scholarly journals The role of haematological indices in predicting early iron deficiency among pregnant women in an urban area of Sri Lanka

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Miruna Sudharshani Kalaimani Rabindrakumar ◽  
V. Pujitha Wickramasinghe ◽  
Lallindra Gooneratne ◽  
Carukshi Arambepola ◽  
Hemantha Senanayake ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Urban Area ◽  
Haematological Indices

scholarly journals Can Homocysteine Be Used to Identify Vitamin B12 or Folate Deficiencies During Pregnancy in Low Resource Settings?

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 707-707
Author(s):  
Gayani Amarasinghe ◽  
Imasha Jayasinghe ◽  
Ayesh Hettiarachchi ◽  
Iresha Koralegedara ◽  
Chamila Kappagoda ◽  
...  
Keyword(s):  
Higher Education ◽  
Sri Lanka ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Folate Deficiency ◽  
Skewed Distribution ◽  
Folate Level ◽  
Predictive Values ◽  
B12 Deficiency

Abstract Objectives With universal iron supplementation during pregnancy, role of other nutritional causes of anemia such as Vitamin B12 and folate deficiencies are increasingly coming to light. Testing vitamin B12 and folate levels is costly and inconvenient in low and middle income settings. Serum Homocysteine level is proposed as a cheaper and more feasible alternative to indicate vitamin B12/folate deficiency. We evaluated the role of Homocysteine as a predictor of B12/folate level among anaemic pregnant women in Sri Lanka. Methods We measured fasting serum total Homocysteine in a randomly selected sub sample of anaemic pregnant women (hemoglobin less than 11g/dl) from the Rajarata Pregnancy Cohort (RaPCo), Anuradhapura, Sri Lanka. They were referred to a special hospital clinic for B12 and folate assessment within 2 weeks of the initial assessment. Homocysteine levels > 6.9 µmol/L in first and > 9.6 µmol/L in second trimesters were defined as Hyperhomocysteinaemia. B12 levels below 203 pg/ml and folate levels below 4ng/ml were defined as deficiency. Sensitivity and specificity were calculated and Spearmen correlation was performed. Results Twenty two anaemic pregnant women in 6 to 18 weeks of gestation were included in the assessment. Median haemoglobin level of the selected sample was 10.2 g/dl (Range 8.2–10.9). Homocysteine (Range 4.43–17, median 8 µmol/L), B12 (Range 149.6–721, median 299.8 pg/ml) and folate (Range 5.5–40, median 16.6 ng/ml) showed skewed distribution. Hyperhomocysteinaemia was observed in 12/22 (50%) pregnant women and B12 deficiency was observed in five participants (22.7% CI 10.1–43.4). None had folate deficiency. Hyperhomocysteinaemia was present in 2/5 (40%) B12 deficient and 10/17 (58.8%) B12 normal participants. Sensitivity of Homocysteine to indicate B12 deficiency was 40% (95% CI 11.8 to 76.9) and specificity was 41.2% (21.6, 67). Predictive values of positive and negative tests were 16.7% and 70% respectively. Homocysteine levels did not correlate with B12 level (Spearmen r = -0.26, p = 0.24) or folate level (spearmen r = 0.04, p = 0.86). Conclusions Elevated Homocysteine levels cannot be used as a reliable indicator of B12 or Folate deficiency in anaemic pregnant women. Funding Sources Accelerating Higher Education Expansion and Development (AHEAD) Operation of the Ministry of Higher Education, Sri Lanka.

scholarly journals The role of hepcidin in the main iron-deficiency syndromes in pregnancy

2016 ◽  
Vol 24 (4) ◽  
pp. 96-103
Author(s):  
M Ayari ◽  
V G Demikhov ◽  
I M Mirov ◽  
E N Zinovyeva ◽  
O N Zhourina ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Therapeutic Option ◽  
Deficiency Anemia ◽  
Key Factor ◽  
Anemia During Pregnancy ◽  
Mixed Origin ◽  
Main Regulator ◽  
In Pregnancy

