Anemia, Iron and Pregnancy Outcome

Abstract

When maternal anemia is diagnosed before midpregnancy, it has been associated with an increased risk of preterm delivery. Maternal anemia detected during the later stages of pregnancy, especially the third trimester, often reflects the expected (and necessary) expansion of maternal plasma volume. Third-trimester anemia usually is not associated with increased risk of preterm delivery. High hemoglobin concentration, elevated hematocrit and increased levels of serum ferritin late in pregnancy, however, all have been associated with increased preterm delivery. This increased risk may reflect in part the failure to expand maternal plasma volume adequately, thus diminishing appropriate placental perfusion. Although controlled trials of iron supplementation during pregnancy have consistently demonstrated positive effects on maternal iron status at delivery, they have not demonstrated reductions in factors that are associated with maternal anemia, i.e., increased risk of preterm delivery and infant low birth weight. One reason for discordant findings may be the exclusion of many gravidas with iron deficiency from these trials or the data concerning gravidas with pregnancy outcomes such as preterm delivery from the analysis. Finally, recent concerns have been voiced about harmful effects of iron supplementation during pregnancy. No adverse effects of iron supplementation on pregnancy outcome have been demonstrated to date. Questions about the efficacy of iron supplementation during pregnancy for reducing adverse outcomes such as preterm delivery and side effects from iron supplementation, including the potential for oxidation of lipids and DNA, require further research in iron-deficient women.

Determinants of weight and length of Indonesian neonates

“…However, the difference of 0.6 weeks might not be biologically significant. In contrast to findings from observational studies (Allen, 2000;Scholl & Reilly, 2000), controlled trials on iron supplementation do not provide evidence for benefits on preventing intrauterine growth retardation (de Onis et al, 1998a,b). Preziosi et al (1997) showed that infants of iron supplemented mothers were longer, but not heavier, at birth than those of nonsupplemented mothers.…”

“…Risk of preterm delivery and low birth weight are associated with iron deficiency anaemia during pregnancy (Scholl & Reilly, 2000). The addition of vitamin A to routine iron supplementation has been shown to increase haemoglobin concentrations during pregnancy (Suharno et al, 1993, Muslimatun et al, 2001.…”

Iron status and its association with pregnancy outcome in Korean pregnant women

“…At least 50% of the anemia has been attributed to iron deficiency (DeMaeyer and Adiels-Tegman, 1985;Singh et al, 1998). Maternal iron deficiency anemia increases the risk of premature delivery and subsequent low birth weight, and may contribute to low iron status and poor health of infants (Allen, 2000;Scholl and Reilly, 2000;Kaiser and Allen, 2002). Also, pregnant women with anemia are at a greater risk of perinatal mortality and morbidity (Haas and Brownlie, 2001;Rasmussen, 2001;Ramakrishnan and Yip, 2002).…”

Does Maternal Iron Deficiency Affect Iron Status Of the Newbornsa and Early Infants ?

“…Yapılan bazı çalışmalarda, gebelerdeki demir eksikliğinin, fetus ve infarıtın demir durumunu etkilediği, prematür doğum prevalansını artırdığı, uzun dönemde büyüme ve gelişme geriliğine neden olabileceği gösteril-miştir (5)(6)(7)(8). Bazı çalışmalarda da annenin demir durumunun bebeğin demir durumuna etkisi olmadığı, bebeklerin demir depolannın ilk dört ay için yeterli olduğu bildirilmiştir (9-1 1).…”