孕妇铁缺乏早期指标及干预措施的研究

目的:探讨孕期妇女铁缺乏早期诊断指标及干预措施。方法:抽取2003年10月1日～2004年4月30日,在宁波市8家妇幼保健院做早孕检查时排除贫血的孕妇982例,于孕16周测定血清铁蛋白(SF),并将SF<12μg/L191例孕妇分为干预组和对照组,干预组予铁剂治疗。结果:铁蛋白<12μg/L与铁蛋白≥12μg/L孕中、晚贫血患病率比较,差异有显著性(P<0.05);干预组和对照组在孕晚期贫血患病率比较差异有显著性(P<0.01)。结论:SF作为妊娠期铁缺乏的诊断指标是可行的,尤其是在基层医院;孕期提示铁缺乏的孕妇应及时补充铁剂,可减少孕妇缺铁性贫血(IDA)的发生。     

福州市育龄妇女铁缺乏症流行病学调查

[目的]对530名育龄妇女(孕妇405人、未孕妇125人)的营养性贫血状况进行调查提出干预措施。[方法]分别从不同孕期及未孕育龄妇女中采血测定血红蛋白(Hb)、血锌原卟啉(ZPP)和血清铁蛋白(SF)水平．并进行有关影响因素问卷调查。[结果]530名育龄妇女中,贫血患病率为23．8%(其中孕妇25．9％,未孕妇16．80),孕妇贫血患病率明显高于未孕妇,孕妇的血红蛋白随孕周的增加而下降,孕妇的血锌原卟啉与未孕妇相比差异有显著性．不同孕期的血清铁蛋白随孕周的增加而逐渐减少。[结论]缺铁性贫血是妇女最常见的营养性疾患之一,必须采取综合性防治措施,积极预防。     

50例妊娠期全血铁蛋白快速检测结果评价

目的 探讨全血铁蛋白在早期发现孕期缺铁性贫血中的应用价值. 方法 选择50名在妇科门诊接受产前检查的孕妇,使用血细胞分析仪检测Hb,胶体金法检测全血铁蛋白,酶联免疫检测法(ELISA)检测血浆铁蛋白. 结果 50例标本中,全血铁蛋白铁缺乏检出比例为48.0％,其中贫血者和非贫血者分别占29.2％和70.8％；血清铁蛋白铁缺乏检出比例为50.0％,其中贫血者和非贫血者分别占28.0％和72.0％；全血铁蛋白组与血清铁蛋白组铁缺乏、贫血和非贫血检出比例比较,差异均无统计学意义. 结论 全血铁蛋白是诊断孕妇早期缺铁性贫血的一个非常敏感的指标,与血浆铁蛋白检测结果有良好的一致性,且检测方法更方便、快捷.     

