scholarly journals Are Pregnant Women Who Are Living with Overweight or Obesity at Greater Risk of Developing Iron Deficiency/Anaemia?

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1572
Author(s):  
Anna A. Wawer ◽  
Nicolette A. Hodyl ◽  
Susan Fairweather-Tait ◽  
Bernd Froessler

Low-grade inflammation is often present in people living with obesity. Inflammation can impact iron uptake and metabolism through elevation of hepcidin levels. Obesity is a major public health issue globally, with pregnant women often affected by the condition. Maternal obesity is associated with increased pregnancy risks including iron deficiency (ID) and iron-deficiency anaemia (IDA)—conditions already highly prevalent in pregnant women and their newborns. This comprehensive review assesses whether the inflammatory state induced by obesity could contribute to an increased incidence of ID/IDA in pregnant women and their children. We discuss the challenges in accurate measurement of iron status in the presence of inflammation, and available iron repletion strategies and their effectiveness in pregnant women living with obesity. We suggest that pre-pregnancy obesity and overweight/obese pregnancies carry a greater risk of ID/IDA for the mother during pregnancy and postpartum period, as well as for the baby. We propose iron status and weight gain during pregnancy should be monitored more closely in women who are living with overweight or obesity.

2007 ◽  
Vol 10 (11) ◽  
pp. 1266-1273 ◽  
Author(s):  
Min Tao ◽  
David L Pelletier ◽  
Dennis D Miller

AbstractObjectiveTo quantify the potential effect of iron defortification in the USA on iron-deficiency anaemia (IDA).MethodsMonte Carlo models were built to simulate iron nutrition in the US population. A hypothetical cohort of 15 000 persons from the general population was used in 15-year simulations to compare the prevalence of IDA with and without fortification.ResultsWith iron fortification, the prevalence of IDA was 2.4% for children aged 3–5 years, 5.4% for women aged 20–49 years, and 0.14% for men aged 20–49 years. The corresponding IDA estimates under iron defortification were 4.5%, 8.2% and 0.46%, respectively. Defortification had little effect on the distribution of iron indicators at or above the 50th percentile within each of these three groups and little effect on the distributions of iron indicators among adult men.ConclusionIron defortification is likely to increase IDA among children and women of reproductive age, but is not likely to have meaningful effects on the iron status of men or the majority of women and children.


BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021793 ◽  
Author(s):  
Kathryn Bunch ◽  
Nia Roberts ◽  
Marian Knight ◽  
Manisha Nair

ObjectiveTo conduct a systematic review to investigate the safety of induction and/or augmentation of labour compared with spontaneous-onset normal labour among pregnant women with iron-deficiency anaemia.DesignSystematic review.SettingStudies from all countries, worldwide.PopulationPregnant women with iron-deficiency anaemia at labour and delivery.InterventionAny intervention related to induction and/or augmentation of labour.Outcome measuresPrimary: Postpartum haemorrhage (PPH), heart failure and maternal death. Secondary: Emergency caesarean section, hysterectomy, admission to intensive care unit.MethodWe searched 10 databases, including Medline and Embase, from database inception to 1 October 2018. We included all study designs except cross-sectional studies without a comparator group, case reports, case series, ecological studies, and expert opinion. The searches were conducted by a healthcare librarian and two authors independently screened and reviewed the studies. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approachto ascertain risk of bias and conducted a narrative synthesis.ResultsWe identified 3217 journal articles, 223 conference papers, 45 dissertations and 218 registered trials. Ten articles were included for full-text review and only one was found to fulfil the eligibility criteria. This was a retrospective cohort study from India, which showed that pregnant women with moderate and severe anaemia could have an increased risk of PPH if they underwent induction and/or augmentation of labour, but the evidence was weak (graded as ‘high risk of bias’).ConclusionThe best approach is to prevent anaemia, but a large number of women in low-to-middle-income countries present with severe anaemia during labour. In such women, appropriate peripartum management could prevent complications and death. Our review showed that at present we do not know if induction and augmentation of labour is safe in pregnant women with iron-deficiency anaemia and further research is required.PROSPERO registration numberCRD42015032421.


