Iron Deficiency in Pregnancy: A Brief Review (original) (raw)
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Iron Deficiency Anemia in Pregnancy: Novel Approaches for an Old Problem
Oman Medical Journal, 2020
Iron needs increase exponentially during pregnancy to meet the increased demands of the fetoplacental unit, to expand maternal erythrocyte mass, and to compensate for iron loss at delivery. In more than 80% of countries in the world, the prevalence of anemia in pregnancy is > 20% and could be considered a major public health problem. The global prevalence of anemia in pregnancy is estimated to be approximately 41.8%. Undiagnosed and untreated iron deficiency anemia (IDA) can have a great impact on maternal and fetal health. Indeed, chronic iron deficiency can affect the general wellbeing of the mother and leads to fatigue and reduced working capacity. Given the significant adverse impact on maternal-fetal outcomes, early recognition and treatment of this clinical condition is fundamental. Therefore, the laboratory assays are recommended from the first trimester to evaluate the iron status. Oral iron supplementation is the first line of treatment in cases of mild anemia. However, considering the numerous gastrointestinal side effects that often lead to poor compliance, other therapeutic strategies should be evaluated. This review aims to provide an overview of the current evidence about the management of IDA in pregnancy and available treatment options.
Prevalence and risk factors of iron deficiency anaemia with pregnancy at Minia University Hospital
Minia Journal of Medical Research
Background; Anaemia in expectant women is a serious worldwide public health problem with adverse pregnancy outcomes. The study aim is to investigate prevelance, sosciodemographic characteristics, medical and obstetrical risk factors of iron deficiency anaemia during pregnancy at Minia maternity university hospital in one year, Subjects and methods; This study is A prospective analytical study, was conducted at the Minia university hospital for gynecology and obstetrics on all pregnant women with hemoglobin level less than 11 gm/dl in the first trimester and less than 10.5 gm/dl in the second and third trimester from November 2019 to October 2021, Result; this study was conducted on 5500 women; 2211 of them had iron deficiency anemia (40.2%), The only factors which emerged as statistically significant were rural residence, low education, Low Family income, Multi-para, low Pregnancy interval, insufficient meals per day, insufficient Meat intake, insufficient vegetables intake, insufficient egg intake, insufficient milk intake, and Parasitic infestation. Conclusion; Based on our findings, there was highly significant difference between the cases with iron deficiency anemia and cases without iron deficiency anemia regarding residence, education, family income, BMI, parity, gestational age, Pregnancy interval, and delivery mode. Iron deficiency anemia was significantly higher with cases took ‹ 3 times per day, meat intake less than 2 times per week, vegetables intake less than 2 times per week, egg intake and milk intake less than 2 times per week and cases that did not take iron supplementation,
Journal of Pregnancy, 2012
Objectives. We conducted a review of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy in developing countries and highlighted their constraints as well as interventions required to strengthen the health services.Methods. Literature from Pubmed (MEDLINE), AJOL, Google Scholar, and Cochrane database was reviewed.Results. Evidence-based preventive treatment options for iron deficiency anaemia in pregnancy include prophylaxis iron supplements and food fortification with iron. Evidence abounds on their effectiveness in reducing the prevalence of iron deficiency anaemia in pregnancy. However, these prospects are threatened by side effects of iron supplements, low utilization of maternal health service in developing countries, partial implementation of preventive treatments, and weak infrastructure and political commitment to implement mass fortification of local staple foods by national governments.Conclusion. Sustainability of effectiveness of preventive tre...
Iron Deficiency among Pregnant Women Attending Antenatal Clinic at the KNUST Hospital, Kumasi, Ghana
British Journal of Medicine and Medical Research, 2015
Background: Pregnant women constitute a high risk group for iron deficiency due to increased iron requirements for foetal and maternal tissues growth. This study sought to find out the prevalence of iron deficiency among Ghanaian pregnant women obtaining antenatal care at the University hospital, Kumasi, Ghana. Methods: The study was conducted between January and May, 2013. A total of 180 women, 150 at various stages of pregnancy and 30 non-pregnant women as control group were recruited for the study. Information on socio-demographic characteristics was obtained from the subjects by means of face-to-face interviews. Using venous blood samples, iron status of subjects was Obirikorang et al.; BJMMR, 6(8): 823-832, 2015; Article no.BJMMR.2015.256 824 assessed by the determination of haemoglobin, haematocrit, mean cell volume, red cell distribution width, serum ferritin, serum iron, serum transferrin, total iron binding capacity, unoccupied iron binding capacity and percentage saturation of transferrin. Intestinal helminthic infestation was determined by stool examination. Results: Decreasing levels of haemoglobin, serum iron, transferrin, Total iron binding capacity and increasing levels of Mean cell volume and RDW-SD were observed as pregnancy advanced. None of the subjects had helminthic infestation. Anaemia, iron deficiency (ID) and iron deficiency anaemia (IDA) were present in 44.0%, 21.5% and 10.4% of the pregnant women, respectively. These prevalence rates increased as pregnancy advanced to term (15.2%, 51.2%, 56.0% for anaemia; 13.8%, 22.9%, 26.1% for ID and 0%, 12.0%, 17.4% for IDA, respectively for the 1st, 2nd and 3rd trimesters). Conclusions: In spite of iron supplementation in pregnancy, a high percentage of the pregnant women are iron deficient and/or anaemic and this remains a public health problem.
Iron Deficiency Anemia in Pregnancy: Intravenous Versus Oral Route
The Journal of Obstetrics and Gynecology of India, 2012
Objectives The aim of this study was to compare the efficacy and safety of intravenous iron with oral iron in the treatment of iron deficiency anemia of pregnancy. Methods A randomized experimental study was conducted at K. J. Somaiya Hospital involving 200 pregnant women with iron deficiency anemia. In the intravenous group iron dose was calculated from: Total iron dose required (mg) = 2.4 9 weight kg 9 target hemoglobinactual hemoglobin) g/dl ? 500. Target hemoglobin was set at 12 g/dl. In the oral group patients received 200 mg oral ferrous ascorbate daily. Hemoglobin and serum ferritin were reviewed at 2, 4, and 6 weeks. Paired and independent t test was applied. Results The change in hemoglobin and ferritin levels from baseline was significantly higher in the intravenous group than the oral group at each measurement (P = 0.000). Conclusion Intravenous iron elevates hemoglobin and restores iron stores faster than oral iron, with no severe adverse reactions. Keywords Iron deficiency anemia Á Hemoglobin Á Serum ferritin Á Iron sucrose Á Oral ferrous ascorbate Shafi D.
Geburtshilfe und Frauenheilkunde
This overview analyzes the data on the controversial therapy of iron substitution during pregnancy, the diagnosis of iron deficiency anemia and the indication-related therapy, and is the first recommendation issued by the OEGGG on the appropriate therapy. The effects of anemia during pregnancy on postnatal outcomes have been intensively investigated with heterogeneous results. A final scientific conclusion with regards to the “optimal” maternal hemoglobin level is limited by the heterogeneous results of various studies, many of which were conducted in emerging nations (with different dietary habits and structural differences in the respective healthcare systems). The current literature even suggests that there may be a connection between both decreased and increased maternal serum hemoglobin concentrations and unfavorable short-term and long-term neonatal outcomes. In Austria, 67 percent of pregnant women take pharmacological supplements or use a variety of dietary supplements. Clin...
Prophylactic Iron Supplementation in Pregnancy: A Controversial Issue
Biochemistry insights, 2017
In our world today, iron deficiency (ID) is the most frequent nutritional deficiency and it is being considered as an epidemic public health crisis. Women of reproductive age and infants are at particular risk of ID, especially in underdeveloped countries. During pregnancy, iron deficiency anemia is a specific risk factor associated with negative maternal and perinatal outcomes. Many countries have iron supplementation (IS) programs-as recommended by the World Health Organization-during pregnancy; however, IS clinical benefits and risks are unclear. This review aims to discuss the threats and benefits of routine IS on maternal and infant outcomes.
Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation
Acta Obstetricia et Gynecologica Scandinavica, 1999
Background. Iron supplementation in pregnancy is a controversial issue. The aim of this review was to summarize the results of relevant papers on this subject. Methods. Placebo-controlled studies on iron treatment in pregnancy were identified from the Cochrane database. Results. Among fertile women, 20% have iron reserves of ±500 mg, which is the required minimum during pregnancy; 40% have iron stores of 100-500 mg, and 40% have virtually no iron stores. The demand for absorbed iron increases from 0.8 mg/day in early pregnancy to 7.5 mg/day in late pregnancy. Dietary iron intake in fertile women is median 9 mg/day, i.e. the majority of women have an intake below the estimated allowance of 12-18 mg/day. Iron absorption increases in pregnancy, but not enough to prevent iron deficiency anemia in 20% of women not taking supplementary iron. Iron-treated pregnant women have greater iron reserves, higher hemoglobin levels, and a lower prevalence of iron deficiency anemia than placebo-treated women both in pregnancy as well as postpartum. Furthermore, children born to iron-treated mothers have higher serum ferritin levels than those born to placebo-treated mothers. An iron supplement of 65 mg/day from 20 weeks of gestation is adequate to prevent iron deficiency anemia. Conclusions. In order to avoid iron deficiency in pregnancy, prophylactic iron supplement should be considered. Iron supplements may be administered on a general or selective basis. The selective approach implies screening with serum ferritin in early pregnancy, in order to identify women who can manage without prophylactic iron.
Iron Use in Pregnant Women and Prevalence of Prenatal Anemia
Turkish Journal of Family Medicine & Primary Care, 2014
Iron Use in Pregnant Women and Prevalence of Prenatal Anemia Iron deficiency anemia is the most common medical disorder of pregnant women. Especially severe anemia is an important factor increasing mortality. Therefore, promoting use of appropriate doses and duration of iron has great importance in preventing iron deficiency in terms of health of the mother and baby.This crosssectional study was designed to determine the number of women who consumed iron and the duration of intake during pregnancy; to examine the effect of age and the number of births on prenatal iron intake, and to determine prenatal anemia prevalence in a tertiary hospital which provides service for an area of medium and low-income families in Istanbul. 4,041 pregnant women who got admitted to Dr. Lutfi Kırdar Kartal Training and Research Hospital for labor were enrolled in the study during the period between 2001-2004. Age, number of pregnancies and duration of iron intake were recorded. Pregnant women with a less than 11 g /dl hemoglobin concentration were considered anemic. Iron intake rate in pregnant women was 56% and the prevalence of anemia was 46%. Mean hemoglobin concentration was 11.1±1.5 g/dl, mean age was 26.5±5.4 years, and mean duration of iron intake was 3.0±2.2 months. Anemia was found in 36.4% of the iron supplemented group, and 58.1% of the unsupplemented group. Hemoglobin (Hb), Hematocrit (Hct), Mean Corpuscular Volume (MCV) values were statistically different between two groups. It was determined that maternal age does not influence the use of iron; but an increase in parity caused a decrease in iron use and an increase in anemia prevalence. It was observed that there was an increase in the use of iron from 2001 to 2004. In conclusion, it was determined that approximately half the pregnant women admitted to the hospital for delivery received iron during their pregnancy; anemia is less common among iron receivers; iron intake is mainly affected by parity not by maternal age and the effect of iron on blood parameters is positive.