Abstract
Background: Anemia is one of the most widely prevalent disorders, affecting the lives of almost half a billion women of reproductive age, contributing to over 100,000 maternal and almost 600,000 perinatal deaths (mostly through pre-term delivery, low birth weight) each year. Increased risk of infant mortality and reduced cognitive development and reduced energy levels which affect productivity in adults are cited. During pregnancy increased requirements, inadequate intake of iron and other micronutrients and parasitic (malaria, hookworm) as wells as bacterial (mostly urinary tract) infections are the main causes. In order to reduce such maternal and neonatal burden, it has been worldwide admitted to adopt cost-effective preventive interventions during pregnancy, including iron-folic acid supplementation, de-hookworming medication and anti-malarial prevention or treatment. Intestinal absorption of iron is limited by a lot of factors including bioavailability, iron status of the woman, substances accompanying or contained in diet, chelating agents such as diet fibers or calcium salts. Any supplementation put additional constraint in terms of absorption. Unabsorbed iron is known to have pro-oxidant properties likely to induce production of free radicals. These in turn might induce oxidative stress accountable for in generation of many obstetrical outcomes. This potential link between oxidative stress resulting from free radicals hyperproduction induced by non absorbed iron and harmful maternal/perinatal conditions is rarely questioned by searchers. Objectives: To determine overall (food and supplemented) iron consumption, iron and oxidative status in a cohort of pregnant women and to seek associations between findings and adverse obstetrical outcomes. Methods: At the University Clinics of Kinshasa, we designed a protocol for a prospective cohort study dealing with clinical and biochemical parameters of oxidative stress among pregnant women iron supplemented. Women with a single pregnancy not exceeding 19 weeks without obvious pathology, regardless of age and parity, were eligible for inclusion in the study. Conclusion: This study is expected to assess consequences of oral iron supplementation during pregnancy in terms of obstetrical outcomes associated with oxidative stress linked to unabsorbed iron.
Highlights
Anemia is defined as a hemoglobin value below the lower limits of its normal range, resulting in tissue hypoxia, the consequences of which will be reflected in a variety of symptoms such as fatigue, lightheadedness, weakness, and exertion dyspnea [1] [2]
At the University Clinics of Kinshasa, we designed a protocol for a prospective cohort study dealing with clinical and biochemical parameters of oxidative stress among pregnant women iron supplemented
In the Democratic Republic of Congo, at University Clinics of Kinshasa, the frequency of anemia during pregnancy is estimated at 53.4% [4]
Summary
Anemia is defined as a hemoglobin value below the lower limits of its normal range, resulting in tissue hypoxia, the consequences of which will be reflected in a variety of symptoms such as fatigue, lightheadedness, weakness, and exertion dyspnea [1] [2]. Causes include iron deficiency as a leading one, parasitic (malaria, hookworms) and bacterial infections (mostly urinary tract infection), micronutrient deficiencies including folic acid, vitamin A, and vitamin B12, and genetically inherited hemoglobinopathies such as drepanocytosis All these causes are most prevalent in women of reproductive age and children, mostly in developing areas facing lower energy and iron intake [5]. Increased risk of infant mortality and reduced cognitive development are cited in children and reduced energy levels which affect productivity in adults [6] Fear of such a burden has urged the WHO to adopt cost-effective preventive interventions during pregnancy, including iron-folic acid supplementation, de-hookworming medication and anti-malarial prevention or treatment [7].
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