Normocytic Anemia in Pregnant Women: A Scoping Review.
Study Goal
The researchers aimed to identify the underlying causes of normocytic anemia in pregnant women, particularly in developing countries, beyond just iron deficiency.
Results Summary
The study found that malaria and HIV were the highest causes of normocytic anemia in pregnant women, followed by worm/intestinal parasite infections, chronic diseases, and bleeding. Anemia of chronic disease and infection often coexisted with iron deficiency anemia, complicating diagnosis.
Population
Pