Iron deficiency anaemia in pregnancy: diagnosis, prevention and treatment (original) (raw)
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Ceylon Medical Journal, 2017
Introduction In Sri Lanka the current prevalence of anaemia during pregnancy is estimated to be less than 20%. Objectives To determine the rate of anaemia defined as hemoglobin concentration < 11 g/dl, and the rate of iron deficiency using the best cut off level of serum ferritin, in women presenting for antenatal care. Methods Three hundred and fifty consecutive pregnant women with gestations between 12 to 20 weeks, presenting to the Academic Obstetric Unit at the Teaching Hospital Mahamodera, Galle, Sri Lanka from 10.11.2014 to 13.01.2015 had their heamoglobin and hematocrit measured by flowcytometry and hydro-dynamic focusing methods using a Sysmex-XS-500i System and serum ferritin measured by electro-chemiluminescence method using a Cobas-e411 Analyzer. The rate of anaemia was calculated. The best cut off level of serum ferritin for the detection of anaemia was obtained using a Receiver Operator Characteristics (ROC) curve, and using this cut off, the rate of iron deficiency was calculated. Results The rate of anaemia was 16.6%. The best cut off level of serum ferritin for the detection of anaemia was < 30 µg/L (the area under the ROC curve was 0.77; 95% CI-0.72 to0.81), with a sensitivity of 78.3% (95% CI 65.8-87.9) and a specificity of 74% (95% CI 68.6-79.0) in detecting anaemia. Using this cut off, 36.9% of the pregnant women had iron deficiency. Conclusion Rates of anaemia (16.6%) and iron deficiency (36.9%) in pregnancy are at levels of mild to moderate public health significance respectively.
Knowledge About Iron Deficiency Anemia Among Pregnant Mothers in the First Trimester in Sri Lanka
The Hemoglobin (Hb) concentration below 11g/dl during pregnancy leads to Iron Deficiency Anemia (IDA). As increased maternal iron needs and demands from the growing fetus and placenta, pregnant mothers are at risk of having IDA which causes many complications during pregnancy and infancy. The purpose of this study is to explore the knowledge about IDA of pregnant mothers in the first trimester. A self-administered questionnaire was distributed in this quantitative descriptive study among 180 pregnant mothers in the first trimester using convenience sampling method, at the antenatal clinics, District General Hospital, Matara. Ethical approval was obtained from the Ethics Review Committee of the National Hospital of Sri Lanka. Data was analyzed by descriptive statistics using SPSS 22 version. Significantly 80% of the respondents have identified low Hb level (<11g/dl) as IDA. Most frequently mentioned causative factors of IDA were inadequate food intake (90%), and imbalance diet (80%) while malaria (10%) and stress (1%) mentioned by only a few pregnant mothers. Sixty percent of pregnant mothers identified that milk and milk products as inhibitors in iron absorption. Two third of pregnant mothers have identified tiredness and pale color of the body as dominant signs of IDA. Most known side effects were low birth weight (32%), premature delivery (30.5%) and postpartum anemia (30%). The study showed that considerable knowledge of pregnant mothers with respect to meaning, causes, signs and, iron-rich food sources of IDA while showing comparatively poor knowledge of the effects of IDA in pregnancy. Therefore, it is recommended to have more awareness programs to further educate on the effects of IDA among pregnant mothers in the first trimester in Sri Lanka.
National journal of community medicine, 2016
Introduction: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnant women. The study was conducted to study the prevalence of iron deficiency anaemia in the antenatal women of urban and rural areas and to identify some risk factors of iron deficiency anaemia and its association with IDA. Material & Methods: A cross sectional study was conducted in urban and rural health training centres of a medical college in Pune. The antenatal women were the study subjects. A total of 180 ANC cases were recruited and studies from both the field practice area attending the outpatient clinics. Sociodemographic profile was recorded & anaemia was assessed using recently done haemoglobin reports in the present pregnancy. The study duration was 6 months. GCP and ethical guidelines were followed as advised for human studies. Results: The prevalence of IDA in the study population was 66%. (rural=81%, urban=51%). IDA prevalence was 54% in primigravida and the prevalence increased as gravid status increased. Iron deficiency anaemia was seen statistically significantly associated with residence, illiteracy, type of diet, and gravida status of the pregnant women. Conclusion: IDA has strong relation with residence (urban/rural), literacy level, social status, monthly income and dietary habits.
