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Query: UMLS:C0240066 (iron deficiency)
7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-five patients have been investigated for anaemia in pregnancy. Using the serum iron/T.I.B.C. ratio as a diagnostic index it has been found that iron deficiency exists in 60% of our expectant mothers with mild anaemia. This type of anaemia was more common in multiparous women and more frequent in the first and second trimesters of pregnancy, There is, therefore, a strong indication for the routine administration of iron supplements to our women during pregnancy and the puerperium.
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PMID:Diagnosis of iron deficiency anaemia among Nigerian pregnant women by serum iron/T.I.B.C. determination. 1 12

The aetiology of severe anaemia (haemoglobin less than 7.0 g dl-1) has been studied in 37 pregnant Zambians. Aetiology was usually multiple; 31 (84%) had Plasmodium falciparum malaria, 23 (62%) were folate deficient, 13 (35%) were iron deficient, one had sickle-cell anaemia and one had the acquired immunodeficiency syndrome (AIDS). Folate deficiency was most often secondary to malarial haemolysis: iron deficiency was nutritional, but hookworm was contributory in about one-third of patients. The anaemia of malaria and folate deficiency was both more common and more severe than anaemia due to iron deficiency; it was seen in younger women although primigravidae were not over-represented, it occurred earlier in pregnancy, and was associated with low birthweight. AIDS must now be included in the differential diagnosis of anaemia in pregnancy. Vigorous antimalarial treatment and prophylaxis are essential in the management and prevention of anaemia in pregnancy. Total dose iron infusion is indicated only when severe iron deficiency anaemia has been proven, and must be accompanied by antimalarial therapy and folic acid supplements. Because of the risk of transmission of human immunodeficiency virus, it is more important than ever to prevent anaemia and malaria in pregnancy, and to give blood transfusion only as a life-saving treatment.
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PMID:The aetiology of severe anaemia in pregnancy in Ndola, Zambia. 268 77

Major causes of anaemia in pregnancy in tropical Africa are malaria, iron deficiency, folate deficiency and haemoglobinopathies: now there is added also the acquired immune deficiency syndrome (AIDS). Anaemia is often multifactorial, with the different causes interacting in a vicious cycle of depressed immunity, infection and malnutrition. Anaemia progresses through 3 stages: compensation, with breathlessness on exertion only; decompensation, with breathlessness at rest and haemoglobin (Hb) below about 70 g/litre; cardiac failure, with Hb below about 40 g/litre. Without treatment, over half of the women with haematocrit less than 0.13 and heart failure die. Maternal anaemia, malaria and deficiencies of iron and folate cause intrauterine growth retardation, premature delivery and, when severe, perinatal mortality. Surviving infants have low birthweights, immune deficiency and poor reserves of iron and folate. They have entered already the vicious cycle of infection, malnutrition and impaired immunity. Treatment with blood transfusions is even more hazardous since the advent of AIDS, and should be limited to saving the life of the mother. Treatment of malaria is complex as chloroquine-resistant strains are now common. Prevention remains relatively easy with proguanil and supplements of iron and folic acid and is highly cost-effective in the improvement of maternal and infant health; it is more important than ever as it avoids the unnecessary exposure of women and infants to HIV transmitted through blood transfusion.
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PMID:Tropical obstetrics and gynaecology. 1. Anaemia in pregnancy in tropical Africa. 269 76

Two hundred Hausa primigravidae at Zaria were divided into five groups in a randomized double-blind trial of antenatal oral antimalarial prophylaxis, and haematinic supplements. Group 1 received no active treatment. Groups 2 to 5 were given chloroquine 600 mg base once, followed by proguanil 100 mg per day. In addition, group 3 received iron 60 mg daily, group 4 folic acid 1 mg daily, and group 5 iron plus folic acid. Forty-five percent were anaemic (haemoglobin (Hb) less than 11.0 g dl-1) at first attendance before 24 weeks of gestation, and malaria parasitaemia (predominantly Plasmodium falciparum) was seen in 27%, of whom 60% were anaemic. The mean Hb fell during pregnancy in group 1, and seven patients in this group had to be removed from the trial and treated for severe anaemia (packed cell volume (PCV) less than 0.26). Only five patients in the other groups developed severe anaemia (P = 0.006), two of whom had malaria following failure to take treatment. Patients in group 1 had the lowest mean Hb at 28 and 36 weeks of gestation, and patients receiving antimalarials and iron (groups 3 and 5) had the highest Hb at 28 weeks, but differences were not significant, possibly due to removal from the trial of patients with severe anaemia. Anaemia (Hb less than 12.0 g dl-1) at six weeks after delivery was observed in 61% of those not receiving active treatment (group 1), in 39% of those protected against malaria but not receiving iron supplements (groups 2 and 4) and in only 18% of patients receiving both antimalarials and iron (groups 3 and 5). Folic acid had no significant effect on mean Hb. Proguanil was confirmed to be a highly effective causal prophylaxis. Prevention of malaria, without folic acid supplements, reduced the frequency of megaloblastic erythropoiesis from 56% to 25%. Folic acid supplements abolished megaloblastosis, except in three patients who were apparently not taking the treatment prescribed. Red cell folate (RCF) concentrations were higher in subjects with malaria, probably due to intracellular synthesis by plasmodia. Infants of mothers not receiving antimalarials appeared to have an erythroid hyperplasia. Maternal folate supplements raised infants' serum folate and RCF. Fourteen per cent had low birth weight (less than 2500 g), and the perinatal death rate was 11%; the greatest number were in group 1, but not significantly. A regime is proposed for the prevention of malaria, iron deficiency, folate deficiency and anaemia in pregnancy in the guinea savanna of Nigeria.
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PMID:The prevention of anaemia in pregnancy in primigravidae in the guinea savanna of Nigeria. 353 Jan 58

