Title: Estimation and Evaluation of Micronutrients and Vitamins Intake during Pregnancy

Authors: Dr Maleka Sultana, Prof. Dr Md. Nurul Amin, Prof. Nizamul Hoque Bhuiyan

 DOI: https://dx.doi.org/10.18535/jmscr/v9i11.09

Abstract

Background: Iron deficiency anemia, folic acid deficiency, and calcium deficiency during pregnancy can lead to adverse outcomes for both the mother and the infant in developing countries. Preventive measure before and during pregnancy can control the rate of maternal and child mortality and morbidity.

Objective: The purpose of the current research work was to find out the prevalence and outcomes of Iron deficiency anemia, folate deficiency, and Calcium deficiency during as well as the steps to prevent and control them.

Method: A whole of 50 blood trials (samples) of pregnant women were drawn into EDTA tubes from December,2019 to February,2020, from the Dhaka Medical College Hospital of Dhaka during the visits of the pregnant women to the Obstetrics & Gynaecology Department by using Sysmex XN-2000.

Result: Among 50 pregnant women, total 13(26%) pregnant women had moderate iron deficiency anemia, 5(10%) pregnant had severe iron deficiency anemia, and total 32(64%) pregnant women had mild iron deficiency anemia during pregnancy, it is also shown from the result that, total 32(64%) pregnant women had mild folate deficiency anemia, 13(26%) pregnant women had moderate folate deficiency anemia, and total 5 (10%) pregnant women had severe folate deficiency anemia. and total 38(76%) pregnant women had normal calcium level and total 12(24%) pregnant had hypocalcemia or Calcium deficiency.

Conclusion: Iron deficiency, folic acid deficiency and calcium deficiency during pregnancy lead to potential threats to the mothers such as miscarriage, pre- eclampsia, hemorrhage. pregnancy induced hypertension (PIH) and also brings out negative outcomes to the infants such as prematurity, low birth weight, growth retardation, cleft lip, cleft palate and neural tube defects. Increasing awareness, proper diagnosis and management of iron, folic acid, calcium deficiency during pregnancy will fill the nutritional gap and control the major causes of mortality and morbidity and poor maternal and fetal outcomes of pregnancy in Bangladesh.

Keywords: Anemia, iron deficiency anemia in pregnancy, folic acid deficiency in pregnancy, hypocalcemia in pregnancy, Dhaka Medical College, Hospital, Bangladesh.

