Prevalence of anemia in pregnant Yemeni women in sana'a city

Dr Fadl Al-Wousabi1, Dr Hafiz Al-Nood2, Dr Sosun Al-Ra'awy3

1 Associate professor, Department of Obstetrics & Gynecology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
2 Associate professor, Department of Hematology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
3 Director of Laboratory Department, Al-Sabain Hospital, Sana'a, Yemen.

Introduction:

Anemia is defined as decreased hemoglobin level or circulating red blood cells and it is the most common hematological disorder during pregnancy particularly in developing countries.
During pregnancy, blood plasma volume increases by about 45% and the red cell mass rises by about 25% above normal by the end of gestation this still causes a fall in hemoglobin (Hb) concentration. Anemia continues to be a major health problem in many developing countries and is associated with increased rates of maternal and prenatal mortality, pre-term delivery, small for gestational age(SGA), lowbirth weight, sepsis and other adverse outcomes(1,2).
Upto 900 mg iron is needed for the rise in red cell mass and for the fetus. Despite an increase in iron absorption, few pregnant women get away from fall in iron stores by the end of pregnancy. The mean corpuscular volume (MCV) rises by about 4 fL in pregnancy which its

decrease is the first sign of iron deficiency that is followed by decrease in mean corpuscular hemoglobin (MCH) and finally anemia appears. Serum ferritin less than 15 ug/L with serum iron lower than 10 umol/L is indication for early iron deficiency in pregnancy.
Also in pregnancy, folate requirements are raised about twice since serum folate level falls to about half the normal concentrations with a less decrease in red cell folate. Megaloblastic anemia is common during pregnancy in some region of the world due to combination of increase folate requirements and poor diet. Both iron and folate intake usually should be increased during pregnancy to avoid iron and folate deficiency anemia particularly during the third trimester.
More than half of the pregnant women in the world have hemoglobin levels indicative of anemia(3). Although only 15%of pregnant women are anemic in developed countries(4). The World Health Organization (WHO) estimates that 58% of pregnant women in developing

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