Currently, there is evidence that hepcidin is the main regulator of iron metabolism in human and pathogenesis key factor for anemia of inflammation. However, the role of hepcidin in multifactorial pathogenesis of anemia in pregnancy is not clear. We presented the results of the laboratory examinations of 78 pregnant women sera in hepcidin, ferritin, erythropoietin during pregnancy, and 116 sera of pregnant women with iron deficiency anemia (IDA) and anemia of mixed origin. The obtained data indicate a statistically significant decrease in the mean hepcidin concentration in pregnants versus non pregnant women. Mean hepcidin level in pregnant women with IDA was decreased, compared with anemia of mixed origin pregnants (p<0.0001). Evaluation of hepcidin concentrations may be useful laboratory test for differential diagnostic of anemia during pregnancy and for determination of optimal therapeutic option between oral iron, parenteral iron or using erythropoiesis -stimulating agents (ESAs) in combination with iron products.

scholarly journals The Role of Serum Transferrîn Receptor in the Diagnosis of Iron Deficiency of Pregnant Women

2005 ◽  
Vol 15 (3) ◽  
pp. 155-161
Author(s):  
Berna Atabay ◽  
Işın Yaprak ◽  
Abdurrahman Gül ◽  
Sadık Akşit ◽  
Feyza Umay ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Transferrin Receptor ◽  
Serum Transferrin ◽  
Serum Transferrin Receptor

scholarly journals The relationship of pregnant women knowledge About iron deficiency Anemia and the role of family In Compliance in consuming Fe tablets in health center

2019 ◽  
Vol 6 (1) ◽  
pp. 49
Author(s):  
Hary Yadi ◽  
Asmarita Jasda
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Health Center ◽  
Iron Deficiency Anemia ◽  
The Body ◽  
Deficiency Anemia ◽  
P Value ◽  
Family Role ◽  
Cross Sectional

<p>Pregnancy leads to increased energy metabolism, hence the need for energy and other nutrients increases during pregnancy. Increased energy and nutrients are needed for growth and development of the fetus, the increase in the amount of the uterus, changes in the composition and metabolism of the mother's body. If  levels of iron in the body of pregnant women is less, then there will be a condition called anemia. That's because iron is an essential microelement for the body. This substance is especially needed in hemopoiesis (blood formation), ie in the synthesis of hemoglobin. The purpose of this study was  to determine Knowledge of Pregnant Women About Iron Deficiency Anemia and Family Role With Compliance In Consuming Iron Tablet in health center . This study was a quantitative research, analytical, with cross sectional study subjects all mothers who have antenatal and get a tablet Fe in Tanjungpinang health center  based on data consist of 40 respondents. The result of this study was significat relationship between knowledge of pregnant women to iron deficiency anemia with Compliance Consuming Tablet iron  show the value of p 0814, the p-value is greater than the p value 0:05 was shows that no have correlation between knowledge of pregnant women about iron deficiency anemia with Compliance Consuming Iron Tablets. Family Role in monitoring drinking iron tablet  with Compliance Consuming Iron Tablets shows the value of p 0.00 is smaller than the value of α 0.05. This shows that there is a relationship between family role in monitoring drinking iron tablet with compliance consuming iron tablet. This study  indicated to increase Knowledge Level Of a Person On Iron Deficiency Anemia  Not Consume The Influence Behavior Of Iron Tablet  But Can Improve The Role Of Family In Compliance With Pregnant Women Eat Iron Tablet.</p>

Erythroid Growth Differentiation Factor 15 and Ferroportin Expression During Gestational Iron Deficiency Anemia

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5286-5286
Author(s):  
Rekha Athiyarath ◽  
Kalaiselvi Sakthivel ◽  
Vinod J Abraham ◽  
Daisy Singh ◽  
Alok Srivastava ◽  
...  
Keyword(s):  
Gene Expression ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Iron Homeostasis ◽  
Iron Absorption ◽  
Deficiency Anemia ◽  
Protein Levels ◽  
In Pregnancy

