A PROSPECTIVE STUDY ON RISK FACTORS OF IRON DEFICIENCY ANEMIA IN PREGNANT WOMEN AND THEIR MANAGEMENT
Objective: Iron deficiency anemia during pregnancy leads to preterm birth, low birth weight and increases the incidence of postpartum hemorrhage (PPH) and the reason for the incidence of PPH is higher in India compared with the rest of the world. In this study, our main goal was to find out the risk factors and complications of iron deficiency anemia and their management in pregnant women.
Methods: It is a prospective study done at Obstetrics and Gynecology Department in Government District Headquarters Hospital, Tiruppur. All subjects were analyzed in full detail and hemoglobin estimation was also done to the patients.
Results: Study found that 52% shows moderate anemia followed by 30% mild and 18% severe, respectively. Risk factors are found in 55% cases. Study found an association between risk factors and severity of anemia.
Conclusion: Iron deficiency anemia continues to be the commonest etiology of anemia in pregnancy. The prevalence of iron deficiency in a pregnant woman is amongst the highest in the world. Untreated iron deficiency has significant adverse feto-maternal consequences. Iron supplementation and antenatal care are the basic requirements to prevent anemia.
2. Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. Gut 2011;60:1309-16.
3. WHO. Worldwide prevalence of anaemia 1993-2005. WHO Global Database on Anaemia, Centers for Disease, Control and Prevention, Atlanta; 2008.
4. Akodu OS, Disu EA, Njokanma OF, Kehinde OA. Iron deficiency anaemia among apparently healthy pre-school children in Lagos, Nigeria. Afr Health Sci 2016;16:61-8.
5. Baker SJ, DeMaeyer EM. Nutritional anemia: its understanding and control with special reference to the work of the World Health Organization. Am J Clin Nutr 1979;32:368-417.
6. WHO. Requirements of Vitamin A, Iron, Folate and Vitamin B12: Report of a Joint FAO/WHO expert consultation. FAO/WHO, Rome; 1988. p. 107.
7. Cook JD, Skikne BS, Baynes RD. Iron deficiency: the global perspective. Adv Exp Med Biol 1994;356:219-28.
8. Patel KV. Epidemiology of anemia in older adults. Semin Hematol 2008;45:210-7.
9. Shander A, Javidroozi M, Ashton ME. Drug-induced anemia and other red cell disorders: a guide in the age of polypharmacy. Curr Clin Pharmacol 2011;6:295-303.
10. Stevens GA, Finucane MM, De-Regil LM. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011:a systematic analysis of population-representative data. Lancet Glob Health 2013;1:e16–e25.
11. Daru J, Cooper NA, Khan KS. Systematic review of randomized trials of the effect of iron supplementation on iron stores and oxygen-carrying capacity in pregnancy. Acta Obstet Gynecol Scand 2016;95:270–9.
12. Malhotra P, Kumari S, Kumar R. Prevalence of anemia in adult rural population of North India. J Assoc Phys India 2004;52:18–20.
13. Ministry of Health and Family Welfare (2015–2016) Govt. of India, National Family Health Survey (NFHS-4), State Fact Sheet. Mumbai: International Institute for Population Sciences; 2011.
14. Haddad L, Hawkes C, Udomkesmalee E. Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington: International Food Policy Research Institute; 2016.
15. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/anemia-during-pregnancy/art-20114455 [Last accessed on 05 Jun 2020]
16. LH Allen. Anemia and iron deficiency: effects on pregnancy out come. Am J Clin Nutr 2000;71:1280s–4s.
17. MA Mbule, YB Byaruhanga, M Kabahenda, A Lubowa. Determinants of anaemia among pregnant women in rural Uganda. Rural Remote Health 2013;13:2259.
18. RE Black, CG Victora, SP Walkeretal. Maternalandchild undernutrition and overweight in low-income and middle income countries. Lancet 2013;382:427–51.
19. McDonagh M, Cantor A, Bougatsos C. U. S. preventive services task force evidence syntheses, formerly systematic evidence reviews. routine iron supplementation and screening for iron de?ciency anemia in pregnant women: a systematic review to update the US preventive services task force recommendation. Agency for Healthcare Research and Quality (US), Rockville; 2015.
20. Sharma JB, Shankar M. Anaemia in pregnancy. J Int Med Sci Acad 2010;23:253–60.
21. Hershko C, Camaschella C. How I treat unexplained refractory iron de?ciency anemia. Blood 2014;123:326–33.
22. Blaud P. Sur les maladies chlorotiques, et sur un mode de traitement spkcifique dans ces affections. [Concerning the chloroses and a specific method of treating these conditions.] Revue m6dicale frangaise et Ptrangande; 1832. p. 45341-367.
23. Achebe MM, Gafter Gvili A. How I treat anemia in pregnancy: iron, cobalamin, and folate. Blood 2017;129:940–9.
24. Silverstein SB, Rodgers GM. Parenteral iron therapy options. Am J Hematol 2004;76:74–8.
25. Camaschella C. Iron de?ciency: new insights into diagnosis and treatment. Hematol Am Soc Hematol Educ Program 2015;2015:8–13.
26. Aronoff GR. Safety of intravenous iron in clinical practice: implications for anemia management protocols. J Am Soc Nephrol JASN 2004;15(Suppl 2):S99–S106.
27. Chertow GM, Mason PD, Vaage Nilsen O. Update on adverse drug events associated with parenteral iron. Nephrol Dial Transplant 2006;21:378–82.
28. Achebe MM, Gafter Gvili A. How I treat anemia in pregnancy: iron, cobalamin, and folate. Blood 2017;129:940–9.
29. Atkinson LS, Baxley EG. Postpartum fatigue. Am Fam Physician 1994;50:113–8.
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