Severity of Maternal Iron Deficiency Anemia and Risk for Low Birth Weight Babies

INTRODUCTION

Anemia is one of the m0st c0mm0n dis0rders in the w0rld and affects patients of all ages and races. The underlying causes and prevalence vary acc0rding t0 age group and s0cio-ec0nomic backgr0und, but pregnant women everywhere are highly vulnerable to developing anemia, and the vast maj0rity of cases are attributable t0 ir0n deficiency.¹ Iron deficiency is the most common nutriti0nal disorder and the main cause of anemia during pregnancy. Published research shows that maternal iron deficiency affects the health of the m0ther and the baby, and is also likely resp0nsible for decreased uterine growth, premature births, and c0gnition. Weakness and lack of nutriti0n.² Babies wh0se birth weight is less than 2,500 grams are known to be infants, regardless of gestational age. The extent to which maternal hemoglobin affects fetal weight remains uncertain. S0me studies showed a strong ass0ciation between low prenatal hemoglobin, while others did n0t find a significant ass0ciation. ³ Therefore, the aim of this study is t0 evaluate maternal hemoglobin before birth and to know its effect on the weight of the fetus at birth.

PATIENTS AND METHODS

This is a cross-sectional study which included 500 pregnant females who had presented and admitted to Obstetrics and Gynecology Department of Bab Alseheiria University Hospital at the time of delivery.

The study group was anemic pregnant females according to WHO definition of anemia with pregnancy which is hemoglobin level below 11 gm%.

Inclusion criteria: Singleton, viable pregnancy. Accurate dates Last Menstrual Period (LMP). Iron deficiency anemia:  Hb level less than 11g%. Serum iron < 7.1mg/l. Serum ferritin < 30ng/l. Total iron binding capacity > 13.1 mmol. BMI > 19.

Exclusion criteria: Women with multiple pregnancies. Pregnancy duration was less than 37 weeks of gestation. Associated medical maternal complications, which may affect fetal birth weight e.g. diabetes, hypertension and cardiac diseases. History of antiphospholipid syndrome. BMI < 19.

Methods:

Verbal and written informed consent was taken before the start of study. The group of study was evaluated for data collection through: Full history obstetric and gynecological history. Examination finding and exclusion of medical disorders. Hb level measurement before delivery. Assessment of fetal outcome birth weight. Serum ferritin. Serum iron. Total iron binding capacity.

Data collection:

Mother's age and risk( primigravida )They are the females who have never become pregnant, the midwives who have given birth two or three times before are chosen, and the Grand Multara who have given birth five or more times before are chosen. Gestational age (calculated using Nigel's formula).

RESULTS

About 26% were primigravida, 26.4% were nullipara and 87% had no history of abortion. Gravidity ranged from 1 to 6 with median 3. Parity ranged from 0 to 5 with median 2. Abortion ranged from 0 to 3 with median 0. Forty percent (40%) delivered via CS.

Table 1: Distribution  regarding obstetric history:

Birth weight  ranged from 1850 to 3500 gm with mean 2593.192 gm. Hemoglobin level ranged from 6.5 to 10.9 g/dL with mean 9.258 g/dL.

Table 2: Birth weight and hemoglobin level among the studied patients:

Thirty six percent (36%)  had fetuses with  Forty-five  (45%) had moderate anemia, while 22.6 % had severe anemia.

Table 3: Distribution  regarding occurrence of  :

There is statistically non-  between the studied groups (with various degrees of anemia severity) regarding gravidity, parity, history of abortion or mode of delivery.

Table 4: Distribution of the studied anemic patients according to severity of anemia:

Studied groups (with various degrees of anemia severity) regarding occurrence of  . On LSD comparison, the difference is significant between each two groups (LBW prevailed in 73.5% within severe group while it occurred in 11.1% within mild group)

Table 5: Relation between obstetric history, mode of delivery and anemia severity:

Table 6: Relation between birth weight and anemia severity:

DISCUSSION

Around 7-15% of all live births per year worldwide are of  , a pregnancy result that is a significant public health concern that is more common in countries with less financial resources. ⁴ There is a greater chance of child mortality and morbidity for babies born with a weight of less than 2,500 grams.   can be favoured by hormonal, social, environmental variables and insufficient lifestyle, either before or during pregnancy. Some dietary factors, such as a diet that is deficient in nutrients and inadequate weight gain during pregnancy, lead to a reduction in nutrient intake that is necessary for fetal development.such as B vitamins and iron. .⁵

Ionic iron is the mineral that encourages fresh hemoglobin production and is the primary source of transfer of energy and oxygen to the organs of the body. (6) At any point of pregnancy and 7

It is anemia caused by iron deficiency (IDA). Roughly 50 percent of cases are worldwide. In terms of iron status, it is necessary to remember that with reduced iron reserves, a significant number of women start pregnancy. In the United States, iron stores are robbed of more than a third of women of childbearing age. At the onset of birth, CRI is 3.8 times more common in pregnant women, which confirms the hypothesis of reduced iron reserves before conception. ⁸

Brannon and Taylor estimated ⁶ 18 percent of IDA distributed among women who are pregnant with hemoglobin levels lower than 115 g/L and ferritin levels lower than

  in infancy and adolescence is a significant determinant of death, morbidity and injury and has a long-term health effect in adult life. In babies with a   (LBW), newborns are 20 times more likely to die than larger babies (about 2.5 Kg) worldwide. It has also been found to be a significant neonatal morbidity risk factor. There are two results, namely short gestational age (premature birth) and limited gestational age, presumably representing a group LBW (childbirth of eight babies less than 2.5 kg) (SGA). ¹⁰

Regarding the obstetric history of the group studied in this study, approximately 26% were virologists, 26.4% were drug-dependent and 87% had no history of miscarriage.. Gravity ranged from 1 to 6 with an average 3. It ranged from parity from 0 to 5 with an average 2. Ranging abortion Z from 0 to 3 average 0 .

In our study, forty percent (40%) were delivered via computer science. Terefe et al.compare ¹³ Hematological features and iron status in newborns from mothers with various anemia and found that most babies were born via vaginal delivery (78.7%).

In our study ranged from birth weight for patients undergoing a study from 1850 to 3500 grams with an average 2593.192 grams. Thirty-six percent (36%)  had fetuses with  . Terefe et al.is found ¹³ The children had an average weight 3,100 grams and was the number of a few of them low weight when childbirth Dah .

In our study, ranged hemoglobin level from 6.5 to 10.9 g / dl an average of 9.258 g / dl. Terefe et al.is found ¹³ The average level of hemoglobin mothers was 12.2 g / dl .

In our study, the 45 patients study subjects (45%) suffer from anemia average , while it was 22.6 % suffer from anemia blood acute . There are statistically  s is statistically significant between the groups of blood anemia mild, medium and severe with regard to age and gravity , and Altec Equal and history of abortion and the method of birth .

Color et al. ¹⁴ In the anemic population, the probability of reduced birth weight was 1.9 times greater. ¹⁴ Jones et al. ¹⁵ In anemic mothers, a rise in the occurrence of   was also found, but the difference from the non-anemic population was marginal.

Terefe et al. ¹³ Cohort mothers with low levels of hemoglobin (

CONCLUSION

This research revealed that iron deficiency anemia in pregnant women is a reasonably common disease. High risk factors are low socioeconomic status, various groups, and old maternal age, and should be taken into account. These reports showed that as a prevention measure, intensive monitoring and supplementation in high-risk pregnancies should be assessed. The latest studies show that   is linked with maternal anemia. Anemia still remains a significant health concern during breastfeeding. Improvements made in the developing world can be partly due to more successful care and diagnosis..