Annotation: Iron Deficiency Anaemia in Pregnancy and its Management

Prof. Khalida Adeeb Khanum Akhtar

The authors of the preceding article on “Iron Sucrose Complex in Iron Deficiency Anaemia of Pregnancy”, have pointed out from literature search the difference in the incidence of iron deficiency anaemia, in women of child bearing age, between western women of developed countries and those in yet developing countries as 50% in the former and 78% in the latter, as a broad general perspective.
In this context it is of specific interest to refer to a study conducted at Holy Family Hospital Rawalpindi, in 1976¹ on a total number of 5000 pregnant women, in whom the percentage of anaemia was found to be 25%, and that of iron deficiency anaemia, was 62.5%. It is pertinent to mention here that this hospital at that time had a well-established private “Deluxe” section for patients of upper social stratum and a general section for lower middle class, with a semi private section for upper middle class group with hardly any patients of lower class.
Further the incidence of anaemia in pregnancy between the women of Deluxe and semi private sections was compared with those of general ward. Surprisingly enough severe anaemia (Haemoglobin (Hb) 6g/dl) was found to be 30% in the former group and 70% in the latter, but this difference became less pronounced with rising Hb. Iron deficiency among the anaemic pregnant women was upto 50% in the well to do women and 75% in the less well to do.
Total Dose Inferon (TDI) intravenous infusion was given after all the necessary precautions on one day (or at the most 2 days depending on the amount of total calculated dose). It was by and large administered to the non-compliant anaemic iron deficient women, around 32 weeks of pregnancy. Folic acid was given simultaneously. (History of allergies, asthma etc. were important exclusion criteria). The safety profile was good. I personally supervised the patients for first ½ to 1 hour of the infusion! The Response was excellent over the next 6 weeks, with maximum rise of Hb in the first week. A few non-responders were subjected to further investigations.
It would be worthwhile to conduct a study of this nature between anaemic, pregnant better to do and poor women of present Holy Family Hospital, Rawalpindi. I would be keen to know the results.

References

1. Akhtar KAK. Experiences with iron deficiency anaemia in pregnancy. RMJ 1976/b;5(1):11-20.