Anaemia and iron deficiency during pregnancy in rural Bangladesh
Public Health Nutrition, 2004
Objective: To study the prevalence of anaemia and its association with measures of iron deficiency (ID) among a group of pregnant women. Design: Cross-sectional survey. Setting: Pregnant women identified through house-to-house visits and participating in community-based antenatal care activities in a rural location of Mymensingh, Bangladesh. Subjects: The estimates are based on 214 reportedly healthy pregnant women in their second trimester. Information on socio-economic status and reproductive history were obtained through home visits and venous blood samples were collected at antenatal care centres. Haemoglobin concentration (Hb) was measured by HemoCue, serum ferritin (sFt) by radioimmunoassay and serum transferrin receptor (sTfR) by enzyme-linked immunosorbent assay methods. ID was defined as presence of either low sFt (, 12 mg l 21 ) or high sTfR (. 8.5 mg l 21 ). Results: The prevalence of anaemia (Hb , 110 g l 21 ) was 50%, but severe anaemia (Hb , 70 g l 21 ) was absent. Low sFt was observed in 42%, high sTfR in 25%, either low sFt or high TfR in 54% and both low sFt and high TfR in 13% of the pregnant women. Two out of three anaemic women had an indication of ID, which was present in 80% of women with moderate (Hb 70 -99 g l 21 ) and 50% with mild (Hb 100-109 g l 21 ) anaemia. Four out of 10 non-anaemic women (Hb $ 110 g l 21 ) also had ID, but the prevalence was significantly lower than that observed in anaemic women (P ¼ 0.001). Conclusions: Despite the high prevalence of anaemia, severe cases were absent. The prevalence of ID increased at lower Hb. However, an increased prevalence was also found among women in the highest category of Hb.
National journal of community medicine, 2016
Result: About 75% of pregnant women were anaemic (Hemoglobin level < 11mg/ml) with about 14.5% being severely anaemic. Moderate anaemia was most common. A significant difference (p<0.001) was observed between anaemic and non-anaemic pregnant women with respect to educational status, socioeconomic status & parity of women. Proportion of anaemic women was higher in age groups <20 years, joint families, women with vegetarian diet. History of menstrual irregularities and prolonged cycles (length of flow >6 days) was reported in significantly higher proportion of anaemic women as compared to non-anaemic women.
2016
Nutritional anaemia in pregnant women continues to be one of the major public health challenges. Anaemia contributes to one fifth of the maternal deaths and large number of preterm deliveries and low birth weight babies in India. The objective is to study the prevalence, various epidemiological factors, clinical presentation in pregnancies complicated with iron deficiency anaemia in a tertiary care teaching hospital in central India. A Prospective observational study was conducted for a period of two years from September 2012 to August 2014. A total of 1644 pregnant women were investigated for evidence of iron deficiency anaemia by performing haemoglobin estimation and peripheral blood smear examination. Information on epidemiological factors was collected through interview and information on clinical profile was collected in predesigned and pretested structured proforma. Statistical analysis was done by finding out percentages, proportions, Mean and Standard deviation (SD), Chi squ...
Iron Deficiency Anemia in Pregnant Mothers as a Cause of Poor Maternal Health in Rural India
2015
Worldwide Iron deficiency anemia (IDA) affects approximately 25% population and in India it affects 80% of pregnant mothers. A prospective observational study was conducted to know relationship between IDA in pregnancy and its effects on maternal health during pregnancy, labour and postpartum. Pregnant mothers with singleton pregnancy with gestational age > 36 weeks were selected and were divided into two groups. Women with Hb >10 gm% classified in nonanemic group and those with Hb<10 were classified in anemic group. It was further confirmed by serum ferritin levels. Both groups were followed till delivery and effects of anemia on maternal health were studied. Number of vaginal deliveries, instrumental deliveries and cesarean section (LSCS) were similar in both groups but more anemic mothers required induction of labour. More anemic mothers had PPH 5(6.09%) as compared to 2(2.56%) in non anemic group. Only anemic mothers after PPH required blood transfusion 3(3.65%). 18 (21...
