The aetiology of severe anaemia in pregnancy in Ndola, Zambia.

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

The aetiology of severe anaemia in pregnancy in Ndola, Zambia.

Ann Trop Med Parasitol. 1989 Feb;83(1):37-49. Unique Identifier : AIDSLINE MED/90087959
Fleming AF; Tropical Diseases Research Centre, Ndola, Zambia.

Abstract: The aetiology of severe anaemia (haemoglobin less than 7.0 g dl-1) has been studied in 37 pregnant Zambians. Aetiology was usually multiple; 31 (84%) had Plasmodium falciparum malaria, 23 (62%) were folate deficient, 13 (35%) were iron deficient, one had sickle-cell anaemia and one had the acquired immunodeficiency syndrome (AIDS). Folate deficiency was most often secondary to malarial haemolysis: iron deficiency was nutritional, but hookworm was contributory in about one-third of patients. The anaemia of malaria and folate deficiency was both more common and more severe than anaemia due to iron deficiency; it was seen in younger women although primigravidae were not over-represented, it occurred earlier in pregnancy, and was associated with low birthweight. AIDS must now be included in the differential diagnosis of anaemia in pregnancy. Vigorous antimalarial treatment and prophylaxis are essential in the management and prevention of anaemia in pregnancy. Total dose iron infusion is indicated only when severe iron deficiency anaemia has been proven, and must be accompanied by antimalarial therapy and folic acid supplements. Because of the risk of transmission of human immunodeficiency virus, it is more important than ever to prevent anaemia and malaria in pregnancy, and to give blood transfusion only as a life-saving treatment.

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS Adolescence Adult Anemia/*ETIOLOGY Anemia, Hypochromic/ETIOLOGY Anemia, Sickle Cell/COMPLICATIONS Animal Female Folic Acid Deficiency/COMPLICATIONS Human Infant, Newborn Malaria/COMPLICATIONS Plasmodium falciparum Pregnancy Pregnancy Complications, Hematologic/*ETIOLOGY Pregnancy Complications, Infectious Pregnancy Outcome Socioeconomic Factors Zambia JOURNAL ARTICLE
900330
M9030278

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