Serum ferritin, folate, cobalamin and hemoglobin concentrations were determined by radioimmunoassay, radioisotopic assay, radioassay and an automated hematology analyser respectively, and then analysed in 221 normal full-term pregnant women in order to evaluate the incidence and the prevalence of nutritional anemia in pregnancy. None of them had received any hematonic during their pregnancy. Their mean age was 27.68 years and the mean duration of pregnancy was 39.51 weeks. Twenty-three (10.41%) of these previously non-anemic pregnant women had clinical anemia after full-term pregnancy. Of the 23 women, 11 (47.83%) had iron-deficiency anemia, with serum ferritin less than 12 micrograms/l; another 11 women had some degree of iron depletion, with serum ferritin less than 20 micrograms/l. So in 22 of the 23 anemic women (95.65%) the cause of anemia may correlate to iron depletion. The remaining one had folate-deficiency anemia. No pure cobalamin deficiency anemia was found in this study. Among the 198 non-anemic normal full-term pregnant women, 92 (46.46%) had iron depletion (serum ferritin less than 20 micrograms/l), of whom 35 (17.68%) had severe iron deficiency, with serum ferritin less than 12 micrograms/l. Another 3 had folate deficiency and 3 had cobalamin deficiency. By including all the anemic and non-anemic pregnant women, 114 (51.58%) of them had some degree of iron depletion. In other words, pregnancy can produce a considerable degree of iron depletion in more than half of the previously non-anemic women.
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PMID:Serum ferritin, folate and cobalamin levels and their correlation with anemia in normal full-term pregnant women. 366 65

The known increased need for iron during pregnancy appears to be met only in part by increased iron absorption and amenorrhea. Considerable demands are made on maternal iron stores and, since many women lack sufficient storage iron, pregnancy may be expected to cause iron deficiency. This may lead to anemia in pregnancy and post partum and could also have a bearing on the iron status of the fetus and the neonate. Based on these considerations, prophylactic supplementation of dietary iron is advocated but remains a disputed issue. In the present controlled, prospective and longitudinal study changes in hematologic status, and in particular in iron stores, during pregnancy were investigated in 44 healthy Caucasian women with uncomplicated pregnancies and deliveries. They were randomly assigned to a study group (n = 21) receiving oral iron supplements from the 16th week of amenorrhea until 6 weeks post partum, and a control group (n = 23) without iron supplementation. Maternal concentrations of hemoglobin, serum iron, serum transferrin and serum ferritin were determined at 16, 28 and 36 weeks of amenorrhea, at delivery, and 6 and 12 weeks post partum. The same variables were determined in cord blood. Iron supplementation appeared to prevent the physiologic fall in hemoglobin and serum iron concentrations which occurred in the control group, but had little influence on the observed rise in transferrin concentrations. Ferritin levels in serum, which are known to reflect mobilisable iron stores, fell to 30% of the initial values in the control group and to 70% in the study group. Six and 12 weeks post partum ferritin levels were still low in the nonsupplemented group (Tab. I).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of oral iron supplementation during pregnancy on maternal and fetal iron status. 672 96

Iron in food is classified as belonging to the haem pool, the nonhaem pool, and extraneous sources. Haem iron is derived from vegetable and animal sources with varying bioavailability. Hookworm infestation of the intestinal tract affects 450 million people in the tropics. Schistosoma mansoni caused blood loss in 7 Egyptian patients of 7.5- 25.9 ml/day which is equivalent to a daily loss of iron of .6-7.3 mg daily urinary loss of iron in 9 Egyptian patients. Trichuris trichiura infestation by whipworm is widespread in children with blood loss of 5 ml/day/worm. The etiology of anemia in children besides iron deficiency includes malaria, bacterial or viral infections, folate deficiency and sickle-cell disease. Severe infections cause profound iron-deficiency anemia in children in central American and Malaysia. Plasmodium falciparum malaria-induced anaemia in tropical Africa lowers the mean haemoglobin concentration in the population by 2 g/dI, causing profound anaemia in some. The increased risk of premature delivery, low birthweight, fetal abnormalities, and fetal death is directly related to the degree of maternal anemia. Perinatal mortality was reduced from 38 to 4% in treated anemic mothers. Mental performance was significantly lower in anemic school children and improved after they received iron. Supplements of iron, soy-protein, calcium, and vitamins given to villagers with widespread malnutrition, iron deficiency, and hookworm infestation in Colombia reduced enteric infections in children. Severe iron-deficiency anemia was treated in adults in northern Nigeria by daily in Ferastral 10 ml, which is equivalent to 500 mg of iron per day. Choloroquine, folic acid, rephenium hydroxynaphthoate, and tetrachlorethylene treat adults with severe iron deficiency from hookworm infestation in rural tropical Africa. Blood transfusion is indicated if the patient is dying of anaemia or is pregnant with a haemoglobin concentration 6 gm/dl. In South East Asia, mg per day prevented iron-deficiency anaemia in pregnancy. Field-trials on nutritional iron deficiency include an acidified milk formula plus ferrous sulphate for infants; biscuits with added bovine hemoglobin for children in Chile; sugar plus sodium ferric EDTA in Guatemala; salt with ferric orthophosphate and sodium acid sulphate in India; and Salt with ferrous sulphate plus sodium hexametaphosphate.
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PMID:Iron deficiency in the tropics. 704 57

