Alarming frequency and after effects of maternal anemia in Pakistan
Keywords:Anemia, fetus, maternal anemia, public awareness, Pakistan, nutritional deficiency, fetal growth
Anemia is caused due to usually iron based nutritional deficiency in blood. Its severity varies from mild to fatal. Recent reported data of Pakistan indicates that anemia cannot be ignored as it may affect fetus or maternal health or may cause death of any of them. The frequent symptoms are poor fetal growth, gastrointestinal bleeding, spontaneous abortion, low infant weight, less placental size and fetal or sometimes maternal death. Moreover, current data highlights that maternal anemia is common among females of province Sindh up to alarming level than in other provinces of Pakistan. As its diagnosis is usually delayed. People ignore the symptoms and still there is lack of awareness among masses. It should be controlled by government and concerned authorities by spreading general public awareness related to preventive measures, handling and cure of maternal anemia and to ensure the lives and health of both mother and developing fetus.
. World Health Organization (WHO). The Prevalence of Anemia in women: a tabulation of available information. Geneva, Switzerland: WHO; 1992/MCH/MSM/92.2.
. Kalaivani K, 2009. Prevalence & consequences of anemia in pregnancy. Indian J Med Res., 130 :627–33.
. Sabina S, S Iftequar, Z Zaheer, MM Khan and S Khan, 2015. An Overview of Anemia in Pregnancy. JIPBS, 2 (2): 144-151.
. Chowdhury S, M Rahman and ABM Moniruddin, 2014. Anemia in pregnancy. Medicine Today, 26(1): 49-52.
. Esmat B, R Mohammad, S Behnam, S Motaghipisheh, S Tayeri, M Arab, S Salahi and H Ali-Akbar, 2010. Prevalence of iron deficiency anemia among Iranian pregnant women. Journal of Reproduction and Infertility, 11(1): 17–24.
. Balarajan Y, U Ramakrishnan, E Ozaltin, AH Shankar and SV Subramanian, 2011. Anemia in low-income and middle-income countries. Lancet, 378 (9809): 2123–2135.
. Salhan S, V Tripathi, R Singh and HS Gaikwad, 2011. Evaluation of hematological parameters in partial exchange and packed cell transfusion in treatment of severe anemia in pregnancy. Anemia,1: 1-7.
. Issaragrisil S, DW Kaufman, T Anderson, K Chansung, PE Leaverton, S Shapiro, and NS Young, 2006. The epidemiology of aplastic anemia in Thailand. Blood, 107:1299–307.
. Montane E, L Ibanez, X Vidal, E Ballarín, R Puig, N García, JR Laporte, 2008. Epidemiology of aplastic anemia. Haematologica, 93: 518–23.
. Marsh JCW, SE Ball, J Cavenagh, P Darbyshire, I Dokal , EC Gordon‐Smith, J Keidan, A Laurie, A Martin, J Mercieca, SB Killick , R Stewart, JAL Yin, 2009. Guidelines for the diagnosis and management of aplastic anemia. Br J Haematol., 147: 43–70.
. Capoor I and J Gade, 2000. Paper presented at the World Congress on Women’s Health on November 10th, 11th & 12th, 2000 at Science City, Calcutta.
. Haider JA and RS Pobocik, 2009. Iron deficiency anemia is not a rare problem among women of reproductive ages in Ethiopia. BMC Blood Disord, 9(7): 1-8.
. Fatemeh M, E Nahid, G Sedigheh and M Jamileh, 2008. Prevalence of anemia risk factors in pregnant women in Kerman, Iran. Iranian Journal Of reproductive Medicine, 8(2): 66-69.
. Balarajan Y, U Ramakrishnan, E A-zaltin, AH Shankar and SV Subramanian, 2013. Anemia in low-income and middle-income countries. Lancet, 378 :0140-6736.
. Souza AI and M Batista-Filho, 2003. Diagnosis and treatment of nutritional anemia in pregnancy. Rev Bras Saúde Matern Infant., 3: 473-47.
. Gebremedhin S and F Enquselassie, 2005. Correlates of anemia among women of reproductive age in Ethiopia. Ethiopian J Health Dev., 25(1): 22-30.
