Fetal Conditions Clinical Trial
Official title:
Effect of Maternal Iron Deficiency Anemia on Fetal Hemodynamics and Neonatal Outcome
This study will be conducted to show the effect of different degrees of maternal iron deficiency anemia on fetal hemodynamics and neonatal outcome and to evaluate the effect of treatment.
Hemoglobin concentration is used to determine the diagnosis and severity of anemia in low
resource settings, an indicator that is routinely screened using WHO-defined hemoglobin
cutoffs. These thresholds are lower for pregnant women (females ≥ 15 years of age) than
non-pregnant women (11.0 g/dl versus 12.0 g/dl). Severity of anemia is determined using
additional cutoffs, with severe anemia defined as a hemoglobin level of less than 7.0 g/dl.
Iron deficiency is defined as a condition in which there are no mobilizable iron stores,
resulting from a long-term negative iron balance and leading to a compromised supply of iron
to the tissues. Finally, the most significant negative consequence of ID is anemia, usually
microcytic hypochromic in nature.
IDA has been linked to unfavorable outcomes of pregnancy. It is the most common nutritional
disorder in the world affecting two billion people worldwide with pregnant women particularly
at risk. According to WHO report, 2001 indicates that IDA is a significant problem throughout
the world ranging from 35-75% in developing countries (average 56%) whereas in industrialized
countries the average prevalence is 14%.
Distribution of blood flow (between the placental and cerebral regions) is determined with
Middle cerebral artery PI/Umbilical artery PI (C/U ratio); this parameter is always > 1.1
during normal pregnancy, but decreases in the case of hypoxia because of umbilical artery
resistance index increase (increase in placental resistance) and cerebral resistance index
decrease (cerebral vasodilation).
Perinatal morbidity & mortality of IUGR infants is 3-20 times greater than normal infants.
These cases may be followed with outpatient monitoring and they often deliver at term.
However process is not severe enough to stop fetal growth completely or to deteriorate. The
umbilical artery and the middle cerebral artery waveforms may be abnormal, without effect is
seen on Doppler and growth until 26-32 weeks gestation; Mild utero-placental insufficiency.
Iron deficiency and iron deficiency anemia during pregnancy are risk factors for preterm
delivery, prematurity and small for gestational age birth weight. Iron deficiency has a
negative effect on intelligence and behavioral development in the infant. It is essential to
prevent iron deficiency in the fetus by preventing iron deficiency in the pregnant woman.
Prevention and control is typically achieved through iron fortification of food staples like
flour and rice and/or through administration of iron supplements most often in iron tablets.
Although iron supplements are widely available and fortified foods constitute a major
component of the diet in the developed world, access is limited in the developing world
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