Abstract Abstract 5286 Iron homeostasis during pregnancy is modulated to meet the increased iron needs but how this is achieved is not very clear. Growth Differentiation Factor (GDF15) produced by the expanded erythroid compartment in β thalassemia has been shown to increase iron absorption by suppressing hepcidin. GDF15 is also highly expressed in the placenta and increasing levels of GDF15 are seen with advancing gestational age of pregnancy. But the role of GDF15 in iron homeostasis in pregnancy has not been elucidated till date. Ferroportin (FPN) is the only known protein involved in iron export and it is the target of hepcidin, the central regulator of iron homeostasis. In this study we analyzed the expression of GDF15 and FPN in pregnant women with iron deficiency anemia. Fourteen pregnant women with proven iron deficiency anemia (IDAP) [Hb<11g/dL and Ferritin <12ng/ul] and thirteen healthy subjects as controls (NC) were enrolled as part of an ongoing study. Serum GDF15 and hepcidin levels were measured by ELISA kits from R&D systems and Bachem, UK respectively. Reticulocytes were isolated and total RNA was purified using Trizol. GDF15 and FPN transcripts were quantified using Taqman Gene expression assays using GAPDH as an internal control. Gene expression values were calculated on the basis of the 2-ΔΔCt method. The mean age of the pregnant women was 22.5±2.5 years. The median ferritin in IDAP was 1.4 and ranged from 0.2 to 8.3 ng/ml. The hepcidin levels were very low [<2ng/ml] in IDAP. Serum GDF15 levels in IDAP was significantly higher as compared to controls [IDAP-3333.71±409 pg/ml vs. NC-309.7±127.0 pg/ml; p=0.000]. Reticulocyte GDF15 mRNA expression was significantly lower [IDAP-25.09 (1.28–239.8) vs. NC-910.4 (0.28–1962); p=0.004] and FPN expression was significantly higher in pregnancy [IDAP-209.8 (48.33–1201) vs. NC-77.96(17.21–281.3); p=0.001] than in the controls. GDF15 mRNA as well as serum GDF15 levels significantly correlated with FPN expression in IDAP [RNA r=0.895; p=0.000; Protein r=0.555, p=0.049] Eight patients were followed up after 8 weeks of supplementation and there was no significant change in the serum GDF15 concentration (3235±468.26pg/ml; p=1.000). However their serum ferritin and hepcidin levels were significantly higher [Ferritin-11.60 (9.80–21.30), p=0.0021; Hepcidin-17.86(0.29–38.50), p=0.015]. There was no significant correlation between GDF15 protein levels and hepcidin (r=0.429, p=0.354). Molecular mechanisms of iron homeostasis in pregnancy are poorly understood. IDAP had very low hepcidin levels which normalized after iron stores were replenished. Elevated GDF15 protein levels in IDAP inspite of low reticulocyte expression indicate that erythroid contribution is minimal and placenta is the main source of GDF15. The significant correlation between GDF15 (mRNA and protein) with FPN expression and absence of correlation with hepcidin levels indicate a possible role for GDF15 in iron homeostasis in pregnancy. These findings has to be validated and the role of GDF15 in modulating FPN and there by iron absorption has to be further elucidated. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Role of cytokines in pregnant women with chronic iron deficiency anemia in preeclampsia pathogenesis

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Dzhabbarova Yu K ◽  
Ismoilova Sh T ◽  
Musakhodzhayeva DA
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Local Level ◽  
Immunosuppressive Drug ◽  
Deficiency Anemia ◽  
Mild Anemia ◽  
Decidual Tissue ◽  
Moderate Anemia

The frequency of development of hypertensive states in IDA reaches 32-45%. The pathogenesis of the combined complications of pregnancy with anemia and preeclampsia, including immunological aspects has been little studied. Purpose: to clarify the role of violations general and local cytokine status in pregnant women with anemia in the genesis of preeclampsia and justify the need to include immuno suppressants for the prevention and treatment of preeclampsia. Materials and methods: In 96 pregnant women with iron deficiency anemia (IDA) and preeclampsia in the third trimester of gestation the cytokine status of IL-1β, IL-6, IL-8, TNFα and lactoferrin in the serum of peripheral blood and in extracts of the placenta decidual tissue was examined by ELISA. Pregnant women were divided into 4 groups: 24-with mild anemia, 18-with moderate anemia, 26-with preeclampsia and with mild anemia and 28 pregnant women with preeclampsia and with moderate anemia. Results: It has been established that preeclampsia on the background of IDA is accompanied by a significant increase in the level of pro-inflammatory cytokines (p<0,05) and the acute phase protein lactoferrin (p<0,05) on the systemic and to a greater extent on the local level in the development of preeclampsia on the background of anemia of moderate severity (p<0,05). Discussion: The data obtained confirm the involvement of the immune system in the pathogenesis of preeclampsia, one of the trigger mechanisms of which is the immune imbalance in iron deficiency anemia. A pathogenetic rationale for the use of immunosuppressive therapy for combined pathology is given. Conclusion: The use of placental hormone - progesterone as an immunosuppressive drug in terms of substantiating new immunotherapy strategies for the prevention of preeclampsia is a topical trend in obstetric practice.

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