. Verhoeff FH, BJ Brabin, L Chimsuku, P Kazembe and RL Broadhead, 1999. An analysis of the determinants of anemia in pregnant women in rural Malawi. Annals of Tropical Medicine and Parasitology, 93: 119-133.
. Bekele A, M Tilahun and A Mekuria, 2016. Prevalence of anemia and its associated factors among pregnant women attending antenatal care in health institutions of Arba Minch Town, Gamo Gofa Zone, Ethiopia. Anemia, 1: 1073-192.
. Lone FW, RN Qureshi and F Emanuel, 2004. Maternal anemia and its impact on perinatal outcome. Tropical Medicine & International Health, 9: 486-490.
. TDHS (2005) Tanzania Demographic and Health Survey 2004-2005. Dar es Salaam, Tanzania: National Bureau of Statistics and ORC Macro.
. Challis J, J Newnham, F Petraglia, M Yeganegi and A Bocking, 2013. Fetal sex and preterm birth. Placenta, 34: 95-9.
. Torricelli M, C Voltolini, FL Vellucci, N Conti, C Bocchi, FM Severi, JR Challis, R Smith and F Petraglia, 2013. Fetal gender effects on induction of labor in postdate pregnancies. Reprod Sci., 20: 670-4.
. Hercberg S, P Preziosi and P Galan, 2001. Iron deficiency in Europe. Public Health Nutr., 4(2B): 537–545.
. Zimmermann MB and RF Hurrell, 2007. Nutritional iron deficiency. Lancet, 370: 511–520.
. Congdon EL, A Westerlund, CR Algarin, D Patricio, Peirano, M Gregas, B Lozoff and CA Nelson, 2012. Iron deficiency in infancy is associated with altered neural correlates of recognition memory at 10 years. J. Pediatr.,160(6): 1027–1033.
. Antal A, S Keri and J Bodis-Wollner, 1997. Dopamine D2 receptor blockade alters the primary and cognitive components of visual evoked potentials in the monkey, Macaca fascicularis. Neurosci Lett., 232(3):179-81.
. Iqbal K, T Zafar, Z Iqbal, M Usman, H Bibi, MS Afreen and J Iqbal, 2015. Effect of iron deficiency anemia on intellectual performance of primary school children in Islamabad. Pakistan Tropical Journal of Pharmaceutical Research, 2: 287-291.
. Mandal AK, A Nicholas, E Wrigley, RE Hopkins, 2005. Case of aplastic anemia in pregnancy. J Obstetr Gynaecol., 25: 66– 7.
. Young NS, 2013. Current concepts in the pathophysiology and treatment of aplastic anemia. Education Program of the American Society of Hematology, 1: 76–81.
. Hameed H, A Hameed, S Bashir, S Akram, M Arshad and R Afzal, 2018. Study of prevalence of anemia among pregnant women and its correlation with different risk factors. Drug Designing, 7:1-5.
. Parks S, AMK Hoffman, ASS Goudar, BA Patel, CS Saleem, DSA Ali, DRL Goldenberg, EPL Hibberd, FJ Moore, GD Wallace, GEM Mcclure and Derman RJ, 2019. Maternal anemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan. BJOG,126(6): 737–743.
. Chaoui A, M Faid and R Belhcen, 2003. Effect of natural starters used for sourdough bread in Morocco on phytate biodegradation. East Mediterr Health J., 9: 141–7.
. Allen L, B de Benoist, O Dary and R Hurrel, 2006. Guidelines on food fortification with micronutrients. Geneva. World Health Organization.
. Shah FJ, A Fareed, WU Zakori, I Ullah, IU Haq and H Khan, 2018. Frequency and outcome of adolescent pregnancy in population of Peshawar. Pakistan Postgraduate Medical Journal, 29(1): 8-12.
. Bibi A, A Kakar, F Shahwani and F Iqbal,2019. Frequency of anemia in pregnant women of different age groups at Quetta: A hospital-based cross-sectional study. Pure Appl. Biol., 8(2): 1043-1050.
. Ervasti M, U Sankilampi, S Heinonen and K Punnonen, 2009. Early signs of maternal iron deficiency do not influence the iron status of the newborn but are associated with higher infant birthweight. Acta Obstet Gynecol Scand., 88: 83-90.
