The Indian Journal of Nutrition and Dietetics

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Iron Deficiency Anemia in Pregnancy: An Overview


Affiliations
1 Department of Clinical Pharmacy Girls Section, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudia Arabia - 16278., Saudi Arabia
2 Department of Pharmaceutical Sciences., India
3 Regional Research Institutes of Unani Medicine, University of Kashmir, Srinagar, Jammu and Kashmir - 190 006., India
     

   Subscribe/Renew Journal


The most common and also the most overlooked dietary deficiency in the world is iron deficiency anaemia. It is not only a problem in developing countries or in countries with few resources, but it is also a problem in industrialised ones. The main goal of this article is to raise awareness about the prevalence of anaemia in pregnancy, the aetiology of anaemia in pregnancy (not just during pregnancy but throughout adolescence) and the prevention of anaemia in pregnancy by extending the vision to the adolescent age group in order to reduce the risk of nutritional deficiency anaemia during pregnancy. Because of their increased iron requirements for rapid growth and menstrual blood loss, adolescent girls are particularly sensitive to this illness. Poor nutrition is the most common cause of anaemia, which is caused not only by socioeconomic reasons but also by cultural and other conditioning factors such as viral infections, which promote malnutrition in teenagers. Malaria, intestinal parasites, diarrhoea, and tuberculosis are among diseases that cause malnutrition. Anemia’s severity and length are crucial during pregnancy since it increases the risk of preterm delivery, low birth weight, maternal mortality, and other complications. Anemia is a worldwide health issue that affects about one-third of the world’s population and is one of the primary causes of disability. Anemia in pregnancy is associated with a high rate of morbidity and death due to a woman’s inability to respond to postpartum blood loss, which can have life-threatening effects. Iron deficiency anaemia has a direct link to hunger; according to the WHO, iron deficiency anaemia occurs in 50-80% of areas with chronic malnutrition. However, iron insufficiency is becoming more widespread in wealthy countries, with an increase of 20%. Iron insufficiency is quite common in women of reproductive age, with roughly 30% of them suffering from it.


Keywords

Pregnancy, Iron Deficiency Anemia, Malnutrition, Adolescence
User
Notifications

  • Sifakis, S. and Pharmakides, G. Anemia in pregnancy. Ann. New York Acad. Sci., 2000, 900, 125-136.

  • Brabin, B.J., Hakimi, M. and Pelletier, D. An analysis of anemia and pregnancy-related maternal mortality. The J. Nutr., 2001, 131, 604S-614S; discussion 614S.

  • Lee, A.I. and Okam, M.M. Anemia in pregnancy. Hematology/Oncol. Clin., 2011, 25, 241-259.

  • Williams, M.D. and Wheby, M.S. Anemia in pregnancy. Med. Clin. North America, 1992, 76, 631-647.

  • Breymann, C. Iron deficiency anemia in pregnancy. Seminars. Hematol., 2015, 52, 339-347.

  • Di Renzo, G.C., Spano, F., Giardina, I., Brillo, E., Clerici, G. and Roura, L.C. Iron deficiency anemia in pregnancy. Women’s Healt., 2015, 11, 891-900.

  • Bayoumeu, F., Buisset, C.S., Baka, N.E., Legagneur, H., Barbarino, P.M. and Laxenaire, M.C. Iron therapy in iron deficiency anemia in pregnancy: Intravenous route versus oral route. Eur. J. Obstet. Gynecol. Reproduct. Biol., 2005, 123, S15-S19.

  • Goodlin, R., Dodry, C.A., Anderson, J.C., Woods, R.E. and Quaife, M. Clinical signs of normal plasma volume expansion during pregnancy. Ame. J. Obstet. Gynecol., 1983, 145, 1001-1007.

  • Chang, S., Zeng, L., Brouwer, I.D., Kok, F.J. and Yan, H. Effect of iron deficiency anemia in pregnancy on child mental development in rural China. Pediat., 2013, 131, 755-763.

  • Horowitz, K.M., Ingardia, C.J. and Borgida, A.F. Anemia in pregnancy. Clin. Laborat. Med., 2013, 33, 281-291.

  • Noronha, J.A., Khasawneh, E.A., Seshan, V., Ramasubramaniam, S. and Raman, S. Anemia in pregnancy-consequences and challenges: A review of literature. J. South Asian Federat. Obstet. Gynecol., 2012, 4, 64-70.

  • Xiong, X., Buekens, P., Alexander, S., Demianczuk, N. and Wollast, E. Anemia during pregnancy and birth outcome: A meta-analysis. Ame. J. Perinatol., 2000, 17, 137-146.

