Anaemia of pregnancy

Abstract

This paper reports the findings of a cross-sectional study of anaemia in Indian and black women attending an antenatal clinic. Anemia as defined by current World Health Organization criteria was detected in 13.2% of Indian women in the first trimester of pregnancy, in 28.1% in the second trimester and in 47.0% in the third trimester. Iron deficiency, diagnosed on the basis of low serum ferritin levels (< 12 ng/ml), was common, the prevalence being 35% in the first trimester and rising to 86% in the third; this demonstrates the effects of the progressively increasing stress on iron metabolism as pregnancy advances. Reduced folate levels (< 3 ng/ml) were detected in 8.8% of subjects in the first trimester and in 47% in the third. It may therefore be concluded that anaemia was common in this group and that its prevalence increased progressively as pregnancy advanced. Iron deficiency was by far the commonest type of deficiency observed. While folate levels were low in a fair proportion of subjects, evidence of coexistent iron deficiency was found in all of them. It is therefore not clear whether or not a primary nutritional deficiency of folic acid contributed towards the production of anaemia. A similar study was done among pregnant black women. Anaemia was detected in 18,8%, 26,0% and 28,6% of subjects in the three trimesters. Iron deficiency, diagnosed on the basis of low serum ferritin levels, was observed in 19% and 40% of women in the first and third trimesters respectively. Reduced folate levels were found in 8,7% of subjects in the first trimester and in 10% in the third. The prevalence of anaemia and particularly iron deficiency was surprisingly high among pregnant black women, although not as high as among Indians. Folate deficiency was detected and probably contributed towards the production of anaemia in the black group.