Associação entre o uso de sais de ferro durante a gestação e nascimento pré-termo, baixo peso ao nascer e muito baixo peso ao nascer

Abstract

The objective was to evaluate the association between prophylactic iron supplementation and prematurity and low birth weight. Pregnant women 20 years and older with 21 to 28 weeks of gestational age were enrolled consecutively in prenatal services in the Unified National Health System in six Brazilian State capitals between 1991 and 1995. Socio-demographic data and information on iron supplementation up until the 28th gestational week were obtained by means of an interview. Outcomes and other variables were collected from medical records. Anemia was present in 31.3% of the 3,865 women. Among anemic women (hemoglobin < 11.0g/dL), 29.8% were taking iron supplements, as compared to 16.7% among non-anemic women (hemoglobin > or = 11.0g/dL). After adjusting for potential confounders, iron was not associated with prematurity (OR = 0.88; 95%CI: 0.73-1.07), low birth weight (OR = 0.99; 95%CI: 0.75-1.31), or very low birth weight (OR = 0.58; 95%CI: 0.29-1.13). The results suggest that iron supplementation up to the 28th gestational week does not reduce the risk of prematurity, low birth weight, or very low birth weight.

Anaemia in pregnant women before and after the mandatory fortification of wheat and corn flours with iron

“…Pregnancy is an important phase of risk for the development of Fe-deficiency anaemia, which is a public health problem due to its associated increased risks of perinatal morbidity and mortality (1) . Approximately 40 % of all maternal deaths during the perinatal period are related to anaemia.…”

Nascimento prematuro e assistência pré-natal: revisão integrativa à luz de Canguilhem Premature birth and prenatal care: integrative review in the light of Canguilhem

“…Such educational deficit occurs due to the school abandonment, which leads to less knowledge regarding pre-natal care, causing insufficient number of consultations and delayed prenatal care. [16][17][18][19] The results found are indicative of the need to improve family planning programs, because the sooner young girls get pregnant, the greater the risk of quitting school and being exposed to unemployment, thereby perpetuating poverty. 16 In addition, pregnant adolescents can be considered at risk for preterm birth, both biological and social factors.…”

“…Preterm birth was associated with prenatal care especially relating the insufficient number of prenatal consultations, [18][19][20] the lack of prenatal attendance 17,20 or inadequate access and quality of the given care. [16][17][18][20][21] Studies conclude that these factors contribute to premature birth, low birth weight and subsequent child mortality.…”

“…In addition to the number of consultations, the early initiation of prenatal care in the first trimester and the care provided to the binomium mother/son are considered important for the reduction of prematurity. 19 In this way, even without statistically significant association between premature births and adequacy of prenatal care, low maternal education situations, low family income, previous history of premature children, previous cesarean birth procedures, overweight or underweight, maternal cigarette use, prior treatment to get pregnant and unstable unions have been identified as eligible for assistance through qualified attention to dyad mother/child. 17.20 -21 Given this, the encouragement of prenatal care and the disincentive to elective caesarean section could contribute to the reduction of preterm births.…”

Prevalência de anemia e deficiência de ferro: relação com índice de massa corporal em gestantes do Centro-Oeste do Brasil

“…4 No diagnóstico da anemia gestacional, a hemoglobina sérica < 11 g/dl tem sido usada com mais frequência nos serviços públicos de saúde de pré-natal, considerando sua praticidade e baixo custo. 5 Entretanto, vários são os marcadores capazes de identificar os estoques de ferro no organismo, antes mesmo da diminuição dos níveis de hemoglobina. 1 Estudos mostram que esses indicadores caracterizam de forma diferente a deficiência de ferro no organismo, variando conforme os pontos de corte utilizados como também em função do período da gestação.…”