Diet and Medication for Anemic Pregnant Women
This paper highlights the efficacy of diet and medication interventions in improving the outcomes among anemic pregnant women. It comprises patients who are pregnant and with anemia from four ethnic groups. It will highlight intervention strategies intended to lessen the anemia among pregnant women with special emphasis on the dependant and independent variables
The development of the maternal environment is a complicated process that involves a cascade of events. These may include hormonal, genetic, biochemical, immunological, or environmental factors. However, nutrition also plays an important role. Especially, a diet regimen needs a perfect balance between the two essential components, nutrients and therapy or medication. With this in hand, the expectation of a successful pregnancy is no more a difficult task. In certain instances, conditions like anemia may complicate the pregnancy outcome which could occur through Iron deficiency. The frequent iron abnormalities are iron deficiency anemia (IDA) and Iron deficiency (ID) which are problematic health concerns globally (Paesano et al., 2010). In the third trimester, the frequency of prepartum anemia is nearly 14-52% in placebo-controlled women and 0-25% in women who are taking iron, which in turn relies on iron dosage (Milman, 2008). Similarly for those who are on ferritin administration, the proportion of IDA is nearly 12- 17% in placebo-controlled women and 0-% in women on ferritin (Milman, 2008). The to compromised neonatal hygiene, decreased weight of newborns, fetal growth retardation, and over trouble for preterm delivery (Paesano et al., 2010). Elevated iron need during pregnancy may contribute to the above-mentioned aberrations (Paesano et al., 2010). On the other hand, chemotherapeutic approaches involving folic acid and ferrous sulfate have some benefits in the improvement of anemia during pregnancy. However, there is limited information on the efficiency of diet and therapy in lessening anemia among pregnant women. Most pregnant women still need effective obstetric and pediatric supervision. A defect in this particular juncture could result in insufficient clinically relevant care for anemic pregnant women. This needs to be overcome by an efficient strategy.
The main purpose of the study is to identify the interventions that may improve outcomes among pregnant women with Anemia. Anemia is a severe health problem worldwide. It causes depleted levels of hemoglobin due to various reasons like malnutrition or poor diet, pregnancy, blood loss due to menstruation, vitamin B12, or folic acid deficiency. Most importantly, in pregnant women anemia occurs due to iron deficiency. It is essential for pregnant women to meet the growing needs of iron to nurture the developing baby. This could be accomplished through proper diet and medication management.
However, there is little information on the intervention strategies being exploited for the improvement of anemia among pregnant women. Especially, the role of nurses is considered important in providing care to anemic patients through the knowledge gained from the practice, theories or models, and education. They still need some assistance from the literature so that they could modify nursing skills in an evidence-based manner for the better improvement of anemia among pregnant women. The central component of this research is to identify and highlight the intervention strategies that may influence the improvement outcomes among anemic pregnant women. Further, this proposal attempts to connect the problem of anemia among pregnant women with nurse care.
What are the risk factors for pregnant women with anemia?
Review of literature
Pregnancy-associated conditions often rely on the optimum levels of certain required nutrients. One such condition is Anemia which is an important health issue among the women of reproductive age. In the developing countries, anemia is reported to be more common in preschool children (Leenstra et al., 2004). This was revealed when two risk population involving pregnant women and preschool children were assessed for Ferritin levels, iron deficiency in a multistage random study (Leenstra et al., 2004). The frequency of anemia and iron deficiency in school attending girls may indicate that these aberrations get induced since the beginning of childhood, right at the school age. This may further complicate the pregnancy success at a later stage. There is need to identify the anemic women population right at the initial stages of life.
The possible factors contributing to iron deficiency and anemia in this population may be low awareness of standardized diet or nutritional imbalance. In certain instances, overweight and obese conditions may interfere with the iron requirement (Eckhardt, Torheim, Monterrubio Barquera & Ruel, 2008). In a study, it was described that the iron needs are not thoroughly met in overweight and obese women in developing countries (Eckhardt et al., 2008). In addition, the supplementation of micronutrients other than iron seems to be inadequate (Eckhardt et al., 2008). Hence, the diet standard is a vital concern among women who are albeit on . In developed nations, pregnant women surviving on low economic conditions have increased vulnerability to Iron deficiency anemia (IDA) (Leblanc & Rioux, 2007).