不同孕期孕妇血清叶酸、维生素B12与铁蛋白表达水平及其意义

目的探讨孕妇血清叶酸、维生素B12、铁蛋白水平(以下简称为"贫血3项指标")及其意义。 方法选择2017年1月至2019年1月，于滨州市第二人民医院进行产前检查并分娩的早、中、晚孕期孕妇，以及进行健康体检的育龄期非妊娠女性各130例为研究对象，分别纳入早、中、晚孕期组及对照组，并对各组受试者进行贫血3项指标检测。采用单因素方差分析及SNK-q法，对4组受试者贫血3项指标检测结果分别进行总体及两两比较；采用χ²检验，对早、中、晚孕期组孕妇贫血3项指标异常(叶酸/维生素B12/铁蛋白这3种物质之一缺乏)、贫血发生率及妊娠并发症发生情况分别进行总体及两两比较；采用独立样本t检验，分别对不同孕期组贫血3项指标异常与正常孕妇分娩新生儿出生时生长发育指标进行比较。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求，所有受试者签署临床研究知情同意书。 结果①早孕期组与对照组受试者贫血3项指标比较，差异均无统计学意义(P>0.05)。中、晚孕期组受试者血清叶酸、维生素B12及铁蛋白水平分别为(8.8±2.4) nmol/L、(238.2±103.8) pmol/L及(41.5±10.3) μg/L，(6.3±1.2) nmol/L、(134.2±23.5) pmol/L及(15.7±6.8) μg/L，均分别低于早孕期组和对照组的(12.9±3.4) nmol/L、(353.7±122.9) pmol/L及(77.7±15.1) μg/L，(13.6±3.8) nmol/L、(376.9±128.7) pmol/L及(80.3±16.3) μg/L，并且差异均有统计学意义(中孕期组vs早孕期组：q＝16.226、12.702、32.478，均为P<0.001；中孕期组vs对照组：q＝18.997、15.254、34.810，均为P<0.001；晚孕期组vs早孕期组：q＝26.120、24.140、55.625，均为P<0.001；晚孕期组vs对照组：q＝28.891、26.691、57.957，均为P<0.001)。随着孕龄增加，孕妇贫血3项指标逐渐下降，并且差异均有统计学意义(P<0.05)。②晚孕期组孕妇贫血3项指标异常发生率、叶酸缺乏性巨幼细胞性贫血及缺铁性贫血发生率，以及贫血总发生率，均分别高于早、中孕期组；中孕期组上述指标发生率，均高于早孕期组，并且上述差异均有统计学意义(P<0.05)。③晚孕期组孕妇妊娠期高血压疾病、心肌缺血/损害、胎儿异常及妊娠并发症总发生率，均分别高于早、中孕期组，并且差异均有统计学意义(P<0.05)。早孕期组与中孕期组上述妊娠并发症发生率比较，差异均无统计学意义(P>0.05)。④早、中、晚孕期组孕妇中，贫血3项指标异常者分娩新生儿的身长，均短于正常者分娩新生儿，并且差异均有统计学意义(P<0.05)；晚孕期组孕妇中，血清铁蛋白水平低者分娩新生儿的出生体重，轻于正常者分娩新生儿，并且差异有统计学意义(P<0.05)。除早孕期组孕妇中维生素B12缺乏者与正常者及晚孕期组孕妇中铁蛋白缺乏者与正常者分娩新生儿头围比较，差异无统计学意义(P>0.05)外，其余情况下，贫血3项指标异常孕妇分娩新生儿出生时头围，均小于正常者分娩新生儿，并且差异均有统计学意义(P<0.05)。 结论随着孕妇孕龄增长，其血清叶酸、维生素B12及铁蛋白水平降低，贫血及妊娠并发症发生风险增加。各孕期孕妇贫血3项指标异常，均可能影响胎儿的生长发育。     

农村孕妇营养状况研究

农村孕妇膳食构成以谷类为主,而豆类、动物食品很少。孕期平均热量达到供给量的90%。蛋白质摄入量不足。钙、维生素A、核黄素的平均摄入量明显低于供给量。血清叶酸、维生素B_(12)的水平随孕期进展明显下降。晚期孕妇核黄素、叶酸、维生素B_(12)不足和缺乏的百分比明显高于孕中期。孕晚期贫血的发生率达19.3%。建议妇幼保健工作者加强对农村孕妇营养指导,提倡多食即经济又合理的豆类食品、绿叶蔬菜等。     

