Iron status of pregnant women and their newborns and the necessity of iron supplementation in infants in Eastern Turkey

Yıl 2011, Cilt: 46 Sayı: 3, 246 - 251, 01.09.2011

Hatice Gamze Poyrazoğlu A. Denizmen Aygün Bilal Üstündağ Saadet Akarsu Serap Yıldırmaz

https://doi.org/10.4274/tpa.46.82

Öz

Aim: Iron deficiency anemia is the most frequent cause of nutritional anemia in the first two years of life The aim of this study is to evaluate iron status of pregnant women and their infants in Eastern Turkey and to determine its effects on iron deficiency anemia in the first year of life Material and Method: This study was performed in 92 pregnant women classified in four groups according to the iron status and iron prophylaxis This study was approved by The Local Ethics Committee Fırat Üniversitesi Tıp Fakültesi Etik Kurulu 25 03 2004 4 Session Pregnant women were followed up from the 14th week and venous blood samples were obtained at presentation Blood samples of infants were obtained at birth and in the third month sixth month and twelfth month of life Complete blood count serum ferritin and iron levels and total iron binding capacity were evaluated in these blood samples One way analysis of variance ANOVA and Pearson rsquo;s and Spearman rsquo;s rank test were used for statistical methods Results: At birth serum iron and ferritin levels were not significantly different between the four groups p lt;0 05 At third month of life; serum iron levels were diminished in accordance with the physiologic changes and at sixth month of life; iron deficiency anemia was developed in 40 of the first group in 57 1 of the second group in 50 of the third group and 69 2 of the fourth group Conclusions: Iron status of infants is not defined only by iron stores at birth The nutrition during the first year of life is also effective In this study iron deficiency anemia was developed in approximately 50 of infants in the sixth month of life although iron storage was sufficient at birth Supplementation of iron in infants in Eastern Turkey is necessary from the third month of life Turk Arch Ped 2011; 46: 238 43

Anahtar Kelimeler

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Doğu Anadolu bölgesinde gebelerde ve doğan bebeklerinde demir durumu ve süt çocuklarında demir desteği gerekliliği

Öz

Amaç: Yaşamın ilk iki yılı içerisindeki besinsel anemilerin en önemli nedeni demir eksikliği anemisidir. Bu çalışmada Doğu Anadolu Bölgesi’nde gebe kadınlarda ve doğan bebeklerinde demir durumunun tanımlanması ve yaşamın ilk yılı içerisinde ortaya çıkan demir eksikliği anemisine etkilerinin araştırılması amaçlandı.

Gereç ve Yöntem: Çalışma demir durumu ve demir desteğine göre dört grupta sınıflandırılan 92 gebe kadında gerçekleştirildi. Yerel etik kuruldan onay alındı (Fırat Üniversitesi Tıp Fakültesi Etik Kurulu 25.03.2004 tarih 4. Toplantı 2. Karar). Gebe kadınlar 14. haftadan itibaren izlendi ve venöz kan örnekleri başvuruda, bebeklerinden ise doğumda, üçüncü, altıncı ve on ikinci ayda elde edildi. Kan örneklerinde tam kan sayımı yanında serum demiri, ferritin ve demir bağlama kapasitesi değerlendirildi. İstatistiksel yöntem olarak tek yönlü Varyans analizi (ANOVA) ve Pearson ve Spearman rank testi uygulandı.

Bulgular: Doğumda dört grup arasında serum demir ve ferritin düzeyleri açısından anlamlı fark yoktu (p<0,05). Üçüncü ayda, serum demir değerleri fizyolojiye uygun olarak azaldı ve altıncı ayda, birinci grupta %40, ikinci grupta %57,1, üçüncü grupta %50 ve dördüncü grupta %69,2 oranında demir eksikliği anemisi gelişti.

Çıkarımlar: Bebeklerin demir durumu doğumdaki demir depolarıyla belirlenemez, yaşamın birinci yılında beslenme de etkilidir. Çalışmada doğumda demir depolarının yeterli olmasına karşın altıncı ayda bebeklerin yarısında demir eksikliği anemisi gelişti. Doğu Anadolu Bölgesinde çocuklarda üçüncü aydan itibaren demir desteği gereklidir.