The physiology of maternal and fetal erythropoiesis in pregnancy shows that hematopoiesis, and the stimulation of hematopoiesis, take place separately in the two circulations. Erythropoietin appears the main regulator in both mother and fetus. The human placenta forms a manifest barrier to endogenous and recombinant erythropoietin, thus fulfilling the cardinal precondition for the use of recombinant erythropoietin in the treatment of maternal pregnancy anemia. The prevalence of maternal anemia in pregnancy and post partum is high; up to 95% of cases are due to iron deficiency, compounded post partum by blood loss during and after delivery. Use of rHuEPO for reversing pregnancy and postpartum anemia has given promising initial results.
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PMID:Erythropoietin in obstetrics. 785 10

A study was undertaken in order to determine the prevalence and aetiology of anaemia in pregnancy in coastal Kenya, so as to establish locally important causes and enable the development of appropriate intervention strategies. 275 women attending the antenatal clinic at Kilifi district hospital, Kenya, were recruited in November 1993. The prevalence of anaemia (haemoglobin [Hb] < 11 g/dL) was 75.6%, and the prevalence of severe anaemia (Hb < 7g/dL) was 9.8% among all parities; 15.3% of 73 primigravidae were severely anaemic, compared with 7.9% of 202 multigravidae (P = 0.07). In primigravidae, malaria infection (Plasmodium falciparum) was strongly associated with moderate and severe anaemia (chi 2 test for trend, P = 0.003). Severe anaemia was more than twice as common in women with peripheral parasitaemia as in those who were aparasitaemic, and parasitaemia was associated with a 2.2g/dL decrease in mean haemoglobin level (P < 0.001). In multigravidae, iron deficiency and hookworm infection were the dominant risk factors for anaemia. Folate deficiency and human immunodeficiency virus infection were not strongly associated with anaemia. It is suggested that an intervention that can effectively reduce malaria infection in primigravidae could have a major impact on the health of these women and their infants.
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PMID:Malaria is an important cause of anaemia in primigravidae: evidence from a district hospital in coastal Kenya. 894 66

The prevalence, causes and role of iron prophylaxis in pregnant women was studied. All women delivered at the National University Hospital, Singapore in 1993 had their haemoglobin estimated. If it was less than 11 g/dl, blood was taken for serum iron, ferritin, transferrin, red cell zinc protoporphyrin, serum folate, vitamin B12 and thalassemia screen to establish cause of anaemia. Data was also collected with regards to their antenatal progress and iron prophylaxis. Logistic regression, Chi-square test, Fischer's exact test and Mantel-Haenszel tests were also used to assess the relationships between categorical variables. The prevalence of anaemia at first antenatal visit was 20.6% while the prevalence of anaemia at delivery was 15.3%. The commonest cause of the anaemia in pregnancy was due to iron deficiency (81.3%). In the non-anaemic group, 90.7% were on prophylactic iron supplements compared to 50.6% in the anaemic group (P < 0.001). Of the 752 women found to be anaemic at booking, 591 received prophylactic iron supplements while 161 women did not. A total of 166 (28.1%) of those with iron supplements were anaemic at delivery, whereas 140 (87.0%) of those who did not receive prophylactic iron remained anaemic at delivery (P < 0.001). Of the 2516 non-anaemic women who received prophylactic iron, 118 (4.7%) developed anaemia at delivery while 133 (34.1%) out of the 390 women who did not receive prophylactic iron were anaemic at delivery (P < 0.001). Multivariate logistic regression analysis revealed the odds of anaemia for a woman not on iron therapy was about 11 times that of her counterpart on prophylactic iron therapy (95% CI 8.76 to 14.13). A 55% reduction in odds of anaemia was estimated per 1 gm% increase in haemoglobin at booking. Prophylactic antenatal iron supplements not only prevent a fall but also improved haemoglobin levels during pregnancy. Those who were not on any iron supplements were 11 times more likely to develop anaemia in the present pregnancy.
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PMID:The role of prophylactic iron supplementation in pregnancy. 1036 8


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