  • Lops, V.R., Hunter, L.P. and Dixon, L.R. Anemia in pregnancy. Ame. Famil. Physi., 1995, 51, 1189-1197.

  • Short, M.W. and Domagalski, J.E. Iron deficiency anemia: Evaluation and management. Ame. Famil. Physi., 2013. 87, 98-104.

  • Clark, S.F. Iron deficiency anemia. Nutr. Clini. Pract., 2008, 23, 128-141.

  • Killip, S., Bennett, J.M. and Chambers, M.D. Iron deficiency anemia. Ame. Famil. Physi., 2007, 75, 671-678.

  • Viteri, F.E. The consequences of iron deficiency and anemia in pregnancy. Nutrient regulation during pregnancy, lactation and infant growth, SCN News, 1994, 127-139.

  • Camaschella, C. Iron-deficiency anemia. New England J. Med., 2015, 372, 1832-1843.

  • Warner, M. and Kamran, M. Iron deficiency anemia. StatPearls Publishing, 2017.

  • Elstrott, B., Khan, L., Olson, S., Raghunathan, V., Deloughery, T. and Shatzel, J.J. The role of iron repletion in adult iron deficiency anemia and other diseases. Eur. J. Haematol., 2020, 104, 153-161.

  • Anand, T., Rahi, M., Sharma, P. and Ingle, G.K. Issues in prevention of iron deficiency anemia in India. Nutr., 2014, 30, 764-770.

  • Lund, C.J. and Donovan, J.C. Blood volume during pregnancy: Significance of plasma and red cell volumes. Ame. J. Obstet. Gynecol., 1967, 98, 393-403.

  • Retief, F. and Brink, A. A study of pregnancy anaemia: blood volume changes correlated with other parameters of haemopoietic efficiency. J. Obstet. Gynaecol. British Empire, 1967, 74, 683-693.

  • Duffus, G.M., MacGillivray, I. and Dennis K.J. The relationship between baby weight and changes in maternal weight, total body water, plasma volume, electrolytes and proteins and urinary oestriol excretion. BJOG: An Int. J. Obstet. Gynaecol., 1971, 78, 97-104.

  • Allen, L.H. Anemia and iron deficiency: Effects on pregnancy outcome. The Ame. J. Clin. Nutr., 2000, 71, 1280S-1284S.

  • Gibson, H.M. Plasma volume and glomerular filtration rate in pregnancy and their relation to differences in fetal growth. BJOG: An Int. J. Obstet. Gynaecol., 1973, 80, 1067-1074.

  • Pirani, B., Campbell, D. and MacGillivray, I. Plasma volume in normal first pregnancy. BJOG: An Int. J. Obstet. Gynaecol., 1973, 80, 884-887.

  • Hoeber, D., Sifringer, M., De Looji, Y.V., Herz, J., Sizonenko, S.V., Kempe, K., Serdar, M., Palasz, J., Hadamitzky, M., Endesfelder, S., Fandrey, J., Felderhoff-Muser, U. and Bendix, I. Erythropoietin restores long-term neurocognitive function involving mechanisms of neuronal plasticity in a model of hyperoxia-induced preterm brain injury. Oxidat. Med. Cellul. long., 2016. 2016, 9247493.

  • Das, J.K., Salam, R.A., Thornburg, K.L., Prentice, A.M., Campisi, S., Lassi, Z.S., Koletzko, B. and Bhutta, Z.A. Nutrition in adolescents: Physiology, metabolism and nutritional needs. Ann. New York Academy of Sci., 2017, 1393, 21-33.

  • Marino, D.D. and King, J.C. Nutritional concerns during adolescence. Pediat. Clin. North America, 1980, 27, 125-139.

  • Lifshitz, F., Tarim, O. and Smith, M.M. Nutrition in adolescence. Endocrinol. Metabol. Clini. North America, 1993, 22, 673-683.

  • Wahl, R. Nutrition in the adolescent. Pediat. Ann., 1999, 28, 107-111.

  • Neumark-Sztainer, D., Story, M., Perry, C. and Casey, M.A. Factors influencing food choices of adolescents: Findings from focus-group discussions with adolescents. J. Ame. Diet. Assoc., 1999, 99, 929-937.

  • Trübswasser, U., et al., Baye, K., Holdsworth, M., Loeffen, M., Jm Feskens, E. and Talsma, E.F. Assessing factors influencing adolescents’ dietary behaviours in urban Ethiopia using participatory photography. Pub. Healt. Nutr., 2021, 12, 3615-3623.

