hepcidin levels and serum iron levels: Hepc = 0.0569 + 0.309 × Fe (r = -0.66; p < 0.001). These results confirm that hepcidin levels increase with increasing hemoglobin levels, reflecting its inhibitory effect on iron absorption. High hepcidin levels may reduce circulating iron levels associated with inflammation. These data demonstrate the value of hepcidin in assessing iron metabolism disorders during pregnancy and allow it to be considered as a potential biomarker for determining the type of anemia.