Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors

Alper Basbug; Cemil İsik Sonmez

doi:10.22391/fppc.430110

Research Article

Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors

Year 2018, Volume: 3 Issue: 3, 108 - 112, 04.10.2018

Alper Basbug , Cemil İsik Sonmez

https://doi.org/10.22391/fppc.430110

Cited By: 2

Abstract

Introduction: Adolescent
pregnancies and their maternal and fetal complications are a global health
burden. Iron deficiency anemia is among the factors, which might contribute to
these negative consequences. In this study, we aimed to evaluate the frequency
of iron deficiency anemia among pregnant adolescents followed at the Düzce
University Medical Faculty Hospital and to investigate its maternal and fetal
effects.

Methods: A total
of 122 pregnant women under 19 years of age were included in this case-control
study. The socio-economic characteristics, hematological status, and adverse
maternal and perinatal outcomes possibly related to iron deficiency anemia were
evaluated.

Results: The incidence of anemia among the studied women was 29.5%, and 56.5%
were receiving iron supplementation. Oral iron supplementation rate was 33.3%
in the anemic group and 66.2% in the non-anemic group (p = 0.01). While the
serum ferritin and hemoglobin levels were lower in the anemic group, iron
binding capacity was lower in the non-anemic group, and the difference between
the groups was statistically significant (p = 0.01, p = 0.01, and p = 0.02;
respectively). Concerning adverse perinatal outcomes, preeclampsia was seen in
11.4% of the anemic group and 4.6% in the non-anemic group; the difference was
statistically significant (p = 0.01).

Conclusions: Iron deficiency anemia is a common problem in adolescent pregnancy.
However, many anemic pregnant adolescents do not receive iron treatment.
Positive effects on some maternal and perinatal outcomes can be achieved by
administering iron supplementation to these women. Iron use should be increased
to combat iron deficiency anemia during pregnancy.