. Bánhidy F, N Acs, EH Puhó and AE Czeizel, 2011. Iron deficiency anemia: pregnancy outcomes with or without iron supplementation. Nutrition, 27: 65-72.
. Kaur M, AM Chauhan and MM Rajput, 2015. Maternal anemia and neonatal outcome, a prospective study on urban pregnant women. J Clin Diagn Res, 9: 4-8.
. Bo L, L Mei-Ying, Z Yang, W Shan-Mi and Z Xiao-Hong, 2016. Aplastic anemia associated with pregnancy. J Maternal Fetal and Neonatal Medicine, 29(7): 1122-1124.
. Pakistan Medical Research Council. National Health Survey of Pakistan 1990–94. Islamabad: Network Publishing Service, 1998.
. Seshadri S, 2001. Prevalence of micronutrient deficiency particularly of iron, zinc and folic acid in pregnant women in South East Asia. Br J Nutr., 85(2): S87–92.
. Harding KL, VM Aguayo, G Namirembe and P Webb, 2018. Matern Child Nutr.;14(S4): e12478: 1-13.
. Figueredo GF, Silva, Cruz and Pereira, 2018. Maternal anemia and iron deficiency anemia similarities and singularities. Health Care Current Reviews, 6 (1): 2375-4273.
. Cao C and KO O’Brien, 2013. Pregnancy and iron homeostasis: an update. Nutr. Rev., 71(1): 35–51.
. Burke RM, JS Leon and PS Sukhdev, 2014. Identification, prevention and treatment of iron deficiency during the first 1000 days. Nutrients, 6(10): 4093–4114.
. Matos JF, LMSA Dusse and KBG Gomes, 2012. Blood tests in microcytic and hypochromic anemia. J Bras Patol Med Lab., 48(4): 255-258.
. Casanova BF, MD Sammel and GA Macones, 2005. Development of a clinical prediction rule for iron deficiency anemia in pregnancy. Am J Obstet Gynecol., 193: 460-466.
. Black RE, CG Victora and SP Walker, 2013. Maternal and child under nutrition and overweight in low-income and middle-income countries. Lancet, 82: 427-451.
. Bencaiova G and C Breymann, 2014. Mild anemia and pregnancy outcome in a Swiss collective. J Pregnancy, 1: 1-7.
. Banjari I, D Kenjerić and ML Mandić, 2015. What is the real public health significance of iron deficiency and iron deficiency anemia in Croatia? A population-based observational study on pregnant women at early pregnancy from eastern Croatia. Cent Eur J Public Health, 23: 98-1.
. Menon KC, EL Ferguson and CD Thomson, 2016. Effects of anemia at different stages of gestation on infant outcomes. Nutrition, 32(1): 61-65.
. Bresani, CC, AL Souza and M Batista-Filho, 2007. Anemia and iron deficiency in pregnant women. Rev Bras Saúde Matern Infant, 7: S15-S21.
. Qi L, RM Van Dam and K Rexrode, 2007. Heme iron from diet as a risk factor for coronary heart disease in women with type 2 diabetes. Diabetes Care, 30: 101-106.
. Donovan A, C Roy and N Andrews, 2006. The ins and outs of iron homeostasis. Physiology, 21: 115-23.
. Bresani CC, MC Braga and DF Felisberto, 2013. Accuracy of erythrogram and serum ferritin for the maternal anemia diagnosis (AMA): A phase 3 diagnostic study on prediction of the therapeutic responsiveness to oral iron in pregnancy. BMC Pregnancy Childbirth, 13: 13.
. Hoffbrand A, F Pettit and P Moss, 2006. Essential hematology. 5th edition.
Malden, Mass.; Oxford: Blackwell Pub., - Essential series. pp: 346-51.
. Ansari NB, SH Badruddin, R Karmaliani, H Harris, I Jehan, O Pasha, N Moss, EM McClure and L Robert, 2008. Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food and Nutrition Bulletin, 29(2): 132-139.
. Rizwan F, Qamarunisa, Habibullah and A Memon, 2010. Prevalence of anemia in pregnant women and its effects on maternal and fetal morbidity and mortality. Pak J Med Sci, 26(1):92-95.
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