Clinical Investigation Of The Incidence Of Iron Deficiency, Iron Deficiency Anemia And Clinical Study Of The Timing Of Prophylactic Iron Supplementation During Pregnancy

ABSTRACTObjective: The aim of this study was to investigate the incidence rates of ID and IDA in local pregnant women,and then explore the time of Preventive iron supplementation in local pregnant women to provide clinical basis for prophylactic iron supplementation, during pregnancy.Methods: The first part:Blood routine test and serum ferritin(SF) were measured in 1856 cases of pregnant women that first prenatal care in our hospital during May 2013 to June 2014 and without iron supplementation to observe the incidence of ID,IDA at different gestational stages and regularity of Hb,SF.The second part:The pregnant women who took prenatal care before 16 weeks in our hospital during August 2013 to October 2014, and had a normal Blood Hb and SF were randomly divided into observational group(take Shengxuening tablets 0.5g bid from 16 weeks) and control group(no iron supplementation temporarily).Hb and SF test were measured at 16 ~the end of 19 weeks,20~the end of 23 weeks,24~the end of 27 weeks,28~the end of 31 weeks,32~the end of 35 weeks,36 weeks ~ delivery.The dose of Shengxuening increase to 0.5g Tid, when SF level below 12 g/L.The Hb, SF, gestational age,birthweight and the incidence of ID,IDA,pregnant complications were noted and compared between two groups.Results: 1 The Investigation results of 1856 pregnant women 1.1 The proportion of anemiaIn this study,the anemic pregnant women were 370 cases,accounting for 19.94% of 1856 cases pregnant women.The proportion of mild anemia in anemic pregnant women was 70.81%,while the moderate anemia was 29.19%,there was no severe anemia case. 1.2 The comparison of the level of Hb and SF in different gestational stagesThe level of SF and Hb showed a trend of gradual decline along with the gestational age at 16~the end of 19 weeks,20~the end of 23 weeks,24~the end of 27 weeks,28~the end of 31 weeks,and there have statistically difference between two adjacent gestational stages.SF fallen to the lowest level in 28~ the end of 31 weeks, and rebounded slightly after 32 weeks.Hb fallen to the lowest levels in 32~the end of 35 weeks(112.41±10.97g/l),and rebounded slightly after 36 weeks. 1.3 The incidence of ID and IDA during pregnancyIn this study,the incidence of ID and IDA were 46.44% and 19.94%.There have no significantly difference in the incidence of ID and IDA between two groups before 20 weeks.The incidence of ID showed a trend of gradual increase trend in 16~the end of 19 weeks,20~the end of 23 weeks, 24~the end of 27 weeks,28~the end of 31 weeks, significantly difference can be find between two adjacent gestational stages.The incidence of ID reached the highest level in 28~the end of 31 weeks(80.00%),and declined slightly after 36 weeks.The incidence of IDA began increase significantly until 24~the end of 27 weeks,and showed a gradual increase trend in 24~the end of 27 weeks,28~the end of 31 weeks,32~the end of 35 weeks.The incidence of IDA reached the highest level in the stage after 36 weeks(38.68%). 2 The results of iron supplementation from 16 weeks during pregnancy 2.1 The comparison of Hb and SF levelThe observational group has a higher level of Hb and SF than the control group during pregnancy after 16 weeks, there have statistically difference between two groups. 2.2 The comparison of incidence of ID and IDA between two groupsThe observational group has a lower incidence rate of ID and IDA than the control group after 24 weeks during pregnancy, and statistically difference can be find between two groups.The incidence rate of ID and IDA of observational group were 42.50% and 15.00% respectively,while the control group were 80.99% and 45.59%. 2.3 The comparison of pregnancy complications and neonatal situationThere have no statistically difference in duration of gestation,infant’s birthweight,and the incidence rate of hypertensive disorders complicating pregnancy,gestational diabetes mellitus,premature delivery,Postpartum hemorrhage,low birthweights between two groups(P>0.05).Conclusions:1 In this survey,the anemic pregnant women were mild anemia and moderate anemia,but prophylactic iron supplementation is essential because the ID was still quite common during late pregnancy.2 The level of Hb and SF have a significantly decline after 16 weeks and shown a gradually decline trend along with the progress of gestational age, while the incidence of ID began to increase after 20 weeks,so preventive iron supplementation should be given at 16 weeks during pregnancy.3 Prophylactic iron supplementation from 16 weeks during pregnancycan significantly reduce the incidence rate of ID and IDA.4 The requirement of iron was increase along with the progress of gestation,so the dose of iron supplementation should be increased at 28 weeks of gestation to prevent the ID and IDA in the later of pregnancy.5 Prophylactic iron supplementation before ID during pregnancy have no significantly impact on the duration of gestation, infant’s birthweight, and the incidence rate of hypertensive disorders complicating pregnancy, gestational diabetes mellitus, premature delivery, Postpartum hemorrhage, low birthweight.The short and long term impact of prophylactic iron supplementation during pregnancy should be investigated in further research.