Prenatal Anemia Research Articles

Prenatal anemia control and anemia in children aged 6-23months in sub-Saharan Africa.

It is unclear whether routine prenatal anemia control interventions can reduce anemia risk in young children. This study examines the associations between prenatal iron supplementation and/or deworming and anemia in children aged 6-23months in sub-Saharan Africa (SSA). We analyzed data from Demographic and Health Surveys conducted between 2003 and 2014 in 25 SSA countries. The surveys collected data on prenatal iron supplementation and deworming and determined children's hemoglobin levels through blood testing. We assessed the associations between prenatal iron supplementation and/or deworming and anemia using multinomial logistic regression. The study included 31,815 mother-child pairs: 25.0%, 41.4%, and 4.8% of children had mild, moderate, and severe anemia, respectively. Compared with children whose mothers did not take iron and deworming drugs prenatally, the risk of moderate/severe anemia was reduced among children whose mothers took only iron supplements for ≥6months (odds ratio [OR]: 0.58; 95% confidence interval [CI]: 0.45-0.76); only deworming drugs (OR: 0.73; 95% CI: 0.56-0.93); deworming drugs plus iron for <6months (OR: 0.79; 95% CI: 0.67-0.93); and deworming drugs plus iron for ≥6months (OR: 0.77; 95% CI: 0.59-0.99). Prenatal use of only iron for <6months was not associated with moderate/severe anemia. Prenatal iron and/or deworming drugs had no effect on mild anemia. Prenatal anemia control interventions are associated with reduced risk of moderate/severe anemia but not with mild anemia in young children in SSA. Iron supplements should be taken for ≥6months or with deworming drugs prenatally to reduce moderate/severe anemia risk in children.

Placental chorioangioma presenting prenatal hemolytic anemia and consumption coagulopathy: a case report

AbstractLarge placental chorioangioma is a rare but serious complication of pregnancy. To our knowledge, this case is the first reported diagnosis of consumption coagulopathy in a fetus using fetal blood sampling (FBS) during pregnancy complicated by placental chorioangioma. A 25-year-old woman, primigravida, was referred to our hospital at 29 weeks of gestation for placental chorioangioma. At 34+1 gestation, polyhydramnios and hyperdynamic circulation were observed in the fetus. FBS demonstrated microangiopathic hemolytic anemia and the presence of consumption coagulopathy. Cesarean section was performed at 34+4 gestation because fetal maturation was expected. A female infant weighing 2158 g was born, with Apgar scores of 6 and 8 at 1 and 5 min, respectively. Neonatal blood sampling results were similar to those of FBS. The infant was treated for hyperdynamic cardiac function, hemolytic anemia, and consumption coagulopathy on mechanical ventilation in the neonatal intensive care unit and recovered fully. When fetal anemia is suspected in a case of large placental chorioangioma, the possibility of developing consumption coagulopathy during the fetal period should be considered.

TUBERCULOSIS CONTROL IN PRIMARY CARE:STATUS QUO AND SUGGESTION

Introduction: Iron deficiency anemia is the most common medical disorder of pregnant women. Especially severe anemia is an important factor increasing mortality. Therefore, promoting use appropriate doses and duration of iron has great importance to prevent iron deficiency in terms of health of the mother and baby. Objectives: This cross-sectional study was designed to determine the number of women who consumed iron, duration of intake during pregnancy, to examine the effect of age and the number of births on prenatal iron intake, and to determine prenatal anemia prevalence in a tertiary hospital which provides service for an area of medium and low-income families in Istanbul. Methods: 4,041 pregnant women who got admitted to our hospital for labor were enrolled in the study for a period of four years between 2001-2004. Age, number of pregnancies and duration of iron intake were recorded. Pregnant women with a less than 11 g /dl hemoglobin concentration were considered anaemic. Findings: Iron intake in pregnant women was 56% and the prevalence of anemia was 46%. Mean hemoglobin concentration was 11.1±1.5 g/dl, mean age was 26.5±5.4 years, and mean duration of iron intake was 3.0±2.2 months. Anemia was found in 36.4% of the iron supplemented group, and 58.1% of the unsupplemented group. Hemoglobin (Hb), Hematocrit (Hct), Mean Corpuscular Volume (MCV) values were statistically different between two groups. It was determined that maternal age does not influence the use of iron; but an increase in parity caused a decrease in iron use and an increase in anemia prevalence. It was observed that there was an increase in the use of iron from 2001 to 2004. Conclusions: In conclusion, it was determined that approximately half the pregnant women admitted to the hospital for delivery received iron during their pregnancy; anemia is less common among iron receivers; iron intake is mainly affected by parity not by maternal age and the effect of iron on blood parameters is positive.