Author(s):  
Kohila Kalimuthu ◽  
Vanusha Avudaithangam

Background: Moderate anaemia seen in about 15-20% of pregnant women. Iron sucrose complex which is used intravenously for the correction of Iron deficiency anaemia. The drug has been able to raise the haemoglobin to satisfactory level when used in moderately anaemic iron deficient pregnant women. The objective of this study was to study the improvement of Hb% after treatment with intravenous Iron sucrose complex in moderately anaemic pregnant women belonging to 24-32 weeks of gestational age.Methods: 50 antenatal patients between gestational age 24-32 weeks with hemoglobin between 8-9.5g/dl were selected and included in this study. They were subjected to blood hemoglobin estimation, hematocrit and peripheral smear study. In each infusion, the maximum total dose administered was 200 mg iron sucrose in 100 ml of normal saline, slow IV infused over 30 minutes. Monitoring was done throughout the infusion to observe for any side effects.Results: Mean hemoglobin among the 50 patients before starting the therapy was 8.172g/dl and the mean hemoglobin at the end of one month of completing the therapy was 11.066g/dl. The rise in mean hemoglobin i.e. the difference in the mean hemoglobin before and after treatment was 2.894g/dl. The p value is 0.0001 which is statistically significant. The mean hematocrit of the 50 patients studied before starting the treatment was 26.772% with a standard deviation of 1.914. The mean hematocrit after completing the therapy was 33.872% with a standard deviation of 1.321. The difference in the mean hematocrit was 7.100% with a p value of 0.0001 which is statistically significant.Conclusions: Intravenous iron sucrose complex is well tolerated and highly efficacious in improving hemoglobin, hematocrit in the treatment of iron deficiency anaemia in antenatal women.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026497 ◽  
Author(s):  
Desmond Aroke ◽  
Benjamin Momo Kadia ◽  
Tsi Njim

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD have led to an increase in the number of women with SCD reaching the reproductive age. Iron deficiency anaemia remains the most common cause of anaemia in pregnancy, affecting 51%–63% of pregnancies in Africa. However, the unavailability of guidelines on supplementation of iron in this pregnant subpopulation often leaves clinicians in a fix. We propose to conduct the first systematic review and possibly a meta-analysis on the prevalence, associated factors and maternal/fetal outcomes of iron deficiency anaemia among pregnant women with SCD.Methods and analysisWe will search the following electronic databases for studies on the iron status of pregnant women with SCD: PubMed, MEDLINE, EMBASE, Google Scholar, African Journals Online, African Index Medicus, Popline and the Cochrane Library. After the selection of eligible studies from the search output, review of full text, data extraction and data synthesis will be performed. Studies obtained from the review shall be evaluated for quality, risk of bias and heterogeneity. Appropriate statistical methods shall be used to pool prevalence estimates for matching studies globally and in subpopulations. This protocol has been reported as per the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationThere is no requirement for ethical approval as the proposed study will use published data. The findings of this study will be published in a peer-reviewed journal and will be presented at conferences.Trial registration numberCRD42018109803.


1996 ◽  
Vol 17 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Werner Schultink

The prevalence of iron-deficiency anaemia remains especially high in developing countries, despite large-scale iron-supplementation programmes. The reasons for the lack of success of these programmes are discussed based on the results of original research conducted in Indonesia. Studies among pregnant women in rural Sulawesi and urban Jakarta demonstrated that besides insufficient coverage of the target group, women's compliance with tablet intake was a serious problem. Compliance may be improved when it is not necessary to take tablets on a daily basis. Studies among pre-school children and non-pregnant women proved the effectiveness of once-weekly and twice-weekly supplementation. These supplementation schedules should also be investigated in pregnant women.