孕妇血清中同型半胱氨酸、叶酸、维生素B_(12)的表达及临床价值分析

目的分析孕妇血清中同型半胱氨酸(HCY)、叶酸、维生素B_(12)的表达及临床价值。方法收集该院2014年8月-2016年2月收治的120例孕妇,分析孕妇血清HCY、叶酸与维生素B_(12)水平与不同临床指标的联系,并分析血糖、血压与孕妇HCY、叶酸、维生素B_(12)水平的相关性。结果年龄≥30岁者血清HCY水平高于30岁者,叶酸、维生素B_(12)水平低于30岁者(P0.05);早产者血清HCY水平高于非早产者,叶酸、维生素B_(12)水平低于非早产者(P0.05);伴妊娠期高血压者血清HCY水平高于非妊娠期高血压者,叶酸、维生素B_(12)水平低于非妊娠期高血压者(P0.05);妊娠期糖尿病者血清HCY水平高于非妊娠期糖尿病者,叶酸、维生素B_(12)水平低于非妊娠期糖尿病者(P0.05);早孕期者、中孕期者、晚孕期者血清HCY、叶酸、维生素B_(12)水平比较没有统计学差异(P0.05);孕妇血清HCY水平与血糖、舒张压、收缩压呈正相关,叶酸和维生素B_(12)水平与血糖、舒张压、收缩压呈负相关。结论孕妇血清HCY、叶酸、维生素B_(12)水平与年龄、早产、妊娠期并发症关系密切,及时有效的检测三者水平能够利于高危人群的识别,重视叶酸与维生素B_(12)的补充,可改善妊娠结局。     

不同孕期妇女血清叶酸、维生素B12和血清铁蛋白检测结果分析

目的分析不同孕期妊娠妇女血清叶酸、维生素B12和血清铁蛋白检测结果。方法选取2015年3月-2017年3月在临洮县人民医院进行产前检查与分娩的孕产妇300例为观察组,另选取同期在该院接受常规检查的健康育龄期未孕妇女120例为对照组。抽血检测血清叶酸、维生素B12、血清铁蛋白等浓度,其中观察组妇女分别于孕中期、孕晚期检测上述指标。比较各组血清叶酸、维生素B12、血清铁蛋白浓度分布情况,分析3项指标与妊娠并发症及妊娠结局的相关性。结果对照组与观察组孕中期血清叶酸、维生素B12及铁蛋白浓度比较,差异无统计学意义(P>0.05);观察组孕晚期时血清叶酸、维生素B12与血清铁蛋白低浓度较对照组及观察组孕中期时均明显提高(均P<0.05);观察组妊娠期高血压、妊娠期糖尿病、羊水过多、胎膜早破及贫血发生率分别为2.67%、9.00%、3.00%、12.67%、58.33%;叶酸、维生素B12低浓度与妊娠期高血压相关、叶酸高浓度与妊娠期糖尿病相关,维生素B12低浓度与羊水过多相关,铁蛋白低浓度与贫血相关,差异有统计学意义(P<0.05)。结论随着孕期的增加,妊娠妇女血清叶酸、维生素B12、血清铁蛋白浓度均呈不同程度降低,三者缺乏易引发妊娠期并发症,影响妊娠结局。     

妊娠妇女贫血和铁缺乏与钩虫、疟疾和维生素A缺乏有关

发展中国家妊娠期妇女贫血和铁缺乏流行的原因尚不完全清楚。本文作者对尼泊尔一社区样本的 336名妊娠期妇女贫血和铁缺乏的发生率和严重性及其与蠕虫、疟疾和维生素 A缺乏之间的关联进行了评估。血红蛋白、红细胞原卟啉 (EP)和血清铁蛋白用静脉血样检测。贫血妇女 (血红蛋白 <110 g/L )占 72 .6 % ,其中中度或重度贫血(血红蛋白 <90 g/L )占 19.9% ,铁缺乏 (EP>70μmol/mol血红素或血清铁蛋白 <10 μg/L)占 80 .6 %。贫血为铁缺乏性的占88%。一半以上 (5 4.2 % )的妇女血清维生素A浓度低 (<1.0 5μmol/L ) ,74.4%的妇女感染钩虫 ,19.8%…     

