Iron deficiency anemia is a nutritional deficiency disease of widespread concern worldwide, according to relevant surveys, the incidence of iron deficiency anemia in mainland pregnant women accounts for about 35%, and the first trimester is not harmful to the fetus, but with the extension of pregnancy time, the second trimester can seriously affect fetal growth and development, maternal health and pregnancy outcomes. In this issue, let's learn about iron deficiency anemia in pregnant women.
Why does the fetus need iron?
The embryo has the ability to make hematopoietic cells from the 4th week, and the iron in the fetus increases with its weight and blood volume, so the fetus receives the most iron in the first 3 months of pregnancy.
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The fetus actively obtains iron from the mother, that is, the iron of the pregnant woman can enter the fetus in a reverse concentration gradient through the placenta, and the placental villi epithelial cells mediate the transfer of ferritin and ferritin in the placenta through receptors, and then supply the fetus with heme, myoglobin and ironase.
Iron deficiency not only causes anemia, but also affects brain development, especially the rapidly developing brain. A large number of studies have shown that anemia in infancy will have long-term adverse effects on the nervous system, iron is involved in the formation of myelination in the brain, the metabolism of neurotransmitters and the energy metabolism of the brain, iron deficiency will cause abnormal myelination in the brain, dopaminergic neurotransmitter system changes, metabolic levels of different brain regions decrease, and then cause abnormal behavior.
Why do pregnant women need iron supplementation?
Pregnant women are at high risk of iron deficiency, mainly because of the significant increase in blood volume, of which the increase begins in 3 months of pregnancy, the fastest increase rate in 4~6 months of pregnancy, the increase rate slows down during pregnancy, and the blood volume in the last weeks of pregnancy is maintained at the highest level.
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Near-term pregnancy increases blood volume by 40%~45% compared with non-pregnant pregnancy, about 1450ml. So as the number of weeks of gestation increases, the chance of anemia increases. Although plasma increases at the same time as red blood cells, the former increases by about 1000ml, and the latter increases by about 450ml, resulting in a decrease in Hb concentration, red blood cell concentration and hematocrit, and total blood viscosity, hemodilution, and predisposition to dilution anemia.
Of all the mineral metabolisms during pregnancy, the iron requirement is the largest, and the total iron requirement in normal pregnancy is 1000 mg, of which 300 mg meets the needs of fetal and placental growth, 500 mg is used for maternal Hb production, and 200 mg is used to supplement losses during delivery.
Why are pregnant women prone to iron deficiency?
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Iron absorption disorders: nausea, vomiting, poor eating, gastrointestinal disorders, gastric acid deficiency, malnutrition, and insufficient protein in food in early pregnancy all affect intestinal iron absorption.
Inadequate iron intake: the sum of iron obtained from food during pregnancy and iron mobilized from storage usually does not meet the physiological needs of pregnancy; Pregnant women without anemia have insufficient iron intake, and plasma ferritin decreases in the second half of pregnancy.
When is iron supplementation good during pregnancy?
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In practice, iron deficiency anemia in the body has a development process, which is divided into the following three stages: first is the depletion of iron storage, followed by iron deficiency erythropoiesis, and finally to iron deficiency anemia. When we see clinically that the patient's Hb is less than normal, it is actually the final anemia stage. In the first two stages, the body already has iron deficiency, but there is no anemia, which is called hidden iron deficiency.
Through the monitoring of maternal blood routine, it was found that anemia in pregnant women mostly occurred in the second and third trimesters, and with the increase of gestational age, the incidence of anemia gradually increased, reaching a peak in the third trimester. Therefore, iron supplementation should be prevented from the first trimester, and should not wait until the Hb decreases.
The World Health Organization recommends that daily oral iron be recommended for all pregnant women, and that medication be started as early as possible throughout pregnancy.
In some areas with a high prevalence of postpartum anemia (greater than 20%), in order to reduce the risk of postpartum anemia, it is recommended to continue oral iron within 6~12 weeks postpartum, and folic acid can be compounded.
▲ Please purchase and use according to the drug instructions or under the guidance of a pharmacist
Fusen compound ferrous sulfate granules are used for the prevention and treatment of pediatric iron deficiency anemia, and can also be used for iron deficiency anemia in pregnant women, lactating women and women with menorrhagia.
Füssen compound ferrous sulfate granules, added vitamin C, orange fruit sweet taste good. Vitamin C can promote iron ion absorption, and in combination with ferrous sulfate, the body's absorption rate of iron from the traditional 2.6% to 11.5%, with a high absorption rate.
Microcapsule technology, small gastrointestinal stimulation, small dose can be used for the prevention and treatment of iron deficiency anemia in various age groups. The attached flavor conditioner has a good taste, 1 time a day, high compliance, and ensures the smooth use of iron preparation.
Little Fusen tips
In general, pregnant women should take a combination of prevention and treatment and actively carry out preconception, during, and postconception iron deficiency screening and intervention to promote eugenics and fertility.
Resources:
[1] LIU Zhenzhen. Effect of iron deficiency anemia during pregnancy on obstetric pregnancy outcomes[J].Chinese Journal of Health Standards and Management, 2018, 009(015):40-42.)
[2] LIU Meilan, ZHANG Jianping. Perinatal iron deficiency and iron supplementation[J].Chinese Journal of Clinicians:Electronic Edition, 2010(5):3.)
[3] Yang Xiuhong. Monitoring and intervention of anemia in pregnant women at different gestational weeks[J].Chinese Journal of Maternal and Child Health, 2007, 22(1):1.)
Disclaimer: The article is for communication reference only, recommended products please use under the guidance of professional doctors.