Pregnancy iron deficiency

It has become apparent that reduction in the dose of the constituents of oral contraceptives has markedly reduced mild and severe adverse effects, providing a relatively safe and convenient method of contraception for many young women. Treatment with oral contraceptives has also been shown to be associated with many benefits unrelated to contraception. These include a reduced risk of ovarian cysts, ovarian and endometrial cancer, and benign breast disease. There is a lower incidence of ectopic pregnancy. Iron deficiency and rheumatoid arthritis are less common, and premenstrual symptoms, dysmenorrhea, endometriosis, acne, and hirsutism may be ameliorated with their use. 

Thus, our attention should shift from the concern of potential adverse effects to the health benefits imparted by hormonal contraceptives. The use of oral contraceptives for at least 12 months reduces the risk of developing endometrial cancer by 50%. Furthermore, the risk of epithelial ovarian cancer in users of oral contraceptives is reduced by 40% compared with that on nonusers. This kind of protection is already seen after as little as 3-6 months of use. Oral contraceptives also decrease the incidence of ovarian cysts and fibrocystic breast disease. They reduce menstrual blood loss and thus the incidence of iron-deficiency anemia. A decreased incidence of pelvic inflammatory disease and ectopic pregnancies has been reported as well as an ameliorating effect on the clinical course of endometriosis. 

Taking the contraceptive hormones provides health benefits not related to contraception, such as regulating the menstrual cycle and decreased blood loss, and incidence of iron deficiency anemia, and dysmenorrhea Health benefits related to the inhibition of ovulation include a decrease in ovarian cysts and ectopic pregnancies. hi addition, there is a decrease in fibrocyctic breast disease, acute pelvic inflammatory disease endometrial cancer, ovarian cancer, maintenance of bone density, and symptoms related to endometriosis in women taking contraceptive hormones. Newer combination contraceptives such as norgestimate and ethinyl estradiol... 

Attention to iron metabolism is particularly important in women for the reason mentioned above. Additionally, in pregnancy, allowances must be made for the growing fetus. Older people with poor dietary habits ( tea and toasters ) may develop iron deficiency. Iron deficiency anemia due to inadequate intake, inadequate utilization, or excessive loss of iron is one of the most prevalent conditions seen in medical practice. 

Restless-legs syndrome occurs in 5% to 15% of the population, making it a common sleep disorder.11,12 The prevalence of RLS increases with age and in various medical conditions such as end-stage renal disease (ESRD), pregnancy, and iron deficiency.13 RLS appears to be more common in women than in men and has a genetic link. The majority of RLS patients (63% to 92%) report a positive family history.14... 

Iron-deficiency anemia can be caused by inadequate dietary intake, inadequate GI absorption, increased iron demand (e.g., pregnancy), blood loss, and chronic diseases. 

Transferrin 8-9 Binds iron in plasma and transports iron to bone Iron deficiency, pregnancy, hypoxia, chronic blood loss, estrogens Chronic infection, cirrhosis, burns, enteropathies, nephrotic syndrome, cortisone, testosterone... 

Iron deficiency is usually due to blood loss, or more rarely to inadequate iron uptake. During pregnancy, increased demand can also cause iron deficiency states. In severe cases, reduced hemoglobin synthesis can lead to anemia ( iron-deficiency anemia ). In these patients, the erythrocytes are smaller and have less hemoglobin. As their membrane is also altered, they are prematurely eliminated in the spleen. 

Singh K, Fong YF, Kuperan P. A comparison between intravenous iron polymaltose complex (Ferrum Haus-mann) and oral ferrous fumarate in the treatment of iron deficiency anaemia in pregnancy. Eur J Haematol 1998 60 119-24. 

Iron deficiency affects more than 1.7 billion people worldwide and has been called the most widespread health problem in the world by the World Health Organization. Due to severe iron deficiency, more than 60 000 women die in pregnancy and childbirth each year, and almost 500 million women of childbearing age suffer from anemia. Dietary iron requirements depend on mrmerous factors, for example, age, sex, and diet composition. Recommended daily intake in the USA varies dependent on gender and age. Potato is a modest source of iron. A study of cultivated varieties showed 0.3-2.3 mg of Fe in a 100 g tuber (True et al., 1978). Ranges of iron content from 6 to 158 p,g/g of DW have been reported (Andre et al., 2007 Wills et al.. 

Nutritional iron deficiency anaemia other causes in which iron deficiency can occur are pregnancy, lactation, infants, children. In patients with malabsorption syndrome, patients who are taking NSAIDs for long period, patients with chronic inflammatory disease and in patients of gastrectomy. 

Any consideration of major issues relating to the balance of benefit and harm, such as cancer or mortality rates, should be supplemented by a consideration of less prominent ones, for example, a reduction in disorders of the menstrual cycle (such as dysmenorrhea, menorrhagia, and the premenstrual syndrome) and the reduced risks of iron deficiency anemia, functional ovarian cysts, uterine fibroids, benign breast disease, pelvic inflammatory disease, and ectopic pregnancy (10,11). 

Iron is an essential nutrient that is sometimes lacking in people s diets. For that reason, physicians often recommend iron for people with certain health conditions, such as iron-deficiency anemia. Some iron products are available without a prescription, either as single-ingredient iron pills or in combination with vitamins or other minerals, including pediatric vitamins with iron. Drugs that contain iron and folic acid are available by prescription and are principally used by women during pregnancy. 

Iron-deficiency anaemia is common in premenopausal females and is associated with iron loss in pregnancy, childbirth and menstruation and in nutritional iron deficiency. Anaemia reduces the oxygen-carrying capacity ofblood. 

Iron deficiency, pregnancy, hypoxia, chronic blood loss, estrogens Kidney dysfunction... 

Pregnancy. The extra iron required by mother and fetus totals 1000 mg, chiefly in the latter half of pregnancy. The fetus takes iron from the mother even if she is iron deficient. Dietary iron is seldom adequate and iron and folic acid (50-100 mg elemental iron plus folic acid 200-500 micrograms/day) should be given to pregnant women from the fourth month. Opinions differ on whether all women should receive prophylaxis or only those who can be identified as needing it. There are numerous formulations. Parents should be particularly warned not to let children get at the tablets. 

Pregnancy, see eJw Embryonic development energy lequirements, 301, 306 fotate deficiency in, 507,511 high blood pressure and, 730 iron deficiency, 751, 756 ]aclalLon,306... 

Epoetin combined with parenteral iron is effective and safe for moderate and severe iron deficiency anemia during pregnancy (26), and iron supplementation is often required (27). The use of epoetin in combination with intravenous iron makes collection of larger numbers of autologous erythrocyte units feasible. However, epoetin does not synergize with G-CSF for the mobilization of peripheral blood progenitor cells in healthy donors (28). 

Sifakis S, Angelakis E, Vardaki E, Koumantaki Y, Matalliotakis I, Koumantakis E. Erythropoietin in the treatment of iron deficiency anemia during pregnancy. Gynecol Obstet Invest 2001 51(3) 150-6. 

Iron supplements are often used to treat iron-deficient anaemia. This might occur through severe haemorrhage, dietary deficiency or malabsorption of iron and in pregnancy. Supplements are usually salts of iron. Iron supplements may be administered orally, or sometimes by injection, in the form of ferrous fumarate, ferrous gluconate, ferrous glycine sulphate and ferrous sulphate. 

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