Iron deficiency anaemia and pregnancy

The iron deficiency anaemia has become such a vexed problem in the Asian countries that it poses a threat not only to the present generations, but also to the future ones. The average anaemia level among women of reproductive age comprises 60% in South Asia and 42% in Southeast Asia. The issue of iron deficiency prevention does also require the implementation of serious and immediate actions for the future of our state.
 
The adverse effects of the iron deficiency for women of childbearing age can be characterized by the fact that it leads to a major increase in maternal, prenatal and perinatal infant mortality and prematurity. The favorable pregnancy outcomes rate for anaemic mothers is 30-40% less,  compared to mothers with normal iron level in the body, whereas the death chance during childbirth among women with anaemia is 5-10 times higher than those of without anaemia.
 
According to various authors, women lose approximately 1200 mg of iron on the average throughout the whole pregnancy period, of which 280 mg are consumed by the fetus, and 90 mg - by the umbilical cord and placenta. Blood loss comprises 150 mg, whereas basal losses due to desquamation of the epithelium compile 230 mg. 450 mg is lost due to expansion of the total volume of red blood cells. The organism is able to restore the iron stores within 4-5 years. In case if a woman gives birth to a child before that period, the anaemia will inevitably develop in her body. The iron deficiency does inevitably occur among women with more than 4 children.
 
According to current data, all the women, without any exception, in their late pregnancy do have the iron deficiency developing in the hidden or explicit form. Not only does anaemia among pregnant women cause low birth weight, premature birth, bleeding during childbirth, but also leads to the weakening of both mother’s and newborn’s body resistance to infections. The pregnant women with iron deficiency are more susceptible to infectious diseases. This can be explained by the fact that iron contributes to the growth of nerve cells, collagen synthesis, the metabolism of porphyrin terminal oxidation and oxidative phosphorylation in cells of the immune system.
 
The majority of babies born from anaemic mothers (57%) have a lower level of hemoglobin. Anaemia does often occur among infants and little kids due to rapid growth, which, in its turn, leads to a sharp increase in demand for iron. The iron deficiency anaemia can inhibit the psychomotor development of the child during the pregnancy or the early childhood period.

Likewise, the scientists found out that the fetus has less evident severity of anaemia than that of his mother. This is due to enhanced expression of placental proteins involved in the transportation of iron to the fetus, whose mother has an anemia(upregulation). That, in its turn, leads to increased efficiency of iron transportation and minimizes the severity of fetal anaemia. The enzyme systems of the brain are also affected during the iron deficiency. Thus, the iron deficiency may impair the cognitive ability of a person at any age. If this occurs during infancy or early childhood, the consequence might be irreversible. These statements can be supported by the researches made in Chile, Guatemala, Indonesia, Egypt, Thailand, and United States. Not only is the physical development of children and youth affected by such changes, but also the mental development is influenced thus reducing the intellectual potential of the country.
 
The iron loss with lactation usually occurs after the birth. The daily loss of iron with the breast milk is estimated to 0,1 mg, 0,28 mg and 0,27 mg during the first, second, third month of breastfeeding. If the breastfeeding lasts longer than 6 months, the iron loss with the breast milk is likely to start affecting the overall status of iron nursing mother.
 
Up to the present moment, none of the world countries has fully solved the problem of anaemia, which still remains one of the most serious issues.