Keywords

Adolescent pregnancy , anemia , iron deficiency

References

Goonewardene M, Shehata M, Hamad A. Anemia in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2012;26:3-24. doi: https://doi.org/10.1016/j.bpobgyn.2011.10.010
McLean E, Cogswell M, Egli I, Wojdyla D, De Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr. 2009; 12: 444-54. doi: https://doi.org/10.1017/S1368980008002401
Clark SF. Iron deficiency anemia. Nutr Clin Pract 2008;23:128–41. doi: https://doi.org/10.1177/0884533608314536
Scholl TO. Maternal iron status: relation to fetal growth, length of gestation, and iron endowment of the neonate. Nutr Rev 2011; 69: 23–9. doi: https://doi.org/10.1111/j.1753-4887.2011.00429
Balarajan Y, Ramakrishnan U, Ozaltin E, et al. Anaemia in low income and middle-income countries. Lancet 2011;378:2123–35. doi: https://doi.org/10.1016/S0140-6736(10)62304-5
de Sa SA, Willner E, Duraes Pereira TA, et al. Anemia in pregnancy: impact on weight and in the development of anemia in newborn. Nutr Hosp 2015;32:2071–9. doi: https://doi.org/10.3305/nh.2015.32.5.9186
Kozuki N, Lee AC, Katz J, Child Health Epidemiology Reference Group. Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes. J Nutr. 2012;142:358–62. doi: https://doi.org/10.3945/jn.111.149237
Sekhar DL, Murray-Kolb LE, Kunselman AR, et al. Differences in risk factors for anemia between adolescent and adult women. J Womens Health (Larchmt) 2016;25:505–13. doi: https://doi..org/10.1089/jwh.2015.5449
WHO. Iron deficiency anaemia: assessment, prevention, and control: a guide for programme managers. Geneva: United Nations Children’s Fund, and United Nations University (WHO/UNICEF/UNU); 2001.
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and mineral nutrition information system. Geneva (Switzerland): World Health Organization; 2011
World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation Part 1: Diagnosis and Classification of Diabetes Mellitus.2nd ed. Geneva, Switzerland: World Health Organization; 1999. (WHO/NCD/NCS/99).
Gardosi J, Mongelli M, Wilcox M, Chang A. An adjustable Fetal Weight Standard. Ultrasound Obstet Gynecol 1995;6:168–74. WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.
Milman N, Taylor CL, Merkel J, Brannon P. Iron status in pregnant women and women of reproductive age in Europe. American J Clin Nutr. 2017; 106:1655–62. doi: https://doi.org/10.3945/ajcn.117.156000
Pinho-Pompeu M, Surita FG, Pastore DA, Paulino DSM, Pinto E Silva JL. Anemia in pregnant adolescents: impact of treatment on perinatal outcomes. J Matern Fetal Neonatal Med. 2017;30:1158-62. doi: https://doi.org/10.1080/14767058.2016.1205032
van den Broek NR, Jean-Baptiste R, Neilson JP. Factors associated with preterm, early preterm and late preterm birth in Malawi. PLoS One 2014;9:e90128. doi: https://doi.org/10.1371/journal.pone.0090128
Smithers LG, Gialamas A, Scheil W, et al. Anaemia of pregnancy, perinatal outcomes and children's developmental vulnerability: a whole-of-population study. Paediatr Perinat Epidemiol 2014; 28: 381–90. doi: https://doi.org/10.1111/ppe.12149
Räisänen S, Kancherla V, Gissler M, et al. Adverse perinatal outcomes associated with moderate or severe maternal anaemia based on parity in Finland during 2006-10. Paediatr Perinat Epidemiol 2014;28:372–80. doi: https://doi.org/10.1111/ppe.12134
Bencaiova G, Breymann C. Mild Anemia and Pregnancy Outcome in a Swiss Collective. Journal of Pregnancy. 2014;2014:307535. doi: https://doi.org/10.1155/2014/307535
Gambling L, Kennedy C, McArdle HJ. Iron and copper in fetal development. Semin Cell Dev Biol. 2011; 22: 637–44. doi: https://doi.org/10.1016/j.semcdb.2011.08.011
Chandra-Mouli V, Camacho AV, Michaud PA. WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. J Adolesc Health 2013;52:517–22. doi: https://doi.org/10.1016/j.jadohealth.2013.03.002
Kaya A.E , Başbuğ A, Sönmez C.I, Barut C, Şengün Y , Çağlar M. Late Adolescent Pregnancies, Maternal and Fetal Outcomes. Family Practice & Palliative Care. 2017; 2: 22-27. doi: https://doi.org/10.22391/920.327993
Mahavarkar SH, Madhu CK, Mule VD. A comparative study of teenage pregnancy. J Obstet Gynaecol 2008; 28: 604–7. doi: https://doi.org/10.1080/01443610802281831
Pena-Rosas JP, De-Regil LM, Dowswell T, Viteri FE. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev 2012; 12: CD004736. doi: https://doi.org/10.1002/14651858.CD004736
Ziaei S, Norrozi M, Faghihzadeh S, Jafarbegloo E. A randomised placebo controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin > or = 13.2 g/dl. BJOG 2007; 114:684–8. doi: https://doi.org/10.1111/j.1471-0528.2007.01325
Shastri L, Mishra PE, Dwarkanath P, Thomas T, Duggan C, Bosch R, McDonald CM, Thomas A, Kurpad AV. Association of oral iron supplementation with birth outcomes in non-anaemic South Indian pregnant women. Eur J Clin Nutr 2015;69:609–13. doi: https://doi.org/10.1038/ejcn.2014.248
Timur H, Kokanalı MK, Topçu HO, et al. Factors that affect perinatal outcomes of the second pregnancy of adolescents. J Pediatr Adolesc Gynecol 2016;29:18–21. doi: https://doi.org/10.1016/j.jpag.2015.05.002

Adölesan gebelerde demir eksikliği anemisi; ilişkili faktörler ve etkilerinin incelenmesi

Year 2018, Volume: 3 Issue: 3, 108 - 112, 04.10.2018

Alper Basbug , Cemil İsik Sonmez

https://doi.org/10.22391/fppc.430110

Cited By: 2

Abstract

Giriş: Adölesan gebelikler ve bu gebeliklerde
görülen maternal ve fetal olumsuz sonuçlar küresel bir sağlık problemidir.
Demir eksikliği anemisi ise bu olumsuz sonuçlara neden olabilecek faktörler
arasında gösterilmektedir. Biz bu çalışma ile Düzce Üniversitesi Tıp Fakültesi
Hastanesinde takip edilmiş adölesan gebeler arasındaki demir eksikliği anemisi
sıklığını, bununla ilişikli olabilecek demografik ve sosyo-ekonomik özellikleri
ve adölesan gebeliklerde görülen demir eksikliği anemisinin maternal ve fetal
sonuçlar üzerine olan etkisini değerlendirmeyi amaçladık.

Yöntem: Retrospektif vaka-kontrol
niteliğindeki bu çalışmaya Düzce Üniversitesi Tıp Fakültesi Kadın Hastalıkları
ve Doğum Kliniğine başvuran 19 yaş altındaki toplam 122 gebe dahil edildi.
Gebelerin sosyo-ekonomik özellikleri, hematolojik durumları ve demir eksikliği
anemisi ile ilişkili olabilecek olumsuz maternal ve perinatal sonuçları
değerlendirildi.

