الفهرس 
IRON DEFICIENCY ANEMIA DURING PREGNANCYOnly 14 pages are availabe for public view
Abstract
Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. Suboptimal iron content in the average mother’s diet and the presence of insufficient iron stores during the reproductive years are causes for this predominance. In many developing countries, iron deficiency anemia (IDA) in pregnancy is more of a rule than an exception with a prevalence of 52%. In the Western societies, the frequency of IDA is approximately 25% in pregnant women not taking iron supplements and less than 5% in women taking iron supplements. Anemia has a significant impact on the health of the fetus and the mother. It can be associated with increased preterm labour, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths.
The ideal treatment for IDA with pregnancy still represents a great challenge. Oral iron preparations are the routine line used for correction of IDA with pregnancy because of its safety, effectiveness and low cost. They include ferrous salts as ferrous sulphate, ferrous fumarate and ferrous gluconate or amino acid chelated iron as ferrous bis-glycinate.
Chelation is a chemical bonding process results from the reaction of a metal ion from a soluble salt with amino acids. Ferrous bis-glycinate is highly stable amino acid chelate which is formed by the binding of two molecules of glycine to one Fe2+ atom. It is absorbed intact into the intestinal mucosal cells and then the iron is dissociated from ferrous bis-glycinate followed by distribution to the tissues. This provides a high bioavailability of iron with the less-likely GIT adverse effects. The main disadvantage of traditional ferrous salts is the frequent gastrointestinal (GIT) side effects as nausea, vomiting, abdominal colic and constipation. This definitely affects the patients’ adherence to treatment and the efficacy of iron preparation. On the other hand, amino acid chelated iron preparations had a lower GIT side effects and more rapid effect than ferrous salts.
This controlled clinical trial was conducted on 150 women distributed into 2 groups each is 75 pregnant women attending the outpatient clinic at Ain shams university maternity hospital who are diagnosed as iron deficiency anemia between 14 -18 weeks with hemoglobin level 8–10.5 g/dL, and serum ferritin <15 μg/l, group (A) took iron chelated amino acid while group (B) took ferrous fumarate, Follow up for outcomes was done by CBC and ferritin serum level, serum iron every 4 weeks for 12 weeks.
This study showed there was significant increase in mean HB and ferritin level in both groups at 4th, 8th and 12th weeks after treatment. However, this was significantly higher in IAAC group than in FF group. Hemoglobin elevation at 4th, 8th and 12th weeks after treatment was significantly higher in IAAC group than in FF group.
Also, blood indices (PCV, MCV) and serum iron level significantly increased in both groups at 4th, 8th and 12th weeks after treatment, with the increase being significantly higher in IAAC group than in FF group.
Maternal side effects were significantly less frequent in IAAC group than in FF group. Maternal compliance was significantly more frequent in IAAC group than in FF group.
There was no significant correlation between hematological improvements and maternal age among the studied groups. There was no significant correlation between hematological improvements and gestational age (GA) among IAAC group. There was a significant correlation between hematological improvements except MCHC and GA among FF group.