Iron Deficiency Anemia with Pregnancy Flashcards
WHO hemoglobin range to diagnose anemia
- below 120 g/l in nonpregnant women. (12 g/dl)
- below 110 g/l in pregnancy. (11 g/dl)
Percent of pregnant women experience Anemia
30% of nonpregnant women
40% of pregnant women experience anaemia.
The most common cause of anaemia worldwide is
iron deficiency, accounting for at least 50% of cases.
Why iron is important for human body
- DNA synthesis
- cell proliferation
- energy production, because it has a unique ability to mediate electron transfer (either reduction or oxidation) in enzymatic reactions.
Where is iron located in the body
- About 2/3 of the body’s iron is found in haemoglobin
- the remainder stored as ferritin and hemosiderin in the liver and reticuloendothelial system.
How is iron levels regulated
- is controlled by hepcidin, a peptide hormone mainly synthesised in the liver.
- Hepcidin is crucial for regulating gut iron absorption and erythrocyte recycling.
What affect levels hepcidin
- It increases in response to high circulating and tissue levels of iron.
- it decreases in tissue hypoxia, iron deficiency and increased erythropoietic activity as a result of inhibited transcription.
Iron distribution
3–4 g total body iron
* 1–2 mg iron is lost daily.
* 1 mg is lost during menstruation each month.
* Absorption in the gut is limited to 1–2 mg/day to replace iron loss, but can increase at times of need.
* Recycling of haem from aged erythrocytes generates approximately 40–60 mg iron/day, which is key to maintaining iron requirements.
What happens if iron has been taken up by enterocytes but is not required?
hepcidin prevents entry of iron into the circulation by reducing the expression of ferroportin, Iron therefore remains in the enterocyte and is lost when these cells are sloughed off.
What is ferroportin?
transmembrane protein that transports iron from the inside to the outside of a cell.
Hepicidin action in acute blood loss
If there is acute blood loss, hepcidin production decreases, which increases importation of iron by ferroportin
What is Hepicidin
5-amino acid peptide hormone that regulates iron uptake and release from stores in response to circulating and tissue levels of iron.
main storage protein for iron
Ferritin
Found in all cells and bodily fluids, the highest concentration being found in hepatocytes.
Blood loss effect on iron
For every millilitre of blood
lost, 0.5 mg iron is lost.
In postmenopausal women, the most common cause of anaemia is
blood loss from the gastrointestinal tract.
In premenopausal women from high-income countries, the most common cause of iron deficiency and iron-deficiency anaemia is
menstrual blood loss
HMB accounts forwhat percent of cases of iron-deficiency anaemia
20–30%