IRON USE IN PREGNANT WOMEN AND PREVALENCE OF PRENATAL ANEMIA

Introduction: Iron deficiency anemia is the most common medical disorder of pregnant women. Especially severe anemia is an important factor increasing mortality. Therefore, promoting use appropriate doses and duration of iron has great importance to prevent iron deficiency in terms of health of the mother and baby. Objectives: This cross-sectional study was designed to determine the number of women who consumed iron, duration of intake during pregnancy, to examine the effect of age and the number of births on prenatal iron intake, and to determine prenatal anemia prevalence in a tertiary hospital which provides service for an area of medium and low-income families in Istanbul. Methods: 4,041 pregnant women who got admitted to our hospital for labor were enrolled in the study for a period of four years between 2001-2004. Age, number of pregnancies and duration of iron intake were recorded. Pregnant women with a less than 11 g /dl hemoglobin concentration were considered anaemic. Findings: Iron intake in pregnant women was 56% and the prevalence of anemia was 46%. Mean hemoglobin concentration was 11.1±1.5 g/dl, mean age was 26.5±5.4 years, and mean duration of iron intake was 3.0±2.2 months. Anemia was found in 36.4% of the iron supplemented group, and 58.1% of the unsupplemented group. Hemoglobin (Hb), Hematocrit (Hct), Mean Corpuscular Volume (MCV) values were statistically different between two groups. It was determined that maternal age does not influence the use of iron; but an increase in parity caused a decrease in iron use and an increase in anemia prevalence. It was observed that there was an increase in the use of iron from 2001 to 2004. Conclusions: In conclusion, it was determined that approximately half the pregnant women admitted to the hospital for delivery received iron during their pregnancy; anemia is less common among iron receivers; iron intake is mainly affected by parity not by maternal age and the effect of iron on blood parameters is positive.

An Innovative Approach to Addressing Anemia in the Perinatal Patient

<h2>Childbearing Poster Presentation</h2><h3>Purpose for the Program</h3> Pregnancy related anemia is a common occurrence in today's healthcare environment. Many factors come into play, such as less than optimum nutritional intake, everyday demands on women, and self‐care deficits. These factors are magnified in the urban setting where limited fiscal and human resources exist. Managing patient care through the continuum, from the prenatal period through the postpartum period, is essential to ensure optimum patient outcomes and efficient use of the limited resources available. <h3>Proposed Change</h3> Changing the process by which patients with prenatal anemia were managed was essential to improve outcomes and decrease the use of resources during the postpartum period. This urban hospital developed a process in which patients with downward trending hemoglobin (<8.0) were provided early interventions to avoid the use of blood transfusions and pharmaceuticals during the postpartum period. The interdisciplinary approach (composed of physicians, nurses, the program coordinator, and the patient) was established to better prepare the patient for delivery. <h3>Implementation, Outcomes, and Evaluation</h3> The first step was to establish guidelines for Bloodless Medicine and Surgery Program (BMSP) consults while not overburdening current resources. Patients that presented with anemia had a BSMP consult. The consult consisted of nutritional counseling, recommendations for treatment, and supportive counseling. Guidelines were adjusted and communication processes between the health center and the BMSP coordinator were modified as needed. The BMSP plan of care documentation changed from manual to electronic documentation, which allowed all team members to access the patient's information. The role of the health center nurses changed to a more active participant in the assessment of the patient's anemia and their intake at each visit. A decrease in postpartum BMSP consults on the postpartum unit was noted after initiation of the program, which indicated improved identification in the prenatal period. <h3>Implications for Nursing Practice</h3> Early intervention with prenatal anemia allows the clinician to intervene when the client is more amenable to learning and following treatment regimes that affect the patient beyond the perinatal period. Continued innovations, such as these, provide evidence that innovative programs initiated by nurses can affect the health of individuals, communities, and healthcare changes overall.

Blood Conservation: An Innovative Program for the Treatment of Prenatal Anemia

Blood Conservation: An Innovative Program for the Treatment of Prenatal Anemia

Assessing Maternal Risk for Fetal-Infant Mortality: A Population-Based Study to Prioritize Risk Reduction in a Healthy Start Community

Study goals were to distinguish between maternal risk factors for fetal versus infant mortality, and to identify which maternal characteristics contributed the greatest risk of mortality overall. This case-control retrospective study abstracted data on more than forty maternal characteristics from 261 prenatal and delivery records: all 26 fetal deaths, all 40 infant deaths and 195 randomly selected surviving births in a high-mortality Healthy Start community. Bivariate and multivariate analyses were conducted. The fetal-mortality population was significantly more likely than the infant-mortality population to have no insurance (P = .047), inadequate prenatal care (P = .039) and previous fetal death (P = .021). Comparing the combined mortality population with the surviving sample, two tiers of risk emerged: Rare-but-lethal risks, including no prenatal care (P < .001) and Child-Protective-Service involvement (P = .001), and common-and-dangerous risks, including inadequate maternal weight gain (OR = 13.55), drug or alcohol abuse (OR = 8.67), obesity (OR = 2.77) and anemia (OR = 3.61). Both fetal and infant mortality groups must be considered when identifying maternal risks. Inadequate prenatal weight gain, obesity and anemia contribute as much to feto-infant mortality as substance abuse. Public health efforts to improve maternal nutrition and healthy weight should be redoubled.

