Dr. (Prof.) Gita Ganguly Mukherjee, DGO, MD, FICOG, FRCOG, Former Prof. & Head, Department of Gynaecology & Obstetrics , R G Kar Medical College & Hospital, Kolkata. While comparing education levels and standard of living to the prevalence of Anaemia across different socio economic groups, this talk covers barriers to good nutrition during pregnancy such as social isolation and fear of weight gain. Using West Bengal as an example, Dr. Gita points that income levels and literacy have a direct co-relation with the number of Anaemia patients in a particular region. The talk goes on to cover a clinical presentation while showcasing the consequences and effects on mothers during pregnancy. She highlights the possible treatments available for Anaemia while sharing that early detection and comprehensive antenatal care can go a long way in preventing adverse pregnancy outcomes.
Anaemia in pregnancy is the most common disorder of the blood during pregnancy. It’s an indicator of both poor nutrition and poor health. Iron deficiency Anaemia (IDA) is the most important contributing factor to global burden of the disease. In India, Anaemia is the second most common cause of maternal deaths, accounting for 20% of total maternal deaths. In pregnancy the Hb concentration and Hct decline during the first and second trimesters because of an expanding blood volume. Without iron supplements, Hb concentration and Hct also remain low in the third trimester. But with adequate iron intake, Hb concentration and Hct gradually rise during the third trimester toward the pre pregnancy levels. According to WHO review (from 1993 to 2005) 42% of pregnant women have Anaemia worldwide. Almost 90% of anaemic women reside in Africa or Asia. Prevalence of anaemia is 76.5% in pregnant women in Nigeria. Iron deficiency is the most common deficiency state. In India various studies from different region of the country reported prevalence of Anaemia between 33 and 100%. Rural area of Delhi prevalence is 96.5%. Maharashtra one of the developed states in India has 56.4% (Rural Maharashtra). The most common type of anaemia is Microcytic hypochromic.
There are various causes of anaemia during pregnancy. The nutritional factors are iron deficiency, Folic acid deficiency. The main reasons for IDA are low intake of iron, destroying iron and other nutrients in food by excessive cooking, poor absorption of iron from diets high in phytate or phenolic compounds. There is blood loss as a result of parasite infections such as hookworms, ascaris, and schistosomiasis ad haemorrhoids or GI bleeds.
Anemia during pregnancy is potentially life-threatening condition. Contribute high maternal mortality, nigh perinatal mortality and LBW infant globally and in India. Early detection and mandatory comprehensive antenatal care can only prevent and reduce high MMK, prevent adverse maternal and pregnancy outcomes. Clear arid simple recommendations For HCPs for the diagnosis, treatment and prevention of Iron deficiency during pregnancy and postpartum period. Iron folate, multi-micronutrient supplementation can improve outcome. Public health programs, such as helminth control, malaria prophylaxis and iron fortification of foods, compulsory Iron -folate supplementation important in developing countries. Community and individual approaches both are essential and interdependent.