Anemia in Pregnancy

Annals of the New York Academy of Sciences - Tập 900 Số 1 - Trang 125-136 - 2000
S. Sifakis1, G. PHARMAKIDES1
1Department of Obstetrics and Gynecology, University Hospital of Heraklion, University of Crete, Heraklion, Greece

Tóm tắt

Abstract: Anemia is one of the most frequent complications related to pregnancy. Normal physiologic changes in pregnancy affect the hemoglobin (Hb), and there is a relative or absolute reduction in Hb concentration. The most common true anemias during pregnancy are iron deficiency anemia (approximately 75%) and folate deficiency megaloblastic anemia, which are more common in women who have inadequate diets and who are not receiving prenatal iron and folate supplements. Severe anemia may have adverse effects on the mother and the fetus. Anemia with hemoglobin levels less than 6 gr/dl is associated with poor pregnancy outcome. Prematurity, spontaneous abortions, low birth weight, and fetal deaths are complications of severe maternal anemia. Nevertheless, a mild to moderate iron deficiency does not appear to cause a significant effect on fetal hemoglobin concentration. An Hb level of 11 gr/dl in the late first trimester and also of 10 gr/dl in the second and third trimesters are suggested as lower limits for Hb concentration. In an iron‐deficient state, iron supplementation must be given and follow‐up is indicated to diagnose iron‐unresponsive anemias.

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Tài liệu tham khảo

Goodland R.D., 1983, Clinical science of normal plasma volume expansion during pregnancy, Am. J. Obstet. Gynecol., 145, 1001, 10.1016/0002-9378(83)90856-6

World Health Organization. 1965. Nutrition in pregnancy and lactation. WHO Tech. Rep. Ser. 302.

World Health Organization. 1968. Nutritional anemias. WHO Tech. Rep. Ser. 405.

10.1016/0002-9378(67)90160-3

10.1111/j.1471-0528.1967.tb03781.x

10.1111/j.1471-0528.1971.tb00240.x

10.1111/j.1471-0528.1973.tb02981.x

10.1111/j.1471-0528.1973.tb02146.x

Baker S.J., 1983, Nutritional anemias, Part 2: Tropical Asia. Clin. Haematol., 10, 843

10.1016/S0025-7125(16)30344-3

Cook J.D., 1983, Nutritional anemia, Contemp. Nutr., 8, 366

10.1097/00003081-197412000-00015

Pryor J.et al.1990.InHematologic Disorders in Maternal‐Fetal Medicine. Wiley‐Liss Inc. New York. pp. 93–111.

Sturgeon P., 1959, Studies of iron requirements in infants III, Influence of supplemental iron during normal pregnancy on mother and infant. B. The infant. Br. J. Haematol., 5, 45

Werner E.J., 1983, Red cell disturbances in the feto‐maternal unit, Semin. Perinatol., 3, 139

10.3109/00016348009156380

Kaneshige E., 1981, Serum ferritin as an assessment of iron stores and other hematologic parameters during pregnancy, Obstet. Gynecol., 57, 238

10.1097/00003081-197303000-00009

10.1016/0002-9378(76)90152-6

10.1016/S0271-5317(82)80108-5

10.1097/00003081-198003000-00005

Meyer M.B., 1975, The interrelationship of maternal smoking and increased perinatal mortality with other risk factors, Analysis of the Ontario Perinatal Mortality Study, 1960–61. Am. J. Epidemiol., 100, 443

Garn S.M., 1981, Maternal hematologic levels and pregnancy outcomes, Semin. Perinatol., 5, 155

Koller O.et al.1990. Maternal hemoglobin concentrations and fetal health.InHematologic Disorders in Maternal‐Fetal Medicine.: 31–46. Wiley‐Liss Inc. New York.

10.3109/00016348009156378

10.3109/00016347909154904

10.1016/S0140-6736(86)91269-9

Sjöstedt J.E., 1977, Oral iron prophylaxis during pregnancy, Acta Obstet. Gynecol. Scand. [Suppl.], 60, 3, 10.1111/aogs.1977.56.s60.3

10.1111/j.1471-0528.1983.tb08891.x

10.3109/00016348009156379

10.1097/00006254-197311000-00001

Prasad A.S., 1979, Leukocyte formation in iron deficiency anemia, Am. J. Clin. Nutr., 32, 550, 10.1093/ajcn/32.3.550

10.1111/j.1471-0528.1982.tb03619.x

Fairbanks V.F.et al.1983. Erythrocyte disorders‐anemias related to disturbances of hemoglobin synthesis.InHematology. W.J. Williams E. Beutler A.J. Erslev & M.A. Lichtman Eds.: 466. McGraw‐Hill. New York.

DZ. 1987. Hematologic Problems in Pregnancy. Medical Economics Books. Oradell NJ.

10.1097/00006254-198211000-00001

Prema K., 1982, The effect of intramuscular iron therapy in anaemic pregnant women, Indian J. Med. Res., 75, 534

Beck W.S. 1983. Erythrocyte disorders‐anemias related to disturbance of DNA synthesis (megaloblastic anemias).InHematology. W.J. Williams E. Beutler A.J. Erslev & M.A. Lichtman Eds.: 434. McGraw‐Hill. New York.

Food and Nutrition Board National Research Council. 1980. Recommended Dietary Allowances. National Academy of Sciences. Washington DC.

Pritchard J.A. & P.C. McDonald Eds. 1980. Megaloblastic anemia.InWilliams Obstetrics l6th edit.: 717. Appleton‐Century‐Crofts. New York.

10.3109/00016347909154593

10.3109/00016348109158126

Oski F.A. 1983. Anemia related to nutritional deficiencies other than vitamin B12 and folic acid.InHematology. W.J. Williams E. Beutler A.J. Erslev & M.A. Lichtman Eds.: 522. McGraw‐Hill. New York.

Warth J.A., 1981, Abnormal dark adaptation in sickle cell anemia, J. Lab. Clin. Med., 98, 189

Morrison J.C.et al.1985. Anemia associated with pregnancy.InGynecology and Obstetrics: Maternal and Fetal Medicine. R. Depp & D.A. Eschenbach Eds.: 16. Harper Row. New York.

10.1111/j.1365-2141.1980.tb05935.x

10.3109/00016348409155545

10.1515/jpme.1977.5.4.172

10.3109/00016348609158396

10.1007/BF02429622

Buchan P.C., 1982, Preeclampsia‐a hyperviscosity syndrome, Am. J. Obstet. Gynecol., 142, 111, 10.1016/S0002-9378(16)32294-3

Begg T.V., 1966, Components in blood viscosity, The relative contributions of hematocrit, plasma fibrinogen and other proteins. Clin. Sci., 31, 87

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Annals of the New York Academy of Sciences

Tập 900 Số 1

125-136

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