Preconception Hemoglobin and Ferritin Concentrations Are Associated with Pregnancy Outcome in a Prospective Cohort of Chinese Women

Prenatal anemia and iron deficiency are associated with adverse birth outcomes, but no previous studies have examined the relation between preconception anemia, iron deficiency, and pregnancy outcome in healthy women. We measured hemoglobin (Hb), ferritin, transferrin receptor (TfR), and vitamins B-6, B-12, and folate concentrations before pregnancy in 405 Chinese women (median time from sample collection to gestation end = 316 d). Both mild (95 </= Hb < 120 g/L) and moderate (Hb < 95 g/L) anemia were significantly associated with lower birthweight (139 and 192 g, respectively); iron-deficiency anemia alone (Hb < 120 g, ferritin < 12 microg/L, no B-vitamin deficiency) was associated with a 242-g decrease in birthweight. Both low (<12 microg/L) and high (>/=60 microg/L) ferritin were also significantly associated with lower birthweight (106 and 123 g, respectively). The risks of low birthweight (LBW) and fetal growth restriction (FGR) were significantly greater among women with moderate anemia compared with nonanemic controls [odds ratio (OR): 6.5; 95% CI: 1.6, 26.7; P = 0.009 and OR: 4.6; 95% CI: 1.5, 13.5; P = 0.006, respectively]. TfR and low ferritin were not associated with adverse birth outcome, but elevated ferritin, which could be a marker of inflammation, was associated with increased risk of LBW (OR: 2.2; 95% CI: 0.9, 5.7; P = 0.09) and FGR (OR: 2.7; 95% CI: 1.3, 5.6; P = 0.008). Preconception anemia, particularly iron-deficiency anemia, was associated with reduced infant growth and increased risk of adverse pregnancy outcome in Chinese women.

High prevalence of postpartum anemia among low-income women in the United States

Objective: To determine the prevalence of anemia from 4 to 26 weeks post partum and to examine prenatal predictors of postpartum anemia. Study Design: Retrospective cohort analysis of 59,428 participants in the Special Supplemental Nutrition Program for Women, Infants, and Children in 12 US states. Results: The prevalence of postpartum anemia was 27%. Anemia rates were higher among minority women, reaching 48% among non-Hispanic black women. Of 9129 women who had normal hemoglobin in the third trimester, 21% had postpartum anemia. Prenatal anemia was the strongest predictor of postpartum anemia (adjusted odds ratio, 2.7; 95% confidence interval, 2.5-2.8). Maternal obesity, multiple birth, and not breast-feeding also predicted postpartum anemia. Conclusion: The high prevalence of post partum anemia among low-income women highlights the importance of anemia screening at 4 to 6 weeks post partum. These data suggest that screening should not be limited, as it is at present, to women considered at high risk. (Am J Obstet Gynecol 2001;185:438-43.)

Grand multiparity—its obstetric implications

3105 cases of infants of at least 20 weeks gestation delivered at Hazard and Whitesburg Memorial Hospitals during the period April 1956-March 1961 were reviewed and grand multiparas (6 or more pregnancies terminated after at least 20 weeks gestation) were compared to women of parity 1-5 to determine the relationship between average birth weight maternal weight gain during pregnancy incidence of stillborn infants number of prenatal visits and number of neonatal deaths. Also comparisons were made relating age and parity of the mother to a variety of obstetrical factors and complications of pregnancy. There were 725 grand multipara deliveries by 516 women. Average birthweight was greater among multiparas. Occurrance of infants of 2500 gm or less was unrelated to parity while incidence of infants 10 pounds or more was greater among multiparas. The incidence of stillborns increased in the grand multipara 2.86% as compared to 1.31% para 1-5 and increased with age. Maternal factors were responsible for the majority of stillbirths regardless of parity. Increasing parity was unrelated to neonatal deaths or length of gestation. Transverse lie face and brow presentations increased among grand multiparas. Several maternal complications were also more frequent including heart disease and diabetis mellitus. Hypertension as a complication of pregnancy and preeclampsia both increased with grand multiparity and with age of patient. Grand multiparas also showed increases in incidence of primary uterine inertia prenatal anemia and postpartum hemorrhage.