Journal of Infertility and Reproductive Biology
ISSN: 2310-7588
The latest research in infertility and reproductive medicine from across the world
Metabolism of hepcidin and iron in pregnant women: pathophysiology and research results
Published date: Jun 20 2025
Journal Title: Journal of Infertility and Reproductive Biology
Issue title: Journal of Infertility and Reproductive Biology: Volume 13, Issue 2
Pages: 82 - 88
Authors:
Abstract:
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.
Keywords: hepcidin, pregnancy, hemoglobin, iron metabolism, pathophysiology
References:
[1] Milman N. Iron and pregnancy: a delicate balance. Ann Hematol. 2006;85(9):559–65. https://doi.org/ 10.1007/s00277-006-0105-3
[2] World Health Organization. The global prevalence of anaemia in 2021. Geneva: WHO; 2024. https://doi.org/10.4060/cc7744en
[3] Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005;352(10):1011–23. https: //doi.org/10.1056/NEJMra041809
[4] Nemeth E, Ganz T. Regulation of iron metabolism by hepcidin. Annu Rev Nutr. 2006;26:323–42. https://doi.org/10.1146/annurev.nutr.26.061505.111303
[5] Pietrangelo A. Ferroportin disease: pathogenesis, diagnosis and treatment. Haematologica. 2015;100(4):479–81. https://doi.org/10.3324/haematol.2014.114157
[6] Sangkhae V, Nemeth E. Regulation of the iron homeostatic hormone hepcidin. Adv Nutr. 2017;8(1):126– 36. https://doi.org/10.3945/an.116.013961
[7] Pagani A, Nai A, Silvestri L, Camaschella C. Hepcidin and anemia: a tight relationship. Front Physiol. 2019;10:1294. https://doi.org/10.3389/fphys.2019.01294
[8] Aringazina R, Mussina A, Zholdassova N, et al. Study of the hepcidin level in pregnant women with and without anemia. Acta Biomed. 2023;94(1):e2023021. https://doi.org/10.23750/abm.v94i1.12713
[9] Ginzburg YZ. Hepcidin–ferroportin axis in health and disease. Vitam Horm. 2019;110:17–45. https://doi.org/10.1016/bs.vh.2019.01.002
[10] Palis J. Erythropoiesis in the mammalian embryo. Exp Hematol. 2024; 136:104283. https://doi.org/10. 1016/j.exphem.2024.104283
[11] Zhao Y, Zhao J, Ma H, et al. High hepcidin levels promote abnormal iron metabolism and ferroptosis in chronic atrophic gastritis. Biomedicines. 2023;11(9):2338. https://doi.org/10.3390/ biomedicines11092338
[12] Rusch JA, van der Westhuizen DJ, Gill RS, et al. Diagnosing iron deficiency: controversies and novel metrics. Best Pract Res Clin Anaesthesiol. 2023;37(4):451–67. https://doi.org/10.1016/j.bpa.2023.11.001
[13] Marques O, Weiss G, Muckenthaler MU. The role of iron in chronic inflammatory diseases: from mechanisms to treatment options in anemia of inflammation. Blood. 2022;140(19):2011–23. https: //doi.org/10.1182/blood.2021013472
