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Anne ve Bebek Kordon Kanı Kan Sayımı ve Ferritin Değerlerinin İnfantta 4. Ayda Anemi, 6. Ayda Nörogelişim Üzerine Etkisi

Yıl 2019, Cilt: 5 Sayı: 3, 408 - 416, 01.01.2019

Öz

Amaç: Erken dönem demir eksikliğinin infantın kognitif fonksiyonlarını olumsuz etkilediği gösterilmiştir. Çalışmayla anne demir durumunun, yenidoğan ve süt çocuğu demir durumu ve anemisi ile erken dönem kognitif fonksiyonlar üzerine etkisini görmeyi amaçladık.Gereç ve Yöntemler: Çalışmamıza Şubat 2013-Mart 2013 tarihleri arasında İzmir Ege Doğumevi’nde 37-42 gestasyon haftaları arasında doğum yapan 59 gebe ve 4 ay sadece anne sütü alan bebekleri dahil edildi. Annelerin doğumdan önceki son 24 saat içinde alınan kan sayımı ve ferritin düzeyleri ve doğumdan hemen sonra kordondan alınan kan sayımı ve ferritin düzeyleri ile bebeklerin 4. ay kan sayımı ve ferritin düzeyleri karşılaştırıldı. Tüm bebeklere 6. aylarında Bayley gelişim testi uygulandı.Bulgular: Yirmisekiz annede demir eksikliği anemisi, 15 annede demir eksikliği saptanırken 16 annede demir depoları yeterli tespit edildi. Demir eksikliği anemisi olan annelerin bebeklerinin kordon kanı Hb, Hct ve Rbc değerleri daha düşük bulundu. Bebeklerin 4 aylık değerlendirilmesinde, demir eksikliği anemisi olan anne bebeklerinde anemi görülme oranı anlamlı yüksekti. Bebekler altı aylıkken yapılan Bayley gelişim testi değerlendirmesi bütün infantlar arasında benzerdi.Sonuç: Demir eksikliği anemisi olan anne bebeklerinde 4. ayda anemi görülme oranı, demir depoları

