临床专科知识讲解习题考试题tusduringregnancy_settingthestageformotherandinfant
5页1、 Ironstatusduringpregnancy:settingthestageformotherand14infantTheresaOSchollABSTRACTPREVALENCEANDETIOLOGYOFANEMIAANDIRONDEFICIENCYINWOMENSupplementationwithironisgenerallyrecommendedduringpreg-nancytomeettheironneedsofbothmotherandfetus.Whendetectedearlyinpregnancy,irondeficiencyanemia(IDA)isassociatedwitha2-foldincreaseintheriskofpretermdelivery.Maternalanemiawhen diagnosed before midpregnancy is also associated with anincreasedriskofpretermbirth.ResultsofrecentrandomizedclinicaltrialsintheUnit
2、edStatesandinNepalthatinvolvedearlysupple-mentation with iron showed some reduction in risk of low birthweightorpretermlowbirthweight,butnotpretermdelivery.Duringthe3rdtrimester,maternalanemiausuallyisnotassociatedwithincreasedriskofadversepregnancyoutcomesandmaybeanindi-catorofanexpandedmaternalplasmavolume.Highlevelsofhe-moglobin,hematocrit,andferritinareassociatedwithanincreasedriskoffetalgrowthrestriction,pretermdelivery,andpreeclampsia.While iron supplementation increases maternal iron stat
3、us andstores,factorsthatunderlieadversepregnancyoutcomeareconsid-eredtoresultinthisassociation,notironsupplements.Ontheotherhand,ironsupplementsandincreasedironstoreshaverecentlybeenlinkedtomaternalcomplications(eg,gestationaldiabetes)andin-creasedoxidativestressduringpregnancy.Consequently,whileironsupplementationmayimprovepregnancyoutcomewhenthemotherisirondeficientitisalsopossiblethatprophylacticsupplementationmayincreaseriskwhenthemotherdoesnothaveirondeficiencyorIDA. Anemia and IDA are not
4、synonymous, even among low-Irondeficiencyisthemostcommonlyrecognizednutritionaldeficitineitherthedevelopedorthedevelopingworld.Duringtheirreproductiveyearswomenareatriskofirondeficiencydueto blood loss from menstruation, in particular that 10% whosufferheavylosses(80mL/mo).Contraceptivepracticealsoplaysaparttheintrauterinedevicesincreasesmenstrualbloodlossby30%50%whileoralcontraceptiveshavetheoppositeeffect.Pregnancyisanotherfactor.Duringpregnancythereisasignificantincreaseintheamountofironrequi
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