Iron Deficiency Anemia in Pregnancy

Breymann, Christian

doi:10.1053/j.seminhematol.2015.07.003

Cited by 208 publications

(217 citation statements)

References 36 publications

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“…70 Anemia (hemoglobin < 10.5 g/dL) is likewise strongly associated with intrauterine growth restriction and prematurity. 71 Consistent with the model, hypervitaminosis A in infants causes severe thrombocytopenia and anemia, which may be due to a direct inhibitory effect on the growth of all bone marrow cellular components, mediated by the upregulation of cyclin-dependent kinase inhibitors. 72 …”

Section: Complications Of Preterm Birthmentioning

confidence: 55%

A role for the liver in parturition and preterm birth

Mawson¹

2016

J Transl Sci

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Neither the mechanisms of parturition nor the pathogenesis of preterm birth are well understood. Poor nutritional status has been suspected as a major causal factor, since vitamin A concentrations are low in preterm infants. However, even large enteral doses of vitamin A from birth fail to increase plasma concentrations of vitamin A or improve outcomes in preterm and/or extremely low birthweight infants. These findings suggest an underlying impairment in the secretion of vitamin A from the liver, where about 80% of the vitamin is stored. Vitamin A accumulates in the liver and breast during pregnancy in preparation for lactation. While essential in low concentration for multiple biological functions, vitamin A in higher concentration can be pro-oxidant, mutagenic, teratogenic and cytotoxic, acting as a highly surface-active, membrane-seeking and destabilizing compound. Regarding the mechanism of parturition, it is conjectured that by nine months of gestation the hepatic accumulation of vitamin A (retinol) from the liver is such that mobilization and secretion are impaired to the point where stored vitamin A compounds in the form of retinyl esters and retinoic acid begin to spill or leak into the circulation, resulting in amniotic membrane destabilization and the initiation of parturition. If, however, the accumulation and spillage of stored retinoids reaches a critical threshold prior to nine months, e.g., due to cholestatic liver disease, which is common in mothers of preterm infants, the increased retinyl esters and/or retinoic acid rupture the fetal membranes, inducing preterm birth and its complications, including retinopathy, necrotizing enterocolitis and bronchopulmonary dysplasia. Subject to testing, the model suggests that measures taken prior to and during pregnancy to improve liver function could reduce the risk of adverse birth outcomes, including preterm birth.

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Section: Complications Of Preterm Birthmentioning

confidence: 55%

A role for the liver in parturition and preterm birth

Mawson¹

2016

J Transl Sci

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“…As blood volume expansion continues and iron demands from the fetal-placental unit increase throughout gestation, reduced maternal Hb levels become apparent. The M-ID group models this clinical scenario well, as maternal Hb levels reside within the range considered normal in non-pregnant women (12–16 g/dL28), and only reach a modest degree of anaemia in the last week of gestation (<11 g/dL29). In the M-ID dams, we observed no changes in plasma ferritin or transferrin levels, which is in contrast to the S-ID model, further demonstrating that this treatment regimen produces a modest insult more likely to be overlooked in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Modest and Severe Maternal Iron Deficiency in Pregnancy are Associated with Fetal Anaemia and Organ-Specific Hypoxia in Rats

Woodman

Care

Mansour

et al. 2017

Sci Rep

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Prenatal iron-deficiency (ID) is known to alter fetal developmental trajectories, which predisposes the offspring to chronic disease in later life, although the underlying mechanisms remain unclear. Here, we sought to determine whether varying degrees of maternal anaemia could induce organ-specific patterns of hypoxia in the fetuses. Pregnant female Sprague Dawley rats were fed iron-restricted or iron-replete diets to induce a state of moderate (M-ID) or severe ID (S-ID) alongside respective controls. Ultrasound biomicroscopy was performed on gestational day (GD)20 to assess uterine and umbilical artery blood flow patterns. On GD21, tissues were collected and assessed for hypoxia using pimonidazole staining. Compared to controls, maternal haemoglobin (Hb) in M- and S-ID were reduced 17% (P < 0.01) and 48% (P < 0.001), corresponding to 39% (P < 0.001) and 65% (P < 0.001) decreases in fetal Hb. Prenatal ID caused asymmetric fetal growth restriction, which was most pronounced in S-ID. In both severities of ID, umbilical artery resistive index was increased (P < 0.01), while pulsatility index only increased in S-ID (P < 0.05). In both M-and S-ID, fetal kidneys and livers showed evidence of hypoxia (P < 0.01 vs. controls), whereas fetal brains and placentae remained normoxic. These findings indicate prenatal ID causes organ-specific fetal hypoxia, even in the absence of severe maternal anaemia.

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“…En Europa la dieta contiene suficiente hierro como para compensar pérdidas de sangre de 80 ml o lo que es lo mismo 1.2 mg/d. La excesiva menstrual es la principal causa de anemia y afecta al 9-14% de las mujeres (21) El embarazo supone una pérdida de aproximadamente 680 mgr de hierro. Esta cantidad es muy superior a la que puede ser a absorbida por lo que durante el mismo se necesita suplemento de hierro.…”

Section: Pérdida De Sangre: Gastrointestinal Urogenital Iatrogénicounclassified

Significado de la anemia en las diferentes etapas de la vida

Llanos

Zamudio²,

Reyes-García

2016

eglobal

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Palabras clave: anemia por deficiencia de hierro; anemia en la gestación, anemia en el anciano.Keywords: Iron deficiency anemia; anemia in pregnancy; anemia in seniors.. RESUMENResumen: La anemia presenta una elevada prevalencia en las consultas de atención primaria y pediatría, y la ADH representa el 50% de todos los casos de anemia. Metodología:Revisión bibliográfica y análisis descriptivo documental sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH y su significado, utilizando una temporalidad determinada en la búsqueda documental y criterios de inclusión atendiendo a las dimensiones que se analizan en el estudio: Nociones acerca del metabolismo del hierro. Nociones acerca de la hematopoyesis. Diagnóstico por el laboratorio y clasificación de las anemias. Clínica de la anemia ferropénica. Causas de la deficiencia de hierro.Resultados y conclusión: EL estudio documental efectuado nos presenta la existencia de publicaciones con contenidos sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH y su significado, evidenciando la importancia de este contenido para el profesional de enfermería en el área de la atención primaria y pediatría. ABSTRACTOverview: Anemia is very common in primary care consultations and pediatrics, and IDA is the cause of 50% of all cases of anemia.Methodology: Literature review and documentary descriptive analysis of the pathogenesis of irondeficiency anemia, the basic diagnostic tests to study IDA and the significance of such using a specific time period in the documentary search and inclusion criteria that takes into account factors that are analyzed in the study: Ideas about the metabolism of iron. Ideas about hematopoiesis. Laboratory diagnosis and classification of anemia. Clinical features of iron deficiency anemia. Causes of iron deficiency.

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Iron Deficiency Anemia in Pregnancy

Cited by 208 publications

References 36 publications

A role for the liver in parturition and preterm birth

A role for the liver in parturition and preterm birth

Modest and Severe Maternal Iron Deficiency in Pregnancy are Associated with Fetal Anaemia and Organ-Specific Hypoxia in Rats

Significado de la anemia en las diferentes etapas de la vida

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