Kaynakça

  • Benoist B, McLean E, Egli I, Cogswell M. World wide prevalence of anaemia 1993-2005. Geneva: World Health Organisation, 2008.
  • Glader B. The Anemias In: Kliegman R, Behrman R, Jenson H, Stanton B. Nelson Textbook of Pediatrics 18th edition. Philadelphia: WB Saunders, 2008: Cilt 2:1014-6.
  • Ağaoğlu L. Kan hastalıkları. Neyzi O, Ertuğrul T. eds. Pediatri, İstanbul: Nobel Tıp Kitapevleri, 2002: Cilt 2: 1051-4.
  • Dallman PR, Yip R, Oski A. İron deficiency and related nutritional anemias. In: Nathan DG. Oski FA eds. Hematology of Infancy and Childhood, 5th ed. Philadelphia: WB Saunders 1998:430-76.
  • Lipschitz DA, Cook JD, Finch CA. A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med 1974;290(22):1213-6.
  • Prasad AN, Prasad C. Iron deficiency; non-hematological manifestations. Prog Food Nutr Sci 1991;15:255-83.
  • Toppare FM. Genel obstetrik-fetal fizyoloji, erken neonatal fizyoloji. Temel Kadın Hastalıkları ve Doğum Bilgisi 1996;2:233-7.
  • Rao R, Georgieff MK. Neonatal iron nutrition. Semin Neonatal 2001;6(5):425-35.
  • Rao R, Georgieff MK. Perinatal aspects of iron metabolism. Acta Pediatr Suppl 2002;91(438):124-9.
  • Kaleli B, Yıldırım B. Gebelik ve Hematolojik Hastalıklar Obstetrik; Maternal-Fetal Tıp ve Perinatoloji. Ankara: Medikal Network, 2001;682-96.
  • Kimya Y, Cengiz C. Gebeliğe bağlı annedeki sistemik değişiklikler. Obstetrik-Maternal-Fetal Tıp ve Perinatoloji. Ankara Medikal Network, 2001:676-81.
  • Yenicesu İ. Gebelik ve Anemi. Obstetrik-Maternal-Fetal Tıp ve Perinatoloji. Ankara Medikal Network, 2001:697- 701.
  • Bayley N. Bayley Scales of infant development. New York, NY: Psychological Corp: 1969.
  • Bayley N. Bayley Scales of Infant Development. 2nd ed. San Antonio, TX: Psychological Corp: 1993.
  • Hack M, Taylor HG, Drotar D, Schluchter M, Cartar L, Wilson-Costello D, Klein N, Friedman H, Mercuri- Minich N, Morrow M. Poor predictive validity of the Bayley Scales of infant development for cognitive function of extremely low birth weight children at school age. Pediatrics 2005;116:333-41.
  • T.C. Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. Gebelerde Demir Destek Proğramı. Ankara: 2007.
  • Harthoorn-Lasthuizen EJ, Lindemans J, Langenhuijsen MM. Does iron-deficient erythropoiesis in pregnancy influence fetal iron supply? Acta Obstet Gynecol Scand 2001;80(5):392-6.
  • Aqrawal RM, Tripathi AM, Aqarwal KN. Cord blood haemoglobin, iron and ferritin status in maternal anaemia. Acta Paediatr Scand 1983;72:545-8.
  • Karasalihoğlu S, Orhaner B, Özaydın E, Kirimi E, Karaca M, Kitapçıoğlu F. The comparison of the hematologic parameters newborns of mothers with sufficient and unsufficient iron stores. T Klinikleri Pediatr 1996;5:10-3.
  • Erdem A, Erden M, Arslan M, Yazıcı G, Eskanderi R, Himmetoğlu D. The effect maternal anemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborn. Maternal Fetal Neonatal Med 2002;11:329-32.
  • Shao J, Lou J, Rao R, et al. Maternal serum ferritin concentration is positively associated with newborn iron stores in women with low ferritin status in late pregnancy. J. Nutr 2012;142:2004-9.
  • Andrews NC, Ullrich CK, Fleming MD. Disorders of iron metabolism and sideroblastic anemia. In: Orkin SH, Nathan DG eds. Nathanand Oski’s Hematology of Infancy and Childhood. 7th ed. Canada: Elsevier Inc, 2009;522-50.
  • Kilbride J, Baker TG, Parapia LA, Khoury SA, Shuqaidef SW, Jerwood D. Anaemia during pregnancy as a risk factor for iron-deficiency anaemia in infancy: A case- control study in Jordan. Int J Epidemiol 1999;28:461-8.
  • Hurtado EK, Claussen AH, Scott KG. Early childhood anemia and mild or moderate mental retardation. Am J Clin Nutr 1999;69:115-9.
  • Pollitt E. Iron deficiency and cognitive function. Annu Rev Nutr 1993;13:521-37.
  • Beard JL, Connor JR, Jones BC. Iron in the brain. Nutr Rev 1993;51:157-70.
  • Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 2001; 107: 1381-6.
  • Lozoff B, Jimenez E, Wolf AW. Long-term developmental outcome of infants with iron deficiency. N Engl J Med 1991;325:687-94.
  • Tamura T, Goldenberg RL, Hou J, Cliver SP, Ramey SL. Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age. J Pediatr 2002;140(2):165-70.
  • Walter T, De Andraca I, Chadud P, Perales CG. Iron deficiency anemia: Adverse effects on infant psychomotor development. Pediatrics 1989;84:7-17.
  • Lozoff B, Wolf AW, Jimenez E. Iron-deficiency anemia and infant development: effects of extended oral iron therapy. J. Pediatr 1996;129:382-9.
  • Deinard AS, List A, Lindgren B, Hunt JV, Chang PN. Cognitive deficits in iron-deficient and iron-deficient anemic children. J Pediatr 1986;108:681-9.
  • Lozoff B, Brittenham GM, Wolf AW, McClish DK, Kuhnert PM, Jimenez E. Iron deficiency anemia and iron therapy effects on infant developmental test performance. Pediatrics 1987;79:981-95.
  • Mireku MO, Davidson LL, Boivin MJ, et al. Prenatal iron deficiency, neonatal ferritin, and infant cognitive function. Pediatrics 2016;138(6):e20161319.
  • Moffatt ME, Longstaffe S, Besant J, Dureski C: Prevention of iron deficiency and psychomotor decline in high-risk infants through use of iron-fortified infant formula: A randomized clinical trial. J Pediatr 1994;125:527-34.