Anahtar Kelimeler

Demir desteği, demir durumu, demir eksikliği anemisi, gebe kadın, süt çocuğu

Kaynakça

• Allen LH. Anemia and iron defeiciency. Effects on pregnancy outcome. Am J Clin Nutr 2000; 71: 1280-4.
• Gümrük F, Altay Ç. Demir metabolizması ve demir eksikliği anemisi. Katkı Pediatri Dergisi 1995; 16: 265-85.
• World Health Organization (WHO) Nutritional anemias report of a. WHO Scientific Group Technical Report Series No: 405, 1968.
• International Nutritional Anemia Consultative Group (INACG). Measurement of iron status. Washington DC: The Nutrition Services, 1995.
• World Health Organization. The prevalence of anemia in women: A tabulation of available information. 2nd ed. Geneva: World Health Organization, 1992.
• Kilbride J, Becker TG, Parapia LA, et al. Anemia during pregnancy as a risk factor for iron deficiency anemia in infancy: a case control study in Jordan. Int J Epidemiol 1999; 28: 461-8.
• Colomer J, Colomer C, Gutierez D, et al. Anaemia during pregnancy as a risk factor for infant iron deficiency report from Valencia Infant Anaemia Cohort (VIAC) study. Paediatr Perinatol Epidemiol 1990; 4: 196-204.
• Booth I, Aukett M, Logan S. Iron deficiency anemia in infancy and early childhood. Arch Dis Child 1997; 76. 549-54.
• Cavla EB, Grazzo V. Prevalence of iron deficiency in children aged 9- 24 months from a large urban area of Argentina. Am J Clin Nutr 1990; 52: 534-40.
• Lozoff B, Wolf AW, Jimenez E. Iron deficiency anemia and infant development: Effects of extended oral iron therapy. J Pediatr 1996; 129: 382-9.
• Kalayoğlu Beşışık S. Demir eksikliği anemisi. Türkiye Klinikleri Hematoloji Dergisi 2004; 2: 96-102.
• Fletcher J, Suter PE. The transport of iron by the human placenta. Clin Sci 1969; 36: 209-29.
• Bergamaschi G, Bergamaschi P, Carlevati S, et al. Transferin receptor expression in the human placenta. Hematologica 1990; 75: 220-3.
• Milman N, Ibsen KK, Christensen JM. Serum ferritin and iron status in mothers and newborn infants. Acta Obstet Gynecol Scand 1987; 66: 205-16.
• Fairweather TSJ. Iron deficiency in infancy; easy to prevent or is it? Eur J Clin Nutr 1992; 46: 9-14.
• Lönnerdal B, Dewey KG. Epidemiology of iron deficiency in infants and children. Annals Nestle Nutrition Services 1995.
• Hemminki E, Rimpela U. Iron supplementation, maternal packed cell volume and fetal growth. Arch Dis Child 1991; 94: 277-80.
• Singla PN, Tyagi M, Kumar A, et al. Fetal growth in maternal anemia. J Trop Pediatr 1997; 43: 89-92.
• Bhargava M, Kumar R, Iyer PU, et al. Effect of maternal anaemia and iron depletion on foetal iron stores, birthweight and gestation. Acta Paediatr Scand 1989; 78: 321-3.
• Ahmad SH, Matto GM, Amir M, et al. Hematological profile of babies of anemic mothers. Indian Pediatr 1984; 21: 753-61.
• Kumar A, Rai AK, Basu S, et al. Cord blood and breast milk iron sta- tus in maternal anemia. Pediatrics 2008; 121: e673-7.
• Akhter S, Momen MA, Rahman MM, et al. Effect of maternal anemia in fetal outcome. Myemensingh Med J 2010; 19: 391-8.
• Ervasti M, Sankilampi U, Heinonen S, et al. 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 2009; 88: 83-90.
• Paiva Ade A, Rando PH, Paqliusi RA, et al. Relationship between the iron status of pregnant women and their newborns. Rev Saude Publica 2007; 41: 321-7.
• Preziosi P, Prual A, Galan P, et al. Effect of iron supplementation on the iron status of pregnant women: Consequences for newborns. Am J Clin Nutr 1997; 66: 1178-250.
• Morton RE, Nysenbaum A, Price K. Iron status in the first year of life. J Pediatr Gastroenterol Nutr 1988; 7: 707-19.
• Murray MJ, Murray AB, Murray NJ, et al. The effects of iron status of Nigerian mothers on that of their infants at birth and 6 months, and the concentration of Fe in breats milk. Br J Nutr 1978; 39: 627-57.
• Yalcin SS, Yurdakok K, Acikgoz D, et al. Short term developmental out- come of iron prophylaxis in infants. Pediatr Int 2000; 42: 625-30.
• Childs F, Aukett A, Darbyshire P, et al. Dietary education and iron defi- ciency anemia in the inner city. Arch dis Child 1997; 76: 144-7.
• Kavukcu S, Taneli NN. Comparison of serum and breast milk ferritin with some hematological parameters in the perinatal period. J Assoc Physicians India 1994; 42: 875-82.