Etiology of anemia in pregnancy in south Malawi
Etiology of anemia in pregnancy in south Malawi
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DOI：
10.1093/ajcn/72.1.247s
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发表时间：
2000-07-01
影响因子：
7.1
通讯作者：
Letsky, EA
中科院分区：
文献类型：
--
作者：
van den Broek, NR;Letsky, EA
背景：妊娠期贫血是发展中国家的一个主要公共卫生问题。在撒哈拉以南非洲，人们普遍认为这种贫血是营养缺乏，特别是缺铁造成的。目的：我们全面评估与妊娠贫血相关的营养和非营养因素。设计：在马拉维布兰太尔对150名孕妇进行横断面研究，测量血清中的铁、叶酸、维生素B-12和维生素A。对骨髓抽吸液进行了评估，对外周血片进行了疟疾寄生虫检查，对粪便和尿液样本进行了寄生虫感染检查，并对遗传疾病和艾滋病毒感染进行了检查。测量c反应蛋白（CRP）浓度和红细胞沉降率作为炎症标志物。结果：在150名贫血妇女中，23%缺铁，没有叶酸、维生素B-12或维生素A缺乏的证据；32%的人缺乏铁和一种或多种其他微量营养素；26%的人不缺铁，但有证据表明缺乏其他一种微量营养素，最常见的是维生素A；19%的人不缺乏所研究的任何微量营养素。在没有营养缺乏的贫血女性中，有54%的人CRP浓度明显高，在骨髓评估铁含量充足的贫血女性中，有73.5%的人CRP浓度明显高。结论：慢性炎症作为妊娠期贫血的一个可能因素，对妇女的临床评价和治疗具有重要意义。
Background: Anemia in pregnancy is a major public health problem in developing countries. In sub-Saharan Africa, such anemia is generally accepted as resulting from nutritional deficiencies, particularly iron deficiency.Objective: We comprehensively assessed the full spectrum of nutritional and nonnutritional factors associated with pregnancy anemia.Design: Iron, folate, vitamin B-12, and vitamin A were measured in serum in a cross-sectional study of 150 pregnant women in Blantyre, Malawi. Bone marrow aspirates were evaluated, peripheral blood films were examined for malaria parasites, stool and urine samples were examined for helminthic infection, and tests were done for genetic disorders and for HIV infection. C-reactive protein (CRP) concentrations and erythrocyte sedimentation rates were measured as markers of inflammation.Results: Of the 150 anemic women, 23% were iron deficient with no evidence of folate, vitamin B-12, or vitamin A deficiencies; 32% were deficient in iron and one or more of the other micronutrients; 26% were not iron deficient but had evidence of one of the other micronutrient deficiencies, most often vitamin A; and 19% were not deficient in any of the micronutrients studied. CRP concentrations were notably high in 54% of the anemic women with no nutritional deficiencies and in 73.5% of the anemic women who were iron replete by bone marrow assessment.Conclusion: The role of chronic inflammation as a possible contributing factor to anemia in pregnancy has important implications for the clinical evaluation and treatment of women.