SF与HGB测定对妊娠妇女缺铁性贫血的应用

目的 分析血清铁蛋白与血红蛋白测定在妊娠妇女缺铁性贫血中的临床应用。方法 随机选取本院在2019年1月-2020年4月收治的100例孕妇作为研究对象,对所有孕妇均在孕早期、孕中期、孕晚期分别予以血清铁蛋白与血红蛋白检验,对比检验结果。结果 随着孕期的增加,血清铁蛋白与血红蛋白含量缺乏人数逐渐递增,不同孕周孕妇中血清铁蛋白缺乏发生率(χ²=11.2025,P=0.0000<0.05);不同孕周孕妇中血红蛋白缺乏发生率(χ²=14.2658,P=0.0000<0.05);孕早、中期,孕早、晚期,孕中、晚期血清铁蛋白水平(P<0.05);孕早、中期,孕早、晚期血清铁蛋白水平(P<0.05),孕中、晚期血清铁蛋白水平(P>0.05);孕中期血清铁蛋白缺乏孕妇孕中期发生贫血高于正常组(χ²=14.2013,P=0.0000<0.05);孕中期血清铁蛋白缺乏孕妇孕晚期发生贫血高于正常组(χ²=13.5245,P=0.0000<0.05)。结论 血清铁蛋白与血红蛋白检验与...     

孕期营养补充剂对妊娠期妇女贫血状况的影响

目的:分析孕期营养补充剂对妊娠期妇女贫血发生的影响。方法:对358例进行产前检查孕妇随机分为观察组(188例)和对照组(170例),分别给予孕期营养补充剂和叶酸,并在孕早、中、晚期测定血红蛋白(Hb)、血清铁离子、铁蛋白、维生素B12和叶酸的浓度,对产妇新生儿进行阿氏评分。结果:观察组孕晚期和临产前孕妇体质指数高于对照组,血红蛋白水平孕中、晚期高于对照组,晚期血清铁离子浓度高于对照组(均P0.05);孕期血清铁蛋白、维生素B12和叶酸与对照组比较无差异(P0.05);新生儿阿氏评分高于对照组(P=0.001)。结论:孕期给予营养补充剂可显著提高孕妇孕晚期和血清铁离子水平,从而有效提高孕妇血红蛋白水平,预防孕期贫血的发生。     

Iron status is an important cause of anemia in HIV-infected Tanzanian women but is not related to accelerated HIV disease progression

In HIV-infected populations from developing countries, it is unclear what proportion of anemia is attributable to iron deficiency (ID) and whether high body iron stores worsen HIV disease progression. We therefore evaluated these research questions in 584 HIV-infected Tanzanian women. Hemoglobin (Hb), serum ferritin (SF), serum transferrin receptor (sTfR), and C-reactive protein (CRP) concentrations were evaluated between 13 and 43 wk after women gave birth. ID was defined as SF or sTfR outside normal ranges, and ID anemia (IDA) as ID plus low Hb. In multivariate Cox regression models, the association between SF and HIV disease progression was assessed. Participants received iron + folate supplements during pregnancy. Hb (r = -0.159; P = 0.0001), SF (r = 0.355; P < 0.0001), and sTfR/log SF index (r = -0.119; P = 0.004) were related to CRP, whereas sTfR (r = 0.029; P = 0.48) was not. Prevalence estimates were 39.7% for ID and 23.6% for IDA. ID was associated with 48.9% of anemia cases. Categories of SF were not significantly associated with HIV-related mortality or progression to stage 4. Nevertheless, SF > 150.0 microg/L was related to a nonsignificantly elevated risk of progression to stage 4 (rate ratio = 1.78; 95% CI = 0.68-4.64; P = 0.24) compared with SF < 12.0 microg/L. In HIV-infected, parous women from sub-Saharan Africa, ID is of moderately high prevalence and is an important underlying cause of anemia. High storage iron does not appear to be related to HIV disease progression in this population, but more research on the role of iron during HIV disease is needed.     

