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3. Приложение . 2021

Pregnancy and childbirth in women with mild iron-deficiency anemia diagnosed in the first trimester

Abstract

The aim of the study was to determine frequency of pregnancy and Labor complications in women with iron-deficiency anemia (IDA) diagnosed in the first trimester.

Material and methods. A retrospective analysis of complaints, anamnestic data, anthropometric data, as well as frequency of pregnancy and labor complications in 90 patients selected by continuous sampling method was carried out. Of these, in 60 pregnant women in the first trimester IDA of mild and moderate severity was diagnosed. In the control group there were 30 pregnant women without IDA.

Results. In pregnant women with IDA from the first trimester an increase in volume of blood loss during vaginal delivery by an average of 63 ml was revealed. The relationship between development of pregnancy against the background of IDA and perineal trauma during childbirth was revealed. Risk of a first or second degree perineal tear increased 1.944 times compared to the control group. In newborns from mothers with IDA, a shorter average length was noted (p<0.05). After childbirth, number of patients with moderate anemia increased by 2.44 times.

Conclusion. IDA is the most common health disorder in women of reproductive age. Pregnancy with IDA (mild to moderate severity) is associated with increased postpartum hemorrhage, increased frequency of perineal ruptures, and shorter average baby height (length) at birth. The optimal choice in women with iron-deficiency (latent or already formed anemia) are oral medication forms. Presence of ascorbic acid in composition of the combination medication, along with ferrous sulfate, increases the absorption of medication (by 30%) and improves Fe2+ uptake. The effectiveness of Sorbifer Durules (with delayed release formula which reduces the number of side effects) that meets these requirements, is reflected in numerous studies involving both pregnant and non-pregnant women.

Keywords:pregnancy; childbirth; iron-deficiency anemia; ferrous sulfate

Funding. The authors received no financial support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Radzinsky V.E., Solovieva A.V., Aleinikova E.Yu., Smirnova T.V., Kuznetsova O.A.Pregnancy and childbirth in women with mild iron-deficiency anemia diagnosed in the first trimester. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2021; 9 (3). Supplement: 6-13. DOI: https://doi.org/10.33029/2303-9698-2021-9-3suppl-6-13 (in Russian)

REFERENCES

1. Radzinsky V.E., Knyazev S.A., Kostin I.N. etc. Predictive obstetrics. Moscow: Redaktsiya zhurnala StatusPraesens, 2021: 520 p. (in Russian)

2. Sun Y., Shen Z.Z., Huang F.L., Jiang Y., Wang Y.W., Zhang S.H., et al. Association of gestational anemia with pregnancy conditions and outcomes: a nested case-control study. World J Clin Cases. 2021; 9 (27): 8008–19. DOI: https://doi.org/10.12998/wjcc.v9.i27.8008 PMID: 34621857; PMCID: PMC8462208.

3. Young M.F., Oaks B.M., Tandon S., Martorell R., Dewey K.G., Wendt A.S. Maternal hemoglobin concentrations across pregnancy and maternal and child health: a systematic review and meta-analysis. Ann N Y Acad Sci. 2019; 1450 (1): 47–68. DOI: https://doi.org/10.1111/nyas.14093 Epub 2019 Apr 17. PMID: 30994929; PMCID: PMC6767572.

4. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. 2020. URL: https://creativecommons.org/licenses/by-nc-sa/3.0/igo

5. Tang G., Lausman A., Abdulrehman J., Petrucci, Rosane J., et al. Prevalence of iron deficiency and iron deficiency anemia during pregnancy: a Single Centre Canadian Study. Blood. 2019; 134 (suppl 1): 3389. DOI: https://doi.org/10.1182/blood-2019-127602

6. Malinowski A.K., Murji A. Iron deficiency and iron deficiency anemia in pregnancy. CMAJ. 2021; 193 (29): E1137-8. DOI: https://doi.org/10.1503/cmaj.210007 PMID: 34312167; PMCID: PMC8321297.

7. Soares M.J., Iqbal K., Kozai K. Hypoxia and placental development. Birth Defects Res. 2017; 109 (17): 1309-29.

8. Anemia and reproductive health. Edit. by V.E. Radzinsky. Moscow: Redaktsiya zhurnala StatusPraesens, 2019: 200 p. (in Russian)

9. Pregravid preparation. Clinical Protocol of the Interdisciplinary Association of Specialists in Reproductive Medicine. Version 2.0. Edit. by V.E. Radzinsky. Moscow: Redaktsiya zhurnala StatusPraesens, 2020: 128 p. (in Russian)

10. Clinical protocol “Iron deficiency anemia". Moscow, 2020. (in Russian)

11. Clinical protocol “Abnormal uterine bleeding". Moscow, 2021. (in Russian)

12. Nash C.M., Allen V.M. The use of parenteral iron therapy for the treatment of postpartum anemia. J Obstet Gynaecol Can. 2015; 37 (5): 439-42.

13. Khaskheli M.N., Baloch S., Sheeba A., Baloch S., Khaskheli F.K. Iron deficiency anaemia is still a major killer of pregnant women. Pak J Med Sci. 2016; 32 (3): 630-4. DOI: https://doi.org/10.12669/pjms 323.9557

14. Yefet E., Yossef A., Nachum Z. Prediction of anemia at delivery. Sci Rep. 2021; 11 (1): 6309. DOI: https://doi.org/10.1038/s41598-021-85622-7 PMID: 33737646; PMCID: PMC7973554.

15. Lin L., Wei Y., Zhu W., Wang C., Su R., Feng H., et al.; Gestational Diabetes Mellitus Prevalence Survey (GPS) Study Group. Prevalence, risk factors and associated adverse pregnancy outcomes of anaemia in Chinese pregnant women: a multicentre retrospective study. BMC Pregnancy Childb. 2018; 18 (1): 111. DOI: https://doi.org/10.1186/s12884-018-1739-8 PMID: 29685119; PMCID: PMC5914057.

16. Pena-Rosas J.P., De-Regil L.M., Garcia-Casal M.N., Dowswell T. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015; 7: CD004736. DOI: https://doi.org/10.1002/14651858.CD004736.pub5 PMID: 26198451.

17. Breymann C., Honegger C., Hosli I., Surbek D. Diagnosis and treatment of iron-deficiency anaemia in pregnancy and postpartum. Arch Gynecol Obstet. 2017; 296 (6): 1229-34.

18. Report on the work of the expert council “Current issues of iron deficiency in the Russian Federation". Terapiya [Therapy]. 2020; 5 (39): 10-9. (in Russian)

19. Stuklov N.I., Mitchenkov A.A. Terapiya Anemia and iron deficiency. Global problems and algorithms of solutions. Terapiya [Therapy]. 2018; 6 (24): 147-56. (in Russian)

20. Shikh E.V., Drozdov V.N., Shulyatyeva N.V., Osipyan E.E. Latent iron deficiency: pathogenetic variants and treatment efficacy in patients infected by H. Pylori. Poliklinika [Policlinic]. 2021; (2): 10-4. (in Russian)

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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