The Effects of Complete Blood Count and Ferritin Values from the Mother and the Umbilical Cord Blood on the Infant’s Anemia at the 4th Month and Neurodevelopment at the 6th Month

Yıl 2019, Cilt: 5 Sayı: 3, 408 - 416, 01.01.2019

Öz

Objective: Studies have shown that early iron deficiency ID in infants has adverse effects on cognitive function. The aim of the study was to determine the relationship between maternal iron status and newborn/infant iron status and the effect of anemia on cognitive functions in the early stage of the infancy.Material and Methods: The study was conducted during February-March 2013 at the Izmir Aegean Obstetrics Hospital and 59 pregnant women and their infants, between 37-42 weeks of gestation and who had been exclusively breastfed for 4 months, were included. Complete blood count and serum ferritin levels of the mothers within 24 hours before the delivery and complete blood count and serum ferritin level of the cord blood just after birth were compared with the complete blood count and ferritin levels at the 4th month. The Bayley Development Test BDT was administered to the infants at the 6th month of life.Results: Twenty-eight mothers had iron deficiency anemia IDA , 15 had iron deficiency ID , and 16 had adequate iron storage. The cord blood Hb, Htc and RBC values were significantly lower in infants whose mothers had IDA. Evaluation of the infants at the 4th month regarding the presence of anemia revealed that the infants of mothers with IDA had significantly higher anemia rates. The results of the BDT performed at six months were similar among all infants.Conclusion: IDA rates at the 4th month of the life were higher among infants of mothers with anemia. The presence of anemia in infants was associated with maternal iron status. The study also showed that IDA does not affect BDT results at the early stages of infancy