  • Hoelscher, D.M., Evans, A., Parcel, G.S. and Kelder, S.H. Designing effective nutrition interventions for adolescents. J. Ame. Diet. Assoc., 2002, 102, S52-S63.

  • Council, N.R. The problem of changing food habits. The Problem of Changing Food Habits: Report of the Committee on Food Habits 1941–1943, 1943.

  • Rani, D.U., Reddy, M.S. and Sreedevamma, M. Nutrition and religion. 2003: Discovery Publishing House.

  • Babar, N.F., Muzaffar, R., Khan, M.A. and Imdad, S. Impact of socioeconomic factors on nutritional status in primary school children. J. Ayub Med. College Abbottabad, 2010, 22, 15-18.

  • MacPhail, P. and Bothwell, T.H. The prevalence and causes of nutritional iron deficiency anemia. In Nestle Nutrition workshop series. 1993. Rowen Press.

  • Abu-Ouf, N.M. and Jan, M.M. The impact of maternal iron deficiency and iron deficiency anemia on child’s health. Saudi Med. J., 2015, 36, 146.

  • Zimmermann, M.B. and Hurrell, R.F. Nutritional iron deficiency. The Lancet, 2007, 370, 511-520.

  • Shaw, J.G. and Friedman, J.F. Iron deficiency anemia: Focus on infectious diseases in lesser developed countries. Anemia, 2011, 2011, 260380.

  • Mahajan, S.D., Sigh, S., Shah, P., Gupta, N. Kochupillai, N. Effect of maternal malnutrition and anemia on the endocrine regulation of fetal growth. Endoc. Res., 2004, 30, 189-203.

  • Singla, P., Tyagi, M., Shankar, R., Dash, D. and Kumar, A. Fetal iron status in maternal anemia. Acta Paediat., 1996, 85, 1327-1330.

  • Erdem, A., Erdem, M., Arslan, M., Yazici, G., Eskandari, R. and Himmetoglu, O. The effect of maternal anemia and iron deficiency on fetal erythropoiesis: Comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborns. The J. Maternal-Fetal. Neonatal Med., 2002, 11, 329-332.

  • Scholl, T.O. Iron status during pregnancy: Setting the stage for mother and infant. The Ame. J. Clin. Nutr., 2005, 81, 1218S-1222S.

  • Bora, R., Sable, C., Wolfson, J., Boro, K. and Rao, R. Prevalence of anemia in pregnant women and its effect on neonatal outcomes in Northeast India. The J. Maternal-Fetal. Neonatal Med., 2014, 27, 887-891.

  • Bouvier, P., Doumbo, O., Breslow, N., Robert, C.F., Mauris, A., Picquet, M., Kouriba, B., Dembele, H.K., Delley, V. and Rougemont, A. Seasonality, malaria, and impact of prophylaxis in a West African village I: Effect on anemia in pregnancy. The Ame. J. Trop. Med. Hyg., 1997, 56, 378-383.

  • Sharma, J.B., Soni, D., Murthy, N.S. and Malhotra, M. Effect of dietary habits on prevalence of anemia in pregnant women of Delhi. J. Obstet. Gynaecol. Res., 2003, 29, 73-78.

  • Kassa, G.M., Muche, A.A., Berhe, A.K. and Fekadu, G.A. Prevalence and determinants of anemia among pregnant women in Ethiopia: A systematic review and meta-analysis. BMC Hematol., 2017, 17, 1-9.

  • Charles, A.M., et al., Predictors of anemia among pregnant women in Westmoreland, Jamaica. Health Care for Women Int., 2010, 31, 585-598.

  • Ayoya, M.A., Brouwer, G.M.S., Traore, A.K., Stoltzfus, R.J. and Garza, C. Determinants of anemia among pregnant women in Mali. Fd. Nutr. Bull., 2006, 27, 3-11.

  • Liyew, A.M., et al. Prevalence and determinants of anemia among pregnant women in East Africa; A multi-level analysis of recent demographic and health surveys. PloS One, 2021, 16, e0250560.

  • Ghimire, N. and Pandey, N. Knowledge and practice of mothers regarding the prevention of anemia during pregnancy, in teaching hospital, Kathmandu. J. Chitwan Med. College, 2013, 3, 14-17.

  • Sarin, A. Severe anemia of pregnancy, recent experience. Int. J. Gynecol. Obstet., 1995, 50, S45-S49.

