الفهرس 
Adaptive Hematological Changes during PregnancyOnly 14 pages are availabe for public view
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Abstract
Anemia in pregnancy is a decrease in the total red blood cells
(RBCs) or hemoglobin<11gm/dl in the blood during pregnancy or in the
period following pregnancy. It involves a reduction in the oxygen
carrying capacity of the blood.
Anemia is an extremely common condition in pregnancy and
postpartum world-wide, conferring a number of health risks to mother
and child.
Maternal signs and symptoms are usually non-specific, but can
include: fatigue, pallor, dyspnea, palpitations and dizziness. There are
numerous well-known maternal consequences of anemia including:
maternal cardiovascular strain, reduced physical and mental
performance, reduced peripartum blood reserves, increased risk for
peripartum blood product transfusion, and increased risk for maternal
mortality.
The most frequent cause of anemia in pregnancy worldwide is
iron deficiency anemia (IDA). Iron is needed for many physiological
processes in the body, and observational studies indicate that iron
deficiency during pregnancy may independently result in cognitive or
behavioral abnormalities in the child.
Babies of women with IDA have an increased risk of being low
birth weight, being born prematurely, being more susceptible to
infections, and suffering death in utero.
During pregnancy, the average total iron requirement is about 30
to 60 mg of elemental iron per day for a 55 kg woman. This iron is used
for the increase in red cell mass, placental needs and fetal growth.
About 40% of women start their pregnancy with low to absent iron
stores and up to 90% have iron stores insufficient to meet the increased
iron requirements during pregnancy and the postpartum period.
WHO recommends an intermittent regimen (e.g. weekly 120 mg
of elemental iron and 2.8 mg of folate) for non-anemic pregnant women
in communities where the prevalence of anemia is < 20%, as an
effective alternative to a daily regimen for prevention of anemia during
pregnancy.
It is thought that an intestinal epithelial cell becomes saturated
with a single oral dose of iron, resulting in reduced iron absorption as
intestinal cell turnover occurs every five to six days, if oral supplements
are administered weekly, new intestinal epithelial cells would be exposed
to each subsequent dose, resulting in improved iron absorption.
Weekly supplements have been shown to produce similar
maternal and infant outcomes as daily supplements of HB and to reduce
the risk of the undesirable high levels of hemoglobin mid and late
pregnancy.
Intermittent oral iron supplementation may also reduce peroxidase
and free radical mediated oxidative stress that damages the intestinal
mucosa resulting in the unpleasant gastrointestinal side effects
associated with daily oral iron supplements. Therefore, weekly regimens
may be more acceptable to women and therefore increase their compliance.