Should We Revisit The Current Definition Of Anemia In Pregnancy?

2015 ◽  
Vol 02 (03) ◽  
Author(s):  
Elie Nkwabong Jean Marie Kasia
PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262436
Author(s):  
Amanda C. Zofkie ◽  
W. Holt Garner ◽  
Rachel C. Schell ◽  
Alexandra S. Ragsdale ◽  
Donald D. McIntire ◽  
...  

Background The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970’s to 1980’s. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed. Objective To define anemia in pregnancy in a United States population including a large county vs. private hospital population using uncomplicated patients. Materials and methods Inclusion criteria were healthy women with the first prenatal visit before 20 weeks. Exclusion criteria included preterm birth, preeclampsia, hypertension, diabetes, short interval pregnancy (<18 months), multiple gestation, abruption, and fetal demise. All women had iron fortification (Ferrous sulfate 325 mg daily) recommended. The presentation to care and pre-delivery hematocrits were obtained, and the percentiles determined. A total of 2000 patients were included, 1000 from the public county hospital and 1000 from the private hospital. Each cohort had 250 patients in each 2011, 2013, 2015, and 2018. The cohorts were compared for differences in the fifth percentile for each antepartum epoch. Student’s t-test and chi-squared statistical tests were used for analysis, p-value of ≤0.05 was considered significant. Results In the public and private populations, 777 and 785 women presented in the first trimester while 223 and 215 presented in the second. The women at the private hospital were more likely to be older, Caucasian race, nulliparous, and present earlier to care. The fifth percentile was compared between the women in the private and public hospitals and were clinically indistinguishable. When combining the cohorts, the fifth percentile for hemoglobin/hematocrit was 11 g/dL/32.8% in the first trimester, 10.3 g/dL/30.6% in the second trimester, and 10.0 g/dL/30.2% pre-delivery. Conclusions Fifth percentile determinations were made from a combined cohort of normal, uncomplicated pregnancies to define anemia in pregnancy. Comparison of two different cohorts confirms that the same definition for anemia is appropriate regardless of demographics or patient mix.


2005 ◽  
Vol 16 (2) ◽  
pp. 179-193
Author(s):  
SYAM DAS ◽  
MOHAMED K MUHASSEB ◽  
ANDREW D LOUGHNEY

Reference to people suffering bouts of severe headache with associated vomiting and visual aura may be found in texts that date back 5000 years but the first clear description of migraine as a distinct clinical entity was provided by Aretaeus of Cappadocia in the second century AD. Today, at least 80% of women experience headaches in adult life and in approximately a quarter of these cases the pain is recurrent and incapacitating. When each episode of headache lasts between 4 and 72 hours and is accompanied by nausea, vomiting, photophobia or phonophobia, the symptoms fulfil the International Headache Society's current definition of the syndrome called migraine, detailed in Table 1.


2010 ◽  
Vol 151 (33) ◽  
pp. 1347-1352 ◽  
Author(s):  
László Szerafin ◽  
János Jakó

Terhesség során az anaemia napjainkban is a leggyakoribb belgyógyászati elváltozások közé tartozik. Az anya és az utód számára egyaránt számos káros következménnyel járhat. Célkitűzés: A szerzők vizsgálták a Szabolcs-Szatmár-Bereg megyében 2008-ban szült nők vérképadatai (hemoglobin, átlagos vörösvértest-térfogat), szérum ferritinszintje és a terhességi kor, a várandósok életkora, az iskolázottság, az előző terhességek száma, a vetélések és koraszülések gyakorisága közötti összefüggéseket. Módszer: A szerzők a megyei, 2008-as védőnői nyilvántartások adatait elemezték. Eredmények: A vérszegénység előfordulásának aránya az I. trimeszterben 2,54%, a másodikban 0,71%, a harmadikban 1,87% volt, és szignifikánsan gyakoribbnak bizonyult a fiatalkorúak (10,30%), az alacsony iskolai végzettségűek (5,55%), a második vagy többedik terhességüket viselők (2,56%) között. A vetélések arányában nem volt különbség, de a koraszülés gyakoribb volt az anaemiás terhesek között (7,14%, vs. 5,46%). Minden vizsgált csoportban az anaemiások számánál jelentősen magasabb volt a normálisnál alacsonyabb átlagos vörösvértest-térfogattal jellemezhető vérképek aránya (6,06–22,88%), ami az esetek döntő többségében kórosan csökkent vasraktárra utal. (Ferritinszint-meghatározás csak az esetek 2,42%-ában történt, ezek között viszont 93,1%-ban kórosan alacsony értéket mértek!) Következtetések: A szerzők a többségükben (latens) vashiányos, jóval ritkábban vashiányos anaemiás várandós esetek kapcsán felhívják a figyelmet a fiatalkorú, alacsony iskolázottságú, illetve többedszer szülő terhesek gondozásának kiemelt fontosságára, valamint már a várandósság korai szakaszában a vérkép helyes értelmezésére, a megfelelő vaspótlás időben történő elkezdésére, sőt, a vasraktárak még fogamzás előtti feltöltésének szükségességére. Ehhez az irodalmi adatok alapján ajánlásokat fogalmaznak meg.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bruno F. Sunguya ◽  
Yue Ge ◽  
Linda Mlunde ◽  
Rose Mpembeni ◽  
Germana Leyna ◽  
...  

Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.


2021 ◽  
Vol 43 (S1) ◽  
pp. 65-70
Author(s):  
Archana M. Agarwal ◽  
Anton Rets

2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.


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