  • Tandon, R., Jain, A. and Malhotra, P. Management of iron deficiency anemia in pregnancy in India. Ind. J. Hematol. Blood Transfus., 2018, 34, 204-215.

  • Jose, A., Mahey, R., Sharma, J.B., Bhatla, N., Saxena, R., Kalaivani, M. and Kriplani, A. Comparison of ferric carboxymaltose and iron sucrose complex for treatment of iron deficiency anemia in pregnancy-randomised controlled trial. BMC Pregnancy. Childbirth, 2019, 19, 1-8.

  • Sabina, S., Iftequar, S., Zaheer, Z., Khan, M.M. and Khan, S. An overview of anemia in pregnancy. J. Innov. Pharm. Biol. Sci., 2015, 2, 144-51.

  • Sorenson, A.W., Wyse, B.W., Wittwer, A.J. and Hansen, R.G. An index of nutritional quality for a balanced diet. New help for an old problem. J. Ame. Diet. Assoc., 1976, 68, 236-242.

  • Farı́as, A., Garcı́a-Esquivel, Z. and Viana, M.T. Physiological energetics of the green abalone, Haliotis fulgens, fed on a balanced diet. J. Experimen. Marine Biol. Ecol., 2003, 289, 263-276.

  • Reji, K., Jacob, L., Kuriakose, L., Linsha, K., Augustine, M., Geroge, M. and Aranha, P.R. Balanced diet: knowledge and practice of adolescents. Ind. J. Pub. Healt. Res. Dev., 2020, 11, 114-118.

  • Patimah, S., Royani, I., Mursaha, A. and Thaha, A.R. Knowledge, attitude and practice of balanced diet and correlation with hypochromic microcytic anemia among adolescent school girls in maros district, South Sulawesi, Indonesia. Biomed. Res., 2016, 27, 165-171.

  • Doustmohammadian, A., Keshavarz, S.A., Doustmohammadian, S., Abtahi, M. and Shahani, M. Nutritional status and dietary intake among adolescent girls. Arch. Advan. Biosci., 2013, 4, 72-77.

  • Singh, A. Micronutrient dietary intake in Latina pregnant adolescents and its association with level of depression, stress, and social support. Nutr., 2017, 9, 1212.

  • Council, N.R. Recommended Dietary Allowances. 1989.


Abstract Views: 235

PDF Views: 0




  • Iron Deficiency Anemia in Pregnancy: An Overview

Abstract Views: 235  |  PDF Views: 0

Authors

Mehrukh Zehravi
Department of Clinical Pharmacy Girls Section, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudia Arabia - 16278., Saudi Arabia
Mudasir Maqbool
Department of Pharmaceutical Sciences., India
Irfat Ara
Regional Research Institutes of Unani Medicine, University of Kashmir, Srinagar, Jammu and Kashmir - 190 006., India

Abstract


The most common and also the most overlooked dietary deficiency in the world is iron deficiency anaemia. It is not only a problem in developing countries or in countries with few resources, but it is also a problem in industrialised ones. The main goal of this article is to raise awareness about the prevalence of anaemia in pregnancy, the aetiology of anaemia in pregnancy (not just during pregnancy but throughout adolescence) and the prevention of anaemia in pregnancy by extending the vision to the adolescent age group in order to reduce the risk of nutritional deficiency anaemia during pregnancy. Because of their increased iron requirements for rapid growth and menstrual blood loss, adolescent girls are particularly sensitive to this illness. Poor nutrition is the most common cause of anaemia, which is caused not only by socioeconomic reasons but also by cultural and other conditioning factors such as viral infections, which promote malnutrition in teenagers. Malaria, intestinal parasites, diarrhoea, and tuberculosis are among diseases that cause malnutrition. Anemia’s severity and length are crucial during pregnancy since it increases the risk of preterm delivery, low birth weight, maternal mortality, and other complications. Anemia is a worldwide health issue that affects about one-third of the world’s population and is one of the primary causes of disability. Anemia in pregnancy is associated with a high rate of morbidity and death due to a woman’s inability to respond to postpartum blood loss, which can have life-threatening effects. Iron deficiency anaemia has a direct link to hunger; according to the WHO, iron deficiency anaemia occurs in 50-80% of areas with chronic malnutrition. However, iron insufficiency is becoming more widespread in wealthy countries, with an increase of 20%. Iron insufficiency is quite common in women of reproductive age, with roughly 30% of them suffering from it.


Keywords


Pregnancy, Iron Deficiency Anemia, Malnutrition, Adolescence

References