A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Pregnancy and Anemia of Various Origin: Effectiveness of a Differentiated Approach

DOI:10.31550/1727-2378-2020-19-8-25-31
For citation: Gasanova B.M., Polina M.L. Pregnancy and Anemia of Various Origin: Effectiveness of a Differentiated Approach. Doctor.Ru. 2020; 19(8): 25–31. (in Russian). DOI: 10.31550/1727-2378-2020-19-8-25-31

Study Objective: To assess the impact of ferrokinetics and serum cytokine profiles on pregnancy outcomes in patients with anemia of various origin.

Study Design: This was a prospective study.

Materials and Methods: A complete blood count was done and levels of serum iron, C-reactive protein (CRP), total protein, and ferritin, as well as cytokine profiles (interleukin [IL]-1β, -4, -8, -10, tumor necrosis factor [TNF]-α, and interferon [IFN]-γ), were assessed in pregnant women with iron deficiency anemia (IDA) (n = 34) and infection-related anemia (n = 28).

Study Results: In patients with IDA, hemoglobin concentration, red blood cell (RBC) count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC) were significantly lower (p<0.05) than in patients with infection-related anemia. Markers of infection-related anemia—increased levels of ferritin (in 82.2% of the women) and CRP—suggested the need for anti-inflammatory and antioxidant treatment.

Women with infection-related anemia had higher levels of pro-inflammatory cytokines than women with IDA (p<0.05): IL-1β levels were 1.7 times higher; those of IL-8 and IFN-γ were 1.4 and 1.8 times higher, respectively, and those of TNF-α and IL-10 were 2.3 and 2.0 times higher, respectively.

The study revealed a relationship between infection-related anemia and various gestational complications (OR = 1.1–3.5) and placental insufficiency (100.0% vs. 63.8% in IDA).

Conclusion: To reduce the frequency of unfavorable perinatal outcomes, differentiated management is required for pregnant women with IDA and infection-related anemia. An optimal approach for women with anemia of any origin includes improvement of the woman’s general health before conception and preventive measures against obstetric complications starting in the early stages of pregnancy. 

Contributions: Dr. B.M. Gasanova participated in developing the idea of the study and its design, collected clinical material, processed and analyzed data, wrote the paper, and approved the final version of the manuscript submitted for publication. Dr. M.L. Polina designed the study, analyzed data, and was scientific editor of the manuscript.

Conflict of interest: The authors declare that they do not have any conflict of interests.

B.M. Gasanova — Dagestan State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Federation Ministry of Science and Higher Education; 1 Lenin Square, Republic of Dagestan, Makhachkala, Russian Federation 367000. Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education); 6 Miklouho-Maclay St., Moscow, Russian Federation 117198. https://orcid.org/0000-0001-6871-7102. E-mail: bchm75@mail.ru

M.L. Polina (Corresponding author) — Medical Center for Women’s Health; 10 Zarevy Proyezd, Moscow, Russian Federation 127282. https://orcid.org/0000-0003-3883-3967. E-mail: polina.ml@mail.ru

Доктор.ру

Table 1

Hematological parameters of pregnant women with anemia of various origin (M ± m)

t4_1.jpg

1 Mean corpuscular volume.

2 Mean corpuscular hemoglobin concentration.

Fig. Specific changes in hematological parameters of pregnant women with anemia of various origin, %

r4_1.jpg 

Table 2

Cytokine profiles of pregnant women with anemia of various origin (M ± m), pg/mL

t4_2.jpg 

Received: 09.01.2020

Accepted: 24.03.2020

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