Kaynakça

  • Benoist B, McLean E, Egli I, Cogswell M. World wide prevalence of anaemia 1993-2005. Geneva: World Health Organisation, 2008.
  • Glader B. The Anemias In: Kliegman R, Behrman R, Jenson H, Stanton B. Nelson Textbook of Pediatrics 18th edition. Philadelphia: WB Saunders, 2008: Cilt 2:1014-6.
  • Ağaoğlu L. Kan hastalıkları. Neyzi O, Ertuğrul T. eds. Pediatri, İstanbul: Nobel Tıp Kitapevleri, 2002: Cilt 2: 1051-4.
  • Dallman PR, Yip R, Oski A. İron deficiency and related nutritional anemias. In: Nathan DG. Oski FA eds. Hematology of Infancy and Childhood, 5th ed. Philadelphia: WB Saunders 1998:430-76.
  • Lipschitz DA, Cook JD, Finch CA. A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med 1974;290(22):1213-6.
  • Prasad AN, Prasad C. Iron deficiency; non-hematological manifestations. Prog Food Nutr Sci 1991;15:255-83.
  • Toppare FM. Genel obstetrik-fetal fizyoloji, erken neonatal fizyoloji. Temel Kadın Hastalıkları ve Doğum Bilgisi 1996;2:233-7.
  • Rao R, Georgieff MK. Neonatal iron nutrition. Semin Neonatal 2001;6(5):425-35.
  • Rao R, Georgieff MK. Perinatal aspects of iron metabolism. Acta Pediatr Suppl 2002;91(438):124-9.
  • Kaleli B, Yıldırım B. Gebelik ve Hematolojik Hastalıklar Obstetrik; Maternal-Fetal Tıp ve Perinatoloji. Ankara: Medikal Network, 2001;682-96.
  • Kimya Y, Cengiz C. Gebeliğe bağlı annedeki sistemik değişiklikler. Obstetrik-Maternal-Fetal Tıp ve Perinatoloji. Ankara Medikal Network, 2001:676-81.
  • Yenicesu İ. Gebelik ve Anemi. Obstetrik-Maternal-Fetal Tıp ve Perinatoloji. Ankara Medikal Network, 2001:697- 701.
  • Bayley N. Bayley Scales of infant development. New York, NY: Psychological Corp: 1969.
  • Bayley N. Bayley Scales of Infant Development. 2nd ed. San Antonio, TX: Psychological Corp: 1993.
  • Hack M, Taylor HG, Drotar D, Schluchter M, Cartar L, Wilson-Costello D, Klein N, Friedman H, Mercuri- Minich N, Morrow M. Poor predictive validity of the Bayley Scales of infant development for cognitive function of extremely low birth weight children at school age. Pediatrics 2005;116:333-41.
  • T.C. Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. Gebelerde Demir Destek Proğramı. Ankara: 2007.
  • Harthoorn-Lasthuizen EJ, Lindemans J, Langenhuijsen MM. Does iron-deficient erythropoiesis in pregnancy influence fetal iron supply? Acta Obstet Gynecol Scand 2001;80(5):392-6.
  • Aqrawal RM, Tripathi AM, Aqarwal KN. Cord blood haemoglobin, iron and ferritin status in maternal anaemia. Acta Paediatr Scand 1983;72:545-8.
  • Karasalihoğlu S, Orhaner B, Özaydın E, Kirimi E, Karaca M, Kitapçıoğlu F. The comparison of the hematologic parameters newborns of mothers with sufficient and unsufficient iron stores. T Klinikleri Pediatr 1996;5:10-3.
  • Erdem A, Erden M, Arslan M, Yazıcı G, Eskanderi R, Himmetoğlu D. The effect maternal anemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborn. Maternal Fetal Neonatal Med 2002;11:329-32.
  • Shao J, Lou J, Rao R, et al. Maternal serum ferritin concentration is positively associated with newborn iron stores in women with low ferritin status in late pregnancy. J. Nutr 2012;142:2004-9.
  • Andrews NC, Ullrich CK, Fleming MD. Disorders of iron metabolism and sideroblastic anemia. In: Orkin SH, Nathan DG eds. Nathanand Oski’s Hematology of Infancy and Childhood. 7th ed. Canada: Elsevier Inc, 2009;522-50.
  • Kilbride J, Baker TG, Parapia LA, Khoury SA, Shuqaidef SW, Jerwood D. Anaemia during pregnancy as a risk factor for iron-deficiency anaemia in infancy: A case- control study in Jordan. Int J Epidemiol 1999;28:461-8.
  • Hurtado EK, Claussen AH, Scott KG. Early childhood anemia and mild or moderate mental retardation. Am J Clin Nutr 1999;69:115-9.
  • Pollitt E. Iron deficiency and cognitive function. Annu Rev Nutr 1993;13:521-37.
  • Beard JL, Connor JR, Jones BC. Iron in the brain. Nutr Rev 1993;51:157-70.
  • Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 2001; 107: 1381-6.
  • Lozoff B, Jimenez E, Wolf AW. Long-term developmental outcome of infants with iron deficiency. N Engl J Med 1991;325:687-94.
  • Tamura T, Goldenberg RL, Hou J, Cliver SP, Ramey SL. Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age. J Pediatr 2002;140(2):165-70.
  • Walter T, De Andraca I, Chadud P, Perales CG. Iron deficiency anemia: Adverse effects on infant psychomotor development. Pediatrics 1989;84:7-17.
  • Lozoff B, Wolf AW, Jimenez E. Iron-deficiency anemia and infant development: effects of extended oral iron therapy. J. Pediatr 1996;129:382-9.
  • Deinard AS, List A, Lindgren B, Hunt JV, Chang PN. Cognitive deficits in iron-deficient and iron-deficient anemic children. J Pediatr 1986;108:681-9.
  • Lozoff B, Brittenham GM, Wolf AW, McClish DK, Kuhnert PM, Jimenez E. Iron deficiency anemia and iron therapy effects on infant developmental test performance. Pediatrics 1987;79:981-95.
  • Mireku MO, Davidson LL, Boivin MJ, et al. Prenatal iron deficiency, neonatal ferritin, and infant cognitive function. Pediatrics 2016;138(6):e20161319.
  • Moffatt ME, Longstaffe S, Besant J, Dureski C: Prevention of iron deficiency and psychomotor decline in high-risk infants through use of iron-fortified infant formula: A randomized clinical trial. J Pediatr 1994;125:527-34.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Serpil Ece Aras Öztürk Bu kişi benim

Selma Aktaş Bu kişi benim

Salih Gözmen Bu kişi benim

Zeynep İlksen Yılmaz Bu kişi benim

Canan Vergin Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 5 Sayı: 3

Kaynak Göster

Vancouver Aras Öztürk SE, Aktaş S, Gözmen S, İlksen Yılmaz Z, Vergin C. Anne ve Bebek Kordon Kanı Kan Sayımı ve Ferritin Değerlerinin İnfantta 4. Ayda Anemi, 6. Ayda Nörogelişim Üzerine Etkisi. Akd Tıp D. 2019;5(3):408-16.