血清铁、TIBC、Tf、SF在缺铁性贫血患儿中的变化及其意义

目的 分析血清铁(SI)、总铁结合力(TIBC)、转铁蛋白(Tf)和铁蛋白(SF)在缺铁性贫血(IDA)患儿中的变化及意义,为临床诊治提供参考依据。方法 选取2014年1月-2016年2月在海南省妇幼保健院治疗的贫血患儿101例,其中IDA患儿67例(IDA组),慢性疾病性贫血(ACD)34例(ACD组),同时选取健康儿童100例作为对照组,检测各组血清SI、TIBC、Tf和SF水平。结果 IDA组患儿SI和SF分别为(4.70±1.30) mol/L和(59.43±18.84) g/L,明显低于对照组和ACD组(P＜0.05);IDA组患儿TIBC为(74.60±6.52) mol/L,明显高于对照组和ACD组(P＜0.05);IDA组和ACD组Tf分别为(3.30±0.52)g/L和(3.35±0.60)g/L,均明显高于对照组(P＜0.05);SI、TIBC和SF 诊断IDA的受试者工作特征(ROC)曲线下面积分别为0.837、0.822和0.755(P＜0.05),Tf ROC曲线下面积为0.515(P＞0.05);SI、TIBC和SF截断值分别为6.99 mol/L、61.90 mol/L和71.92 g/L,诊断IDA的灵敏度分别为73.50%、97.00%和73.50%,特异度分别为94.00%、64.70%和70.10%。结论 SI、TIBC和SF在小儿缺铁性贫血诊断中有一定的价值,可作为缺铁性贫血和慢性疾病性贫血鉴别诊断指标。     

Iron deficiency and Helicobacter pylori infection in the United States

Using data from the current National Health and Nutrition Examination Survey (1999-2000), the authors assessed whether Helicobacter pylori infection is associated with iron deficiency and iron-deficiency anemia (IDA) in the United States. Iron deficiency was defined as at least two abnormal results out of three biomarkers of iron stores. IDA was defined as a low hemoglobin level in the presence of iron deficiency. H. pylori infection was measured by serology. Complex survey estimators were used in the analysis. For 7,462 survey participants aged >or=3 years, H. pylori infection was associated with decreased serum ferritin levels (percent change = -13.9%, 95% confidence interval (CI): -19.5, -8.0) but not with levels of free erythrocyte protoporphyrin, transferrin saturation, or hemoglobin (percent change = 1.5%, -2.8%, and -1.1%, respectively). Multinomial logistic regression analyses indicated that H. pylori infection was associated with the prevalence of IDA (prevalence odds ratio (POR) = 2.6, 95% CI: 1.5, 4.6) and, to a lesser degree, other types of anemia (POR = 1.3, 95% CI: 1.0, 1.7). H. pylori infection was associated with a 40% increase in the prevalence of iron deficiency (POR = 1.4, 95% CI: 0.9, 2.0) after controlling for relevant covariates. In the United States, H. pylori infection was associated with iron deficiency/IDA regardless of the presence or absence of peptic ulcer disease.     

妊娠中期母亲铁营养与3~5月龄婴儿缺铁性贫血关系的研究

目的 研究孕中期母亲铁营养状况与3~5月龄婴儿缺铁性贫血(iron-deficiency anemia,IDA)的关系,为预防儿童IDA的发生提供科学依据。方法 测定妊娠中期母亲和脐带血血清铁蛋白(serum ferritin,SF)和血常规,随访至婴儿3~5月龄,测定婴儿血常规,对血红蛋白(hemoglobin,Hb)低于105 g/L的婴儿采集静脉血测定SF。比较妊娠中期母亲铁营养状况、脐带血SF和3～5月龄婴儿IDA的关系。结果 1) 3~5月婴儿IDA的发生率在孕中期铁缺乏组和正常组分别是12.9%和1.5%(χ²=4.62,P<0.05);2) 脐带血SF<75μg/L的发生率在孕中期铁缺乏组和正常组分别是25.8%和4.6%(χ²=9.6,P<0.05);3)3~5月龄婴儿IDA的发生率在脐带血SF<75 μg/L组是31.6%,脐带血SF≥75 μg/L组是2.8%(χ²=16.21,P<0.01)。结论 妊娠中期母亲轻度缺铁可减少胎儿期铁贮备,与早期婴儿IDA呈正相关。     

Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores

Iron status, prevalence of iron deficiency and elevated iron stores, and the effect of gastrointestinal ulceration on iron status in free-living Taiwanese elderly persons were all assessed in a nationally representative, cross-sectional nutrition survey--the Elderly NAHSIT. The survey included blood measurements of iron indices. Data were collected from 1202 elderly men and 1152 elderly women aged 65 years and older. Multiple iron measures, including serum ferritin (SF), transferrin saturation (Tsat), and hemoglobin were used to evaluate the prevalence of iron deficient erythropoiesis (ID) and iron deficiency anemia (IDA). Despite no routine practice of iron fortification in Taiwan, elderly subjects had a low prevalence of ID and IDA. The prevalence of ID was 2.3% in men and 1.4% in women. The prevalence of IDA was 2.5% in men and 2.0% in women. In contrast, 15.7% of men and 9.8% of women had elevated iron stores as diagnosed by SF>300 microg/L. Subjects with a history of gastrointestinal ulceration had significantly lower serum ferritin than those without ulcers, but the prevalence of anemia, ID and IDA was unaffected. In conclusion, elderly people in Taiwan are an iron-replete population with a high prevalence of elevated iron stores and a low prevalence of iron deficiency.     

北京山区学龄儿童铁营养状况及亚临床铁缺乏的干预效果

目的　调查北京山区学龄儿童机体铁营养状况、亚临床铁缺乏 (SID)患病率及观察采用乙二胺四乙酸钠铁 (NaFeEDTA)间断补充与早期铁干预效果。方法　对北京市房山山区 7～ 13岁学龄儿童 10 12名进行膳食调查、膳食频率调查与体内铁生化指标检测 ,依现行标准筛检贮存铁减少(IDs)、红细胞生成缺铁 (IDE)和缺铁性贫血 (IDA)儿童共 2 6 7名 ,给予口服NaFeEDTA胶囊 ( 6 0mgFe/粒 ) ,每次 1粒 ,IDs与IDE儿童 ,每周 1次 ;IDA儿童每周 3次 ,连续 9周。重复测定体内铁生化指标 ,并与干预前进行比较。结果　各年龄组儿童能量、蛋白质、铁和维生素C平均每日摄入量均达到推荐的膳食营养素摄入量 ,但膳食铁构成中血红素铁所占比例较低 ;该人群血液铁生化指标检测平均值 :血清铁蛋白含量为 ( 5 0 83± 33 0 9) μg/L ,红细胞游离原卟啉 (FEP)含量为 ( 489 44± 2 19 6 1) μg/L ,FEP/血红蛋白 (Hb)比值为 ( 3 83± 1 96 ) ,Hb含量为 ( 130 5 7± 10 82 )g/L ;总铁缺乏 (IDs+IDE +IDA)儿童检出率为 2 6 5 %,其中IDs占 15 5 %,IDE占 7 1%,IDA占 3 9%,SID占缺铁总人数的 85 4%,为IDA儿童的 5 8倍。进行铁干预后 ,体内各项铁指标显著提高并恢复至正常水平。结论　SID是值得重视的隐匿人群 ,采取早期鉴定、干预与综合     

559例婴幼儿铁缺乏症调查与防治

本文对6月～3岁559名婴幼儿进行铁缺乏症调查与防治。缺铁性贫血(IDA)患病率为53.85％,无贫血儿铁减少期(ID)及红细胞生成铁缺乏期(IDE)共48.11％,且各年龄组IDE均明显高于ID。贫血与发Fe、Zn无明显差异,而与发铜有非常明显差异。以调整饮食,铁强化食品,果味维生素C对轻度贫血232例分别进行防治观察,均有同样效果。     

