Comprehensive morphological study of free radical processes in chronic chorioamnionitis on the background of iron deficiency anemia in pregnancy.

OBJECTIVE: Aim: To establish the features of free radical processes in the endotheliocytes of the chorionic plate of the placenta in chronic chorioamnionitis against the background of iron deficiency anemia of pregnant women using both chemiluminescent and histochemical methods of research. PATIENTS AND METHODS: Materials and Methods: 82 placentas from parturients at 37 - 40 weeks of gestation were studied. Including, for comparison, the placenta during physiological pregnancy and the observation of iron deficiency anemia of pregnant women without inflammation of the placenta. The number of observations in specific study groups is given in the tables. To achieve the objective and solve the tasks set in this study, there were carried out the following histochemical, chemiluminescent, morphometric and statistical methods of material processing. RESULTS: Results: In case of chorionamnionitis against the background of anemia in pregnancy, the R/B ratio (R/B - ratio between amino- (blue) and carboxyl (red) groups of proteins)) in the method with bromophenol blue according to Mikel Calvo was 1.56±0.021, indicators of chemiluminescence of nitroperoxides were 133±4.5, relative optical density units of histochemical staining using the method according to A. Yasuma and T. Ichikawa was - 0.224±0.0015. CONCLUSION: Conclusions: With chronic chorioamnionitis, the intensity of the glow of nitroperoxides, the average indicators of the R/B ratio, and the optical density of histochemical staining for free amino groups of proteins are increased compared to placentas of physiological pregnancy and anemia of pregnant women. Comorbid i anemia of pregnant women causes increasing of the intensity of the glow of nitroperoxides, the average values of the R/B ratio, and the optical density of histochemical staining for free amino groups of proteins comparing to placentas with inflammation without anemia. The key factor in the formation of morphological features of chronic chorioamnionitis with comorbid anemia is the intensification of free radical processes, which is reflected by the increase in the concentration of nitroperoxides in the center of inflammation, with the subsequent intensification of the processes of oxidative modification of proteins, which is followed by the increasing activity of the processes of limited proteolysis.

Gestational anemia and maternal antenatal and postpartum psychological distress in a prospective FinnBrain Birth Cohort Study.

BACKGROUND: Gestational anemia, most commonly caused by iron deficiency, may increase the risk of maternal anxiety and depression and have a potentially far-reaching impact on mother's and newborn's health. Several mechanisms, such as effects of iron deficiency on cerebral neurotransmitter metabolism, have been suggested. None of the earlier studies have assessed the association between gestational anemia and depression, anxiety and pregnancy-related anxiety simultaneously. METHODS: Women, participating in the FinnBrain Birth Cohort Study and attending maternity welfare clinics in Turku, whose hemoglobin (Hb) values during pregnancy were available were included in this study (n = 1273). The study group consisted of 301 women with Hb levels < 11.0 g/dL at any time during pregnancy, and 972 women with Hb ≥ 11.0 g/dL were included in the control group. Symptoms of depression, anxiety, and pregnancy-related anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS), Symptom Checklist-90 (SCL), and Pregnancy-Related Anxiety Questionnaire (PRAQ) questionnaires at 14, 24, and 34 gestational weeks, and EPDS and SCL were also performed 3 and 6 months postpartum. RESULTS: Gestational anemia was not associated with an increased risk of depression either prenatally or postpartum when the analyses were adjusted for maternal age at birth, parity, smoking during pregnancy, maternal education, and gestational age. However, a weak connection was found between gestational anemia and prenatal anxiety in the early pregnancy. Furthermore, the analysis between women with Hb < 10.0 g/dL and those with Hb ≥ 10.0 g/dL showed an association between gestational anemia and anxiety in the late pregnancy, but otherwise no difference in psychological distress was found. CONCLUSIONS: No evidence supporting the association between gestational anemia and antenatal or postpartum depression was found. However, a weak connection between gestational anemia and antenatal anxiety was observed. This finding needs further investigation to establish timing and investigate causality.

Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections.

OBJECTIVES: Gestational IDA has been linked to adverse maternal and neonatal outcomes, but the impact of iron supplementation on outcome measures remains unclear. Our objective was to assess the effects of gestational IDA on pregnancy outcomes and compare outcomes in pregnancies treated with either oral or intravenous iron supplementation. METHODS: We evaluated maternal and neonatal outcomes in 215 pregnancies complicated with gestational IDA (Hb<100 g/L) and delivered in our tertiary unit between January 2016 and October 2018. All pregnancies from the same period served as a reference group (n=11,545). 163 anemic mothers received oral iron supplementation, and 52 mothers received intravenous iron supplementation. RESULTS: Gestational IDA was associated with an increased risk of preterm birth (10.2% vs. 6.1%, p=0.009) and fetal growth restriction (FGR) (1.9% vs. 0.3%, p=0.006). The gestational IDA group that received intravenous iron supplementation had a greater increase in Hb levels compared to those who received oral medication (18.0 g/L vs. 10.0 g/L, p<0.001), but no statistically significant differences in maternal and neonatal outcomes were detected. CONCLUSIONS: Compared to the reference group, prematurity, FGR, postpartum infections, and extended hospital stays were more common among mothers with gestational IDA, causing an additional burden on the families and the healthcare system.

Comparison of the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of iron deficiency anemia among pregnant women seen at the out-patient department of a tertiary medical center on 2016-2017 / Philippine Journal of Obstetrics and Gynecology

Background@#Anemia is a major global problem that affects women and prevalent during pregnancy. Effective management is needed to prevent adverse maternal and pregnancy outcomes. Ferrous iron salts are the preparation of choice and recommended for both prevention and treatment of iron deficiency anemia (IDA). However, most commonly available iron supplement are poorly absorbed, with gastrointestinal disturbances as side effect.@*Objective@#To compare the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of IDA among pregnant women seen at the out-patient department of a tertiary medical center.@*Methodology@#This study is a single blind randomized clinical trial which included women 18 to 40 years old, with singleton pregnancies diagnosed with IDA without any co-existing fetal and maternal complications seen at the OutPatient Department. Forty eight eligible participants were randomized, with 24 women allocated on each treatment arm who took their assigned treatment twice a day for 90 days. Hemoglobin, hematocrit, MCHC, MCV, RDW & serum ferritin levels were taken at baseline and monitored on days 30, 60 and 90 from initiation of treatment. Mean blood parameters between two treatment arms were compared on days 30, 60 and 90 post-treatment as well as the mean difference of blood parameters on days post-treatment from the baseline using T-test. Chi-square was used to compare adverse effects between two treatment arms.@*Results@#No statistically significant differences in the mean blood parameters on days 30 and 60 of treatment between Iron amino acid chelate and Ferrous sulfate. It was only on day 90 from initiation of treatment when there were a significantly higher hematocrit and MCHC and lower RDW in Iron amino acid chelate compared to Ferrous sulfate group. All of the CBC parameters on days 30, 60, and 90 post-treatment when compared to baseline level were significantly increased for both treatment arms. However, day 90 level of serum ferritin in the Iron amino acid chelate group significantly increased unlike those in ferrous sulfate group.@*Conclusion@#Iron amino acid chelate is comparable to Ferrous sulfate in the treatment of IDA among pregnant women. Iron amino acid chelate was found to be superior to Ferrous sulfate in achieving optimum treatment response even at a lower dose with lesser adverse effects. Hence, better oral iron treatment tolerability, thereby, compliance to long-term therapy can be expected resulting to successful treatment outcome.