CURRENT APPROACHES BASED ON EVIDENCE IN IRON AND FOLATE DEFICIENCY ANEMIA IN PREGNANCY

Year 2019, Volume: 50 Issue: 3, 167 - 174, 15.09.2019

Zümrüt Bilgin , Nurdan Demirci

https://doi.org/10.16948/zktipb.469571

Cited By: 3

Abstract

Abstract: Anemia is the most common hematologic problem during pregnancy. It is estimated
that 38.2% of pregnant women in the world are anemic. The frequency of anemia
in women of reproductive age in Turkey is reported to vary between 20% and
39.9%. Anemia during pregnancy is evaluated in two groups as acquired and
inherited. During pregnancy, iron deficiency, which is often an acquired
deficiency anemia, and less frequently folic acid deficiency anemia occur. The
main cause of iron deficiency anemia (IDA) is; The low level of iron before
pregnancy, increased absorption during pregnancy is an increasing need.
Hemoglobin (Hb) and serum ferritin levels are measured primarily for the
diagnosis of iron deficiency anemia. The lowest Hb value during pregnancy
should be <11 gr/dL in 1st and 3rd trimester and <10.5 gr/dL in second
trimester.  Anemia in pregnancy;
increased risk of illness and death of the mother (20-40%), and increased risk
of intrauterine growth retardation, low birth weight, preterm delivery and
perinatal mortality in the fetus. In order to prevent maternal and fetal
complications, it is important to give iron and folate support to pregnant
women. Oral iron therapy in iron deficiency anemia is given as the first-line
therapy. Intravenous (IV) iron treatment is preferred in cases such as failure
of oral treatment, compliance to treatment, very low hemoglobin values and need
for fast iron replacement. In this review, it is aimed to examine the evidence
based current approaches in iron and folate deficiency anemia during pregnancy.

Keywords

Pregnancy, iron and folate anemia

GEBELİKTE DEMİR VE FOLAT EKSİKLİĞİ ANEMİSİNDE KANITA DAYALI GÜNCEL YAKLAŞIMLAR

Abstract

Özet:Anemi,
gebelikte en yaygın hemotolojik bir sorundur. Dünyadaki gebe kadınların %38.2'sinin
anemik olduğu, tahmin edilmektedir. Türkiye’de üreme çağındaki kadınlarda anemi
sıklığının %20 ile %39.9 arasında değiştiği belirtilmektedir. Gebelik
dönemindeki anemiler edinsel ve kalıtsal olmak üzere iki grupta değerlendirilir.
Gebelikte sıklıkla edinsel yetmezlik anemilerinden olan demir eksikliği ve daha
az sıklıkla da folik asit eksikliği anemisi oluşur. Demir eksikliği anemisi (DEA)’nin en temel nedeni;
gebelik öncesinde demir düzeyinin düşüklüğü, gebelikte absorbsiyonun artması
ile artan gereksinimdir. Demir eksikliği anemisinin tanısı için öncelikle hemoglobin
(Hb) ve serum ferritin düzeyi ölçülür. Gebelikte en düşük Hb değeri 1. ve 3. trimesterde <11 gr/dL,
2. trimesterde <10,5 gr/dL’olmalıdır. Gebelikte anemi; annenin
hastalanma ve ölüm riskinde artışla (%20-40 oranında), fetüste ise intrauterin büyüme
geriliği,  düşük doğum ağırlığı, erken
doğum ve perinatal mortalite riskinde artışla ilişkilidir. Maternal ve fetal
komplikasyonların önlenmesi için gebe kadınlara demir ve folat desteği
verilmesi önemlidir. Demir eksikliği anemisinde oral demir tedavisi birinci basamak tedavi olarak verilir. Oral
tedavi yanıtsızlığı, tedaviye uyum sorunu, çok düşük hemoglobin değerleri ve
hızlı demir replasmanına ihtiyaç duyulması gibi durumlarda intravenoz (İV)
demir tedavisi tercih edilmektedir. Bu derlemede gebelikte demir
ve folat eksikliği anemisinde kanıta dayalı güncel yaklaşımların incelenmesi
amaçlanmıştır.

Keywords

Gebelik, demir ve folat anemisi

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