孕期铁缺乏症妇女免疫细胞活性观察

目的　分析孕期铁缺乏和缺铁性贫血 (IDA)时妇女免疫细胞功能的变化。方法　检测 12 8名铁缺乏和 5 2名正常孕妇及 5 0名孕前妇女的T淋巴细胞亚群CD 3 、CD 4 、CD 8和自然杀伤 (NK)细胞CD16活性 ,分析孕妇不同程度铁缺乏时各免疫指标的变化。结果　孕期妇女外周血T细胞亚群CD 3 、CD 4 细胞百分比及CD 4 /CD 8比值显著低于非孕育龄妇女 ;孕期妇女随着铁缺乏程度的加重 ,CD 3 、CD 4 细胞的百分比随之下降 ;IDA孕妇的CD 3 、CD 4 细胞的百分比、CD 4 /CD 8比值显著低于正常孕妇 (P <0 0 1,P <0 0 5 ,P <0 0 5 ) ;IDA孕妇CD16细胞百分比低于正常孕妇 ,但尚无显著性差异。结论　铁缺乏孕妇T细胞亚群数量改变 ,NK细胞活性的下降尚需增加样本数进一步观察     

Multiple micronutrient deficiencies persist during early childhood in Mongolia

Data on the prevalence of micronutrient deficiencies in children in Mongolia is limited. We therefore determined the prevalence of anaemia, iron deficiency anaemia (IDA), and deficiencies of iron, folate, vitamin A, zinc, selenium, and vitamin D among young Mongolian children. Anthropometry and non-fasting morning blood samples were collected from 243 children aged 6-36 months from 4 districts in Ulaanbaatar and 4 rural capitols for haemoglobin (Hb), serum ferritin, folate, retinol, zinc, selenium, and 25-hydroxyvitamin D (25-OHD) assays. Children with alpha-1-glycoprotein >1.2mg/L (n=27) indicative of chronic infection were excluded, except for folate, selenium, and 25-hydroxyvitamin D assays. Of the children 14.5% were stunted and none were wasted. Zn deficiency (serum Zn <9.9 micromol/L) had the highest prevalence (74%), followed by vitamin D deficiency 61% (serum 25-OHD<25 nmol/L). The prevalence of anaemia (24%) and iron deficiency anaemia (IDA) (16%) was lower, with the oldest children (24-36 mos) at lowest risk. Twenty one percent of the children had low iron stores, and 33% had vitamin A deficiencies (serum retinol < 0.70 micromol/L), even though two thirds had received vitamin A supplements. Serum selenium values were low, perhaps associated with low soil selenium concentrations. In contrast, no children in Ulaanbaatar and only 4% in the provincial capitols had low serum folate values (<6.8 nmol/L). Regional differences (p<0.05) existed for anaemia, deficiencies of vitamin A, folate, and selenium, but not for zinc or IDA. Of the children, 78% were at risk of > or = two coexisting micronutrient deficiencies emphasizing the need for multimicronutrient interventions in Mongolia.     

Iron status during pregnancy: setting the stage for mother and infant

Supplementation with iron is generally recommended during pregnancy to meet the iron needs of both mother and fetus. When detected early in pregnancy, iron deficiency anemia (IDA) is associated with a > 2-fold increase in the risk of preterm delivery. Maternal anemia when diagnosed before midpregnancy is also associated with an increased risk of preterm birth. Results of recent randomized clinical trials in the United States and in Nepal that involved early supplementation with iron showed some reduction in risk of low birth weight or preterm low birth weight, but not preterm delivery. During the 3rd trimester, maternal anemia usually is not associated with increased risk of adverse pregnancy outcomes and may be an indicator of an expanded maternal plasma volume. High levels of hemoglobin, hematocrit, and ferritin are associated with an increased risk of fetal growth restriction, preterm delivery, and preeclampsia. While iron supplementation increases maternal iron status and stores, factors that underlie adverse pregnancy outcome are considered to result in this association, not iron supplements. On the other hand, iron supplements and increased iron stores have recently been linked to maternal complications (eg, gestational diabetes) and increased oxidative stress during pregnancy. Consequently, while iron supplementation may improve pregnancy outcome when the mother is iron deficient it is also possible that prophylactic supplementation may increase risk when the mother does not have iron deficiency or IDA. Anemia and IDA are not synonymous, even among low-income minority women in their reproductive years.