Bulgular: Çalışmaya dahil edilen
kadınlar arasında anemi görülme oranı %29,5’di ve demir suplemantasyonu alan
kadın oranı %56,5’di. Anemik grupta oral demir suplemantasyon oranı %33,3 iken
non-anemik grupta %66,2 idi (p=0,01). Serum ferritin, hemoglobin değerleri
anemik grupta daha düşük iken, demir bağlama kapasitesi non-anemik grupta daha
düşüktü ve gruplar arasındaki fark istatistiksel olarak anlamlıydı (p=0,01,
p=0,01, p=0,02; sırasıyla). Olumsuz perinatal sonuçlar açısından yalnızca
preeklampsi; anemik grupta %11.4 oranında görülürken, non-anemik grupta %4,6
oranında görüldü. Gruplar arasındaki fark istatistiksel olarak anlamlıydı (p=0,01).

Sonuç: Adölesan gebelikte demir eksikliği anemisi sık karşılaşılan bir
sorundur. Buna rağmen birçok anemik adölesan gebe demir tedavisi
almamaktadır. Demir eksikliği anemisi,
demir suplemantasyonu ile tedavi edilirse bazı maternal ve perinatal sonuçlar
üzerine olumlu etkileri olabilir. Gebelikte demir eksikliği anemisi ile
mücadele için demir kullanımının yaygınlaştırılması gerekmektedir.

Keywords

Adölesan gebelik , anemi , demir eksikliği

References

Goonewardene M, Shehata M, Hamad A. Anemia in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2012;26:3-24. doi: https://doi.org/10.1016/j.bpobgyn.2011.10.010
McLean E, Cogswell M, Egli I, Wojdyla D, De Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr. 2009; 12: 444-54. doi: https://doi.org/10.1017/S1368980008002401
Clark SF. Iron deficiency anemia. Nutr Clin Pract 2008;23:128–41. doi: https://doi.org/10.1177/0884533608314536
Scholl TO. Maternal iron status: relation to fetal growth, length of gestation, and iron endowment of the neonate. Nutr Rev 2011; 69: 23–9. doi: https://doi.org/10.1111/j.1753-4887.2011.00429
Balarajan Y, Ramakrishnan U, Ozaltin E, et al. Anaemia in low income and middle-income countries. Lancet 2011;378:2123–35. doi: https://doi.org/10.1016/S0140-6736(10)62304-5
de Sa SA, Willner E, Duraes Pereira TA, et al. Anemia in pregnancy: impact on weight and in the development of anemia in newborn. Nutr Hosp 2015;32:2071–9. doi: https://doi.org/10.3305/nh.2015.32.5.9186
Kozuki N, Lee AC, Katz J, Child Health Epidemiology Reference Group. Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes. J Nutr. 2012;142:358–62. doi: https://doi.org/10.3945/jn.111.149237
Sekhar DL, Murray-Kolb LE, Kunselman AR, et al. Differences in risk factors for anemia between adolescent and adult women. J Womens Health (Larchmt) 2016;25:505–13. doi: https://doi..org/10.1089/jwh.2015.5449
WHO. Iron deficiency anaemia: assessment, prevention, and control: a guide for programme managers. Geneva: United Nations Children’s Fund, and United Nations University (WHO/UNICEF/UNU); 2001.
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and mineral nutrition information system. Geneva (Switzerland): World Health Organization; 2011
World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation Part 1: Diagnosis and Classification of Diabetes Mellitus.2nd ed. Geneva, Switzerland: World Health Organization; 1999. (WHO/NCD/NCS/99).
Gardosi J, Mongelli M, Wilcox M, Chang A. An adjustable Fetal Weight Standard. Ultrasound Obstet Gynecol 1995;6:168–74. WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.
Milman N, Taylor CL, Merkel J, Brannon P. Iron status in pregnant women and women of reproductive age in Europe. American J Clin Nutr. 2017; 106:1655–62. doi: https://doi.org/10.3945/ajcn.117.156000
Pinho-Pompeu M, Surita FG, Pastore DA, Paulino DSM, Pinto E Silva JL. Anemia in pregnant adolescents: impact of treatment on perinatal outcomes. J Matern Fetal Neonatal Med. 2017;30:1158-62. doi: https://doi.org/10.1080/14767058.2016.1205032
van den Broek NR, Jean-Baptiste R, Neilson JP. Factors associated with preterm, early preterm and late preterm birth in Malawi. PLoS One 2014;9:e90128. doi: https://doi.org/10.1371/journal.pone.0090128
Smithers LG, Gialamas A, Scheil W, et al. Anaemia of pregnancy, perinatal outcomes and children's developmental vulnerability: a whole-of-population study. Paediatr Perinat Epidemiol 2014; 28: 381–90. doi: https://doi.org/10.1111/ppe.12149
Räisänen S, Kancherla V, Gissler M, et al. Adverse perinatal outcomes associated with moderate or severe maternal anaemia based on parity in Finland during 2006-10. Paediatr Perinat Epidemiol 2014;28:372–80. doi: https://doi.org/10.1111/ppe.12134
Bencaiova G, Breymann C. Mild Anemia and Pregnancy Outcome in a Swiss Collective. Journal of Pregnancy. 2014;2014:307535. doi: https://doi.org/10.1155/2014/307535
Gambling L, Kennedy C, McArdle HJ. Iron and copper in fetal development. Semin Cell Dev Biol. 2011; 22: 637–44. doi: https://doi.org/10.1016/j.semcdb.2011.08.011
Chandra-Mouli V, Camacho AV, Michaud PA. WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. J Adolesc Health 2013;52:517–22. doi: https://doi.org/10.1016/j.jadohealth.2013.03.002
Kaya A.E , Başbuğ A, Sönmez C.I, Barut C, Şengün Y , Çağlar M. Late Adolescent Pregnancies, Maternal and Fetal Outcomes. Family Practice & Palliative Care. 2017; 2: 22-27. doi: https://doi.org/10.22391/920.327993
Mahavarkar SH, Madhu CK, Mule VD. A comparative study of teenage pregnancy. J Obstet Gynaecol 2008; 28: 604–7. doi: https://doi.org/10.1080/01443610802281831
Pena-Rosas JP, De-Regil LM, Dowswell T, Viteri FE. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev 2012; 12: CD004736. doi: https://doi.org/10.1002/14651858.CD004736
Ziaei S, Norrozi M, Faghihzadeh S, Jafarbegloo E. A randomised placebo controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin > or = 13.2 g/dl. BJOG 2007; 114:684–8. doi: https://doi.org/10.1111/j.1471-0528.2007.01325
Shastri L, Mishra PE, Dwarkanath P, Thomas T, Duggan C, Bosch R, McDonald CM, Thomas A, Kurpad AV. Association of oral iron supplementation with birth outcomes in non-anaemic South Indian pregnant women. Eur J Clin Nutr 2015;69:609–13. doi: https://doi.org/10.1038/ejcn.2014.248
Timur H, Kokanalı MK, Topçu HO, et al. Factors that affect perinatal outcomes of the second pregnancy of adolescents. J Pediatr Adolesc Gynecol 2016;29:18–21. doi: https://doi.org/10.1016/j.jpag.2015.05.002