2010 ◽  
Vol 282 (5) ◽  
pp. 577-580 ◽  
Author(s):  
Christian Breymann ◽  
Christoph Honegger ◽  
Wolfgang Holzgreve ◽  
Daniel Surbek

2015 ◽  
Vol 55 (4) ◽  
pp. 273-280 ◽  
Author(s):  
Carlos Baeza-Richer ◽  
Eduardo Arroyo-Pardo ◽  
Ruth Blanco-Rojo ◽  
Laura Toxqui ◽  
Angel Remacha ◽  
...  

Author(s):  
Mazharul Islam ◽  
Atiya Khan ◽  
Arish Mohammad Khan Sherwani

Introduction: Iron Deficiency Anaemia (IDA) is the most widespread micronutrient deficiency. Globally, nearly two billion people are affected by anaemia. This disease most often affects children, women of child-bearing age, and pregnant women. Nearly half of the pregnant women in the world are estimated to be anaemic. Its prevalence varies according to region and socio-economic conditions. The majority of those who are anaemic live in developing countries where the problem is exacerbated by limited access to inadequate resources and appropriate treatment. Aim: To find out the prevalence of IDA in the reproductive age group women and its associated factors. Materials and Methods: This hospital based, cross-sectional study was conducted among 400 females, of age group 15-49 years. After obtaining the written informed consent, eligible subjects were inquired about socio-demographic variables, socio-economic status, anthropometric measurements and risk factors. Required investigations were done. All the information was recorded on the semi-structured schedule form. Chi-square/Fisher’s-exact test was used to find the significance of study parameters on categorical scale between two or more groups. Results: Prevalence of IDA was found to be 42% (168/400). Prevalence of IDA was significant with habitat (p=0.0180), exercise (p=0.0004), amount of blood loss during menstruation (p<0.0001), duration of flow during menstruation, (p=0.0020), consumption of fish (p=0.0002), consumption of legumes (p=0.002), consumption of green leafy vegetable (p<0.0001). Conclusion: Results confirmed an increased prevalence of IDA in women of reproductive age group.


2021 ◽  
Author(s):  
◽  
Esther Calje

<p>Background: Globally there is no consensus on haemoglobin (Hb) parameters that define maternal anaemia. Therefore it is difficult to distinguish physiological anaemia of pregnancy from anaemia associated with pathology. Low maternal iron status is associated with adverse outcomes, although the evidence is difficult to interpret. Non-anaemic iron deficiency requires prevention and treatment, before end stage iron deficiency anaemia. Increases in serum ferritin (SF) secondary to inflammation, gives misleading results of iron stores if not tested with C-reactive protein (CRP). Given the complexities, how do Lead Maternity Carer (LMC) midwives in New Zealand manage anaemia and iron deficiency, without a clinical guideline?  Methods: In this descriptive study, quantitative data was retrospectively collected from September-December 2013, from LMC midwives (n=21) and women (n=189), in one New Zealand area. Main outcomes assessed were women’s iron status. Anaemia was defined as Hb <110g/L in the first trimester, <105g/L in subsequent trimesters, and <100g/L postnatally. Iron deficiency was defined as SF <20 μg/L, if CRP<5mg/L. A secondary analysis of iron status and body mass index (BMI) was undertaken.  Results: Of the 186 women who had Hb testing at booking, 46% did not have ferritin tested concurrently. Of the 385 ferritin tests undertaken, 86% were not tested with CRP. Despite midwives prescribing iron for 48.7%, and recommending iron for 16.9% of second trimester women, 47.1% had low iron status before birth. Only 22.8% had Hb testing postpartum, including 65.1% (of 38) with blood loss >500mls. Results of a secondary analysis showed a significant difference (p=.05) between third trimester ferritin levels in women with BMI ≥ 25 (Md SF 14 μg/L) and BMI < 25 (Md SF 18 μg/L).  Conclusions: Inconsistent testing of ferritin made it difficult to assess maternal iron status, especially without concurrent testing of CRP. Midwives may not understand and recognise the progression from iron sufficiency to end-stage iron deficiency anaemia. Even without further research this small study may indicate the need for improved education for midwives, and a clinical guideline. More complex studies on the prevalence in New Zealand, BMI and iron status, and maternal outcomes especially in the postpartum period, are warranted.</p>


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