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Key Words
Iron stores * Folate stores * Anemia * Pregnancy * Ferritin
Abstract
Background: A lack of information about the role that iron and folate stores (erythrocyte folate) play on the anemia incidence in pregnant women. Objective: To evaluate the predictive value of ferritin and erythrocyte folate before pregnancy in relationship to the incidence of anemia throughout pregnancy. Methods: Thirty-five non-anemic non-pregnant women were evaluated 1 or 2 months before the pregnancy. After becoming pregnant they were evaluated every 4 weeks starting in the 8th week of pregnancy until 1 month post-partum. Every evaluation included determination of hemoglobin, ferritin and erythrocyte folate. Results: When the women started gestation with an insufficient iron store (<20 gg/1), the trend was to present anemia at significantly earlier gestational ages, in such a way that at week 20 of gestation almost 60% of the women with an inadequate store had anemia and only 25% of the women with an adequate store had this condition. On the other hand, the pregestational erythrocyte folate did not predict anemia incidence. Conclusions: Pregestational ferritin concentration predicts value of incidence of anemia throughout pregnancy.
Copyright 2003 S. Karger AG, Basel
According to the 1999 National Nutrition Survey (Mexico) [ 1 ], the prevalence of anemia in pregnant women was of 26.4%. Even though this value is lower than that reported for developing countries (56%), it is still higher than the prevalence reported for developed countries (18%) [2]. The causes of anemia are multifactorial but most of the cases could be due to the initiation of pregnancy with insufficient stores of iron, folate and vitamin B12 among other nutrients. In fact, the influence of pregestational iron status on hemoglobin concentration patterns throughout pregnancy has been documented [3]. However, there is little information about the role folate stores (erythrocyte folate) play on hemoglobin concentrations throughout pregnancy. An inverse relationship between plasma folic acid and erythrocyte concentrations and reproductive performance evaluated by the newborn's birth weight and gestation length has been documented in some studies with pregnant women [4].
At this point it is important to establish a clear difference between women with genetic defects of folic acid metabolism that translate to a higher incidence of neural tube defects [51 and those women...