There are 26 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Research
Authors	Alper Basbug 0000-0003-1825-9849 Cemil İsik Sonmez 0000-0001-7854-3804
Publication Date	October 4, 2018
Submission Date	June 3, 2018
Acceptance Date	September 25, 2018
Published in Issue	Year 2018 Volume: 3 Issue: 3

Cite

APA	Basbug, A., & Sonmez, C. İ. (2018). Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors. Family Practice and Palliative Care, 3(3), 108-112. https://doi.org/10.22391/fppc.430110
AMA	Basbug A, Sonmez Cİ. Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors. Fam Pract Palliat Care. October 2018;3(3):108-112. doi:10.22391/fppc.430110
Chicago	Basbug, Alper, and Cemil İsik Sonmez. “Iron Deficiency Anemia in Adolescent Pregnancy: Investigation of Its Effects and the Related Factors”. Family Practice and Palliative Care 3, no. 3 (October 2018): 108-12. https://doi.org/10.22391/fppc.430110.
EndNote	Basbug A, Sonmez Cİ (October 1, 2018) Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors. Family Practice and Palliative Care 3 3 108–112.
IEEE	A. Basbug and C. İ. Sonmez, “Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors”, Fam Pract Palliat Care, vol. 3, no. 3, pp. 108–112, 2018, doi: 10.22391/fppc.430110.
ISNAD	Basbug, Alper - Sonmez, Cemil İsik. “Iron Deficiency Anemia in Adolescent Pregnancy: Investigation of Its Effects and the Related Factors”. Family Practice and Palliative Care 3/3 (October2018), 108-112. https://doi.org/10.22391/fppc.430110.
JAMA	Basbug A, Sonmez Cİ. Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors. Fam Pract Palliat Care. 2018;3:108–112.
MLA	Basbug, Alper and Cemil İsik Sonmez. “Iron Deficiency Anemia in Adolescent Pregnancy: Investigation of Its Effects and the Related Factors”. Family Practice and Palliative Care, vol. 3, no. 3, 2018, pp. 108-12, doi:10.22391/fppc.430110.
Vancouver	Basbug A, Sonmez Cİ. Iron deficiency anemia in adolescent pregnancy: investigation of its effects and the related factors. Fam Pract Palliat Care. 2018;3(3):108-12.