Etiopathogenesis of nutritional anemia in pregnancy: a therapeutic approach

Basu, R. N.; Sk, Sood; Ramachandran, K; Mathur, M; Ramalingaswami, V.

doi:10.1093/ajcn/26.6.591

Cited by 21 publications

(11 citation statements)

References 12 publications

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“…Among pregnant women in Hyderabad, India, 2 mg oral B 12 added to 30 mg iron and 500 mg folic acid did not produce a response in Hb concentration signi®cantly different from that of iron and folic acid alone 71 . Among anaemic pregnant women in New Delhi, 10 mg B 12 , either alone or in combination with iron and folate, appeared to have no effect on Hb concentration, although the sample size was small and supplementation lasted only 4 weeks 68 .…”

Section: Vitamin B 12mentioning

confidence: 86%

The role of vitamins in the prevention and control of anaemia

Fishman

Christian

West

2000

Public Health Nutr.

263

208

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Objective: While iron de®ciency is regarded as the major cause of nutritional anaemia, changes in vitamins A, B 12 , C and E, folic acid and ribo¯avin status have also been linked to its development and control. This paper provides a systematic review of vitamin supplementation trials relating to the control of nutritional anaemia. Methods: A MEDLINE search was used to ®nd reports of vitamin supplementation trials that reported changes in anaemia or iron status. Results: Vitamin A can improve haematological indicators and enhance the ef®cacy of iron supplementation. Both folate and vitamin B 12 can cure and prevent megaloblastic anaemia. Ribo¯avin enhances the haematological response to iron, and its de®ciency may account for a signi®cant proportion of anaemia in many populations. Vitamin C enhances the absorption of dietary iron, although population-based data showing its ef®cacy in reducing anaemia or iron de®ciency are lacking. Vitamin E supplementation given to preterm infants has not reduced the severity of the anaemia of prematurity. Vitamin B 6 effectively treats sideroblastic anaemia. Multivitamin supplementation may raise haemoglobin (Hb) concentration, but few studies have isolated the effect of multivitamins from iron on haematological status. Conclusions: In general, the public health impact of vitamin supplementation in controlling anaemia is not clear. Neither are the complex interactions involving multiple vitamins in haematopoiesis suf®ciently understood to explain the observed variability in haematological responses to vitamins by age, population, vitamin mixture and dosages. Further research is needed to understand the roles of individual and combined vitamin de®ciencies on anaemia to design appropriate micronutrient interventions to prevent anaemia.

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Section: Vitamin B 12mentioning

confidence: 86%

The role of vitamins in the prevention and control of anaemia

Fishman

Christian

West

2000

Public Health Nutr.

263

208

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“…Although the incidence of meg aloblastic anemia during gestation is very low, about 2-4% [4,5], it seems likely that even nonanemic preg nant women had subnormal cobalamin levels to wards the end of pregnancy. Nevertheless, vitamin B12 deficiency has been regarded as insignificant be cause the liver normally contains a reserve of vitamin B12 sufficient for several years.…”

Section: Discussionmentioning

confidence: 99%

“…It has been emphasized that folic acid deficiency is common during pregnancy [4,5]. Blotet al [14] report that more than one third of the women after 6 months of pregnancy or at delivery exhibit plasma folate levels below normal.…”

Section: Discussionmentioning

confidence: 99%

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Levels of Iron, Vitamin B<sub>12</sub>, Folic Acid and Their Binding Proteins during Pregnancy

Zamorano¹,

Arnalich²,

Casas

et al. 1985

Acta Haematol

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One hundred pregnant women, not anemic and not receiving iron or vitamin supplements, were chosen at random among the three trimesters of pregnancy to determine the incidence of unexpected iron, plasma folate and/or cobalamin deficiency, and the significance of fluctuating levels of their respective binding proteins. Pregnant females had a nonsignificant fall in serum iron and a fourfold decline in serum ferritin in the 3rd trimester compared with 1st trimester values. There was a steady decrease in plasma cobalamin and cobalophilin levels in every trimester but no difference in transcobalamin II values. Unsaturated cobalamin (UBBC) and unsaturated transcobalamin binding capacity (UTCBC) were lower in the 1st trimester fully recovering afterwards. Plasma folate levels were not lower, although there was a steady reduction in total and unsaturated folate binding capacity throughout pregnancy

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“…However, in spite of the high prevalence of folate deficiency and of the biological effects of the treatment, there was no obvious correlation between folate status (or folate treatment) and the haematological data, these data being similar at delivery in both groups, one treated by iron alone and the other by the association of iron and folic acid. Other authors have pre viously described similar results: folate treatment does not increase the effect of iron supplementation during pregnancy [12,13] and does not pre vent the anaemia of pregnancy when given alone [1,14].…”

Section: Discussionmentioning

confidence: 57%

Influence of Routine Administration of Folic Acid and Iron during Pregnancy

Blot

Papiernik

Kaltwasser

et al. 1981

Gynecol Obstet Invest

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Haematological and folic acid status were assessed in 200 women in the 6th month of pregnancy. Folic acid deficiencies with no or little haematological impairment were found in one third of the cases, and their occurrence increased when the socioeconomic level was low. During the last trimester of pregnancy, the women were given either iron alone or iron and folic acid supplementation. In the mothers, the rise of folate values in serum and red blood cells, in the folic acid-supplemented group, had no obvious haematological consequences, showing that iron therapy alone can, in developed countries, prevent the anaemia in pregnancy. In the infants, there was no difference in the haematological indices, whatever the mothers’ treatment had been. However, a significant difference appeared for the gestational age and, therefore, the height and weight. Folic acid supplementation during pregnancy increased its duration by virtually 1 week.

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Etiopathogenesis of nutritional anemia in pregnancy: a therapeutic approach

Cited by 21 publications

References 12 publications

The role of vitamins in the prevention and control of anaemia

The role of vitamins in the prevention and control of anaemia

Levels of Iron, Vitamin B<sub>12</sub>, Folic Acid and Their Binding Proteins during Pregnancy

Influence of Routine Administration of Folic Acid and Iron during Pregnancy

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