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1 . 2022

Iron deficiency anaemia and liver condition in pregnant women: correlation connection

Abstract

The aim of the study was to evaluate the anaemia markers and the level of hepatic tests in pregnant women with anaemia in dynamics, and to conduct correlation analysis to optimize the obstetrics management.

Material and methods. There were examined 2253 pregnant women, of whom 171 (7.6%) were diagnosed with anaemia. The blood tests including RBC, hemoglobin level, hematocrit, MCH, ALT, AST, bilirubin levels were evaluated at 6–12th weeks, 20th week, and 30th week of pregnancy. The ferritin and transferrin levels, and common iron binding ability were determined at the 30th week of pregnancy. All women in the study group were treated with iron of up to 4 weeks during early gestation.

Design: observational, cohort, closed research.

Results. Against the background of anti-anemic therapy for 4 weeks, there was a significant increase in hemoglobin, hematocrit, RBC, MCH at 20th weeks of gestation. When comparing the medians of the studying haematological tests conducted at the 30th week, significant differences were achieved only in terms of MCH, while the indicators of hemoglobin, hematocrit, and RBC remained at the same level. The levels of ALT, AST and bilirubin differed significantly in all stages of pregnancy (р=0,000). The ferritin level at the 30th week was on average lower than the normal rate, and was 12.957±6.843µg/l. Correlation analyses revealed moderate correlation between RBC, Hb and Ht (R from 0.48 to 0.61), ALT and AST (r=0.63), which persisted by the 20th week of pregnancy. There were also a moderate correlation between bilirubin and Hb (r=0.25) and weak correlation between bilirubin and Ht (r=0.20) at 6–12 weeks of gestation. There was a moderate correlation between ALT and AST (r=0.54), as well as between Hb and MCH (r=0.276). There were a weak correlation between transferrin and RBC (r=-0.171), and between bilirubin and ferritin (r=0.18), and between bilirubin and the common sideropexy power (r=-0.15).

Conclusion. In case of detection of anaemia in pregnant women, it is advisable to recommend the use of hepatoprotectors against the background of iron therapy. The use of such integrated approach will also improve the conditions of pregnant women, and contribute to the accumulation of iron in hepatic cells. If initial anaemia is detected, iron preparations should be taken throughout pregnancy, which contribute as blood management, as prevention of severe anaemia in labor. Initial hemoglobin levels 125 g/l or less may be considered as a criterion for pre-latent iron deficiency in pregnant women. It is recommended to determine the iron and ferritin levels in trimester I.

Keywords:pregnancy; anaemia; laboratory anaemia tests; hepatic enzymes

Funding. The author received no financial support.

Conflict of interest. The author declares no conflict of interest.

Contribution. Conceptualization – concept statement; statement and development of key goals and objectives.

Conducting research – data analysis and interpretation – Karakhalis L.Yu.; Andreeva M.D.; text preparation and editing – critical revision of the manuscript with a valuable intellectual investment – Karakhalis L.Yu.; Andreeva M.D.; approval of the final manuscript – acceptance of responsibility for all aspects of the work, integrity of all parts of the article and its final version – Karakhalis L.Yu.; Andreeva M.D., Ahidzhak A.N., Ignatyeva E.O.; methodology development (methodology development and design) – Karakhalis L.Yu.; Andreeva M.D., Ahidzhak A.N., Ignatyeva E.O.; text preparation and editing – drafting of the manuscript; contribution to the scientific layout; preparation of final work – Ahidzhak A.N., Ignatyeva E.O

For citation: Karakhalis L.Yu., Andreeva M.D., Ahidzhak A.N., Ignatyeva E.O. Iron deficiency anaemia and liver condition in pregnant women: correlation connection. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2022; 10 (1): 38–45. DOI: https://doi.org/10.33029/2303-9698-2022-10-1-38-45 (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
Savel'eva Galina Mikhailovna
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology of the Pediatric Department of the N.I. Pirogov Russian National Scientific Research Medical University under the Ministry of Health of Russia
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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