References

  1. Grobman WA, Gersnoviez R, Landon MB, et al. Pregnancy outcomes for women with placenta previa in relation to the number of prior cesarean deliveries. Obstet Gynecol. 2007;110(6):1249–1255. doi:10.1097/01.AOG.0000292082.80566.cd.
  2. Ananth CV, Demissie K, Smulian JC, et al. Placenta previa in singleton and twin births in the United States, 1989 through 1998: a comparison of risk factor profiles and associated conditions. Am J Obstet Gynecol. 2003;188(1):275–281. doi:10.1067/mob.2003.10.
  3. Cresswell J, Ronsmans C, Calvert C, et al. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Trop Med Int Health. 2013;18(6):712–724. doi:10.1111/tmi.12100.
  4. Fan D, Wu S, Wang W, et al. Prevalence of placenta previa among deliveries in Mainland China: a PRISMA-compliant systematic review and meta-analysis. Medicine. 2016;95(40): e5107. doi:10.1097/md.0000000000005107.
  5. Butler E, Dashe J, Ramus R. Association between maternal serum alpha-fetoprotein and adverse outcomes in pregnancies with placenta previa. Obstet Gynecol. 2001;97(1):35–38. doi:10.1016/s0029- 7844(00)01095-4.
  6. Stoltzfus, R. J., L. Mullany, and R. E. Black. 2004. “Iron Deficiency Anemia.” In Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. M.Ezzati, A. D. Lopez, A. Rodgers, and C. J. L. Murray, eds. Geneva: World Health Organization.
  7. National Institute of Population Research and Training (NIPORT), Mitraand Associates, ICF International (2013) Bangladesh Demographic and Health Survey Report 2011.Dhaka, Bangladesh and Rockville, MD: NIPORT, Mitra and Associates, and ICF International.
  8. Ahmed F, Prendiville N & Narayan A (2016) Micronutrient deficiencies among children and women in Bangladesh: progress and challenges. J Nutr Sci5,e46.
  9. National Institute of Population Research and Training, Mitraand Associates & ICF International (2011) Bangladesh Demographic and Health Survey 2011. Dhakaand Calverton, MD: NIPORT, Mitra and Associates, and ICF International.
  10. Public Health Nutrition: 3(4), 385±393385 Anaemiain Bangladesh: a review of prevalence and aetiology Faruk Ahmed* Institute of Nutrition and Food Science, University of Dhaka, Dhaka-1000, Bangladesh Submitted 23 August 1999: Accepted20March 2000
  11. Fairlie FM, Sibai BM. Hypertensive diseases of pregnancy. In: Reece EA, ed. Medicine of the Fetus and Mother. Philadelphia, Pa: JB Lippincott; 1992:925-942.7. Kaunitz AM, Hughes JM, Grimes DA, Smith JC, Rochat RW, Kafrissen ME. Causes of maternal mortality in the United States. ObstetGynecol.1985; 65:605-612.
  12. Cunningham FG,      MacDonald     PC, Gant NF. Hypertensivedis. Orders in pregnancy. In: Williams Obstetrics.18th ed. Norwalk, Conn: Appleton & Lange;1989:653-694.
  13. Folate and      cobalamin        deficiencies and hyperhomocysteinemia in Bangladesh 2 Mary V Gamble, Habibul Ahsan, Xinhua Liu, Pam Factor-Litvak, Vesna Ilievski, Vesna Slavkovich, Faruque Parvez, and Joseph H Graziano Am J Clin Nutr.2005 June;81(6):1372-1377.
  14. Botto LD, Mulinare J, Erickson JD. Domultivita Minor folicacid supplements reduce the risk for congenital heart defects? Evidence and gaps. Am J Med GenetA.2003;121A:95-101.
  15. Bailey LB, Berry RJ. Folic acid supplementation and the occurrence of congenital heart defects, orofacialclefts, multiple births, and miscarriage. Am J Clin Nutr.2005; 81:1213S-1217S.
  16. Huhta JC, Linask K, Bailey L. Recent advances in the prevention of congenital heart disease. Curr Opin Pediatr.2006; 18:484-489.
  17. Ionescu-Ittu R, Marelli AJ, Mackie AS, Pilote L. Prevalence of severe congenital heart disease after folic acid fortification of grain products: time trend analysis in Quebec, Canada.BMJ.2009;338; b1673.
  18. The impact of maternal iron deficiency and iron deficiency anemia onchild’s health Noran M. Abu-Ouf, MBChB,MSc, Mohammed M. Jan, MBChB, FRCPC. J.Hopkins,"Folate-Deficiency Anemia".A. Almaghamsi, M. H. Almalki and B. M. Buhary," Hypocalcemiain Pregnancy: A Clinical Review Update," Oman Medical Journal, vol. 33, no. 6, pp. 453-462,2018.
  19. L.K. Vricella, "Emerging understanding and measurement of plasma volume expansion in pregnancy, "Am J Clin Nutr,vol.106,no.(Suppl),p.1620S-5S,2017.
  20. G.WHO, "Calcium supplementation in pregnant women, "2013. a.M.T.I.A.I.A.R.C.K.C., N. Sheikh Mohammed Shariful Islam, "National drug policy reform for non communicable diseases in low-resource countries: an example from Bangladesh," Bull World Health Organ,vol.95,p.382–384,2017.

Corresponding Author

Dr Maleka Sultana

HMO, Department of Obstetrics and Gynecology, DMC