Nutritionists have played key role in the selection process of pregnant women and at 36 +/- 2 weeks of gestation parameters like mean corpuscular volume, Hb,serum ferritin, and at six months of age transferrin saturation (TS), total iron binding capacity (TIBC),SF (Leblanc & Rioux, 2007).The pregnant women surviving on low income have similar frequency of IDA as that observed in high income groups. Most of these participants had abnormal Hb and SF levels (Leblanc & Rioux, 2007). Pregnant women had their abnormal anemic levels in the multipara and late stages of gestation (Kagu, Kawuwa, & Gadzama, 2007). In addition, the influence of malaria parasitaemia was also high in multipara and primigravidae (Kagu et al., 2007). This has indicated that the infestation of parasitic potozoans like malaria and Shistosoma and, educational awareness, decreased birth gap period were identified as risk contributing factors for anemia among pregnant women (Kagu et al., 2007).
Therefore, the risk factors necessary for the incidence or prevalence of anemia among pregnant women would also need to be considered from the infectious disease context. This could be because of the possibility that these parasites ay interfere with the normal homeostatic or metabolic machinery and accelerate the chances of acquiring anemia. Pregnant women need to be weary of cautionary measures about the living environment. Next, treatment strategies involving iron have certain side effects that need to be considered (Zhou,Gibson, Crowther,& Makrides, 2009).Dosage levels of iron in high and small amounts may induce problems related gastrointestinal tract (Zhou et al., 2009). Experiments conducted after the supplementation of iron at various doses have demonstrated that hemoglobin levels have shown a good response to iron (Zhou et al., 2009). This was apparent with 20mg, 40mg and 80 mg per day. One hundred and seventy-nine (99%) women completed the trial (Zhou et al., 2009).
Gastric abnormalities like vomiting, nausea, and stomach pain were however in decreased proportion for the group that received lower doses of iron compared to that received a higher dose (Zhou et al., 2009).Supplementation of iron may need to be cautiously recommended for the treatment of anemia especially with regard to the dosage (Zhang et al., 2009).This could minimize the to gastrointestinal tract. Epidemiology of anemia during is still unresolved with regard to the risk contributing factors. Initiative programs focusing on pregnancy-monitoring has shed light on anemia (Zhang, et al., 2009). Hemoglobin levels tested in each trimester of pregnancy has shown the proportion of 32.6% prevalence of anemia. There is also marked difference in each trimester (Zhang et al., 2009).
With this data in hand, researchers have noted that hypertension, which is in the form of mild and severely induced in pregnancy, job, education at pre high school level, and age are risk factors for anemia(Zhang et al., 2009). In addition, the supplementation of folic acid before the conception was shown to lessen the risk of anemia in the first trimester (Zhang et al., 2009). Whereas, in the 2nd and 3rd trimesters parental care implemented following the 1st trimester has enhanced risk contributing effect on anemia (Zhang et al., 2009). The magnitude of hypertensive disorders is closely associated with risk of anemia and 1st trimester anemia has low risk corresponding to the at the time of pre conception (Zhang et al., 2009). School girls at the teenage level may be susceptible candidates for the risk of anemia and in some circumstances anemia may also affect the physical work performance in nonpregnant adolescents and teenage pregnancies (Leenstra et al., 2009).
Hence, when adolescent schoolgirls were evaluated for iron levels and effect of vitamin A on hemoglobin concentration, hemoglobin levels were high with regard to the placebo group receiving iron for a prolonged period (Leenstra et al., 2009).
This observation was confined to iron deficient adolescent girls in contrast to those with sufficient iron levels (Leenstra et al., 2009). In addition, the same treatment strategy when applied for nonmenstruating and menstruating girls, the results did not show any variation (Leenstra et al., 2009). However, vitamin A did not exert any effect on iron levels (Leenstra et al., 2009).This has strengthened the connection between elevated hemoglobin levels and iron intake provided weekly among adolescent girls (Leenstra et al., 2009). It is important to note that this approach has profound significant impact on the effects caused by malaria in anemic pregnant women. Hence, iron supplementation could serve as the good diet resource among menstruating iron deficient teenage girls and also for the subsequent years of their pregnancy stage (Leenstra et al., 2009). Thus could also indirectly mitigate that parasitic influence on the anemic pregnant women (Leenstra et al., 2009).