2020
Anemia is a very common problem in obstetrics and perinatal care. Iron deficiency and related anemia during pregnancy are highly prevalent both in developed and underdeveloped counties and even within a country in different geographical regions with different etiologies such as standards of living. To find the differences in the prevalence and causes of IDA as well as contribution of different etiological factors in promoting IDA in pregnant women. A sample size of 280 was calculated and the study was carried to analyze the frequency of IDA at Khyber Teaching Hospital and the impact percentage of different etiological factors in development of IDA in pregnant women of age less than 40 years and without any comorbidities. Following causes were identified; low socioeconomic state, food quality, education level, number of previous pregnancies and stage (trimester) of pregnancy. Out of 280 pregnant women 185 were found normal Hb levels, 84 having mild anemia ,11 were found to have mild anemia. 95 women had microcytic anemia. Additionally, 173 out of total anemia pts were found to have monthly income of less than 20,000 being the most predictable factor. Third trimester was mostly credited for IDA in pregnancy. Similarly triplet, followed by twin and then singleton pregnancy was responsible for IDA. Anemia has serious longterm effects on the health of mother as well as fetus besides obstetrics complications.
Background: Anaemia is the commonest medical disorder associated with pregnancy. It contributes to one fifth of the maternal deaths and large number of preterm deliveries and low birth weight babies in India. Objectives: To study maternal and perinatal outcome in pregnancies complicated by anaemia. Setting-Tertiary care teaching hospital in central India.. A total of 1644 pregnant women were screened for evidence of iron deficiency anaemia. Maternal and perinatal outcome of women with moderate to severe anaemia was analyzed. Statistical analysis: was done by finding out percentages, proportions, Mean and Standard deviation (SD), Chi square test. Results: Prevalence of anaemia among pregnant women was 49.40%. Mild, moderate and severe degree of anaemia was seen in 19.46%, 25.06% and 04.86% cases respectively. The incidence of preterm delivery and low birth weight babies was two times more than women with normal haemoglobin values. The perinatal mortality and morbidity among babies born to anaemic women was high. There was no maternal mortality in the present study. Conclusion: The study revealed that anaemic women are more prone for life threatening obstetric and medical complications, preterm labour, low birth weight babies and perinatal morbidity and mortality., Strengthening the peripheral health care delivery system, regular antenatal care, high risk pregnancy identification, oral and parenteral iron therapy and institutional deliveries can reduce the incidence of anaemia and the resultant morbidity and mortality.
BMC Hematology , 2018
Background: Early detection and treatment of iron deficiency during pregnancy is crucial for optimum pregnancy outcomes. Anaemia is a late indictor of iron deficiency measured as Hb < 11 g/dL, and is widely used as a proxy for iron deficiency. We aimed to evaluate the role of red cell indices as a screening tool for early detection of iron deficiency among pregnant women in an urban area of Sri Lanka. Method: A cross-sectional study was conducted among 110 apparently healthy pregnant women ≤12 weeks of gestation attending antenatal clinics in Colombo, Sri Lanka. Women already on nutritional supplements were excluded. Full blood count, serum ferritin (SF) and high sensitive C-reactive protein (hs-CRP) assessments were performed. The women with evidence of inflammation as indicated by hs-CRP > 10 mg/L were excluded (N = 20) from data analysis. Anaemia (Hb < 11 g/dL) and iron deficiency (SF < 30 μg/L) were defined according to WHO guidelines. Receiver operating characteristics curves were used to derive red blood cell indices that showed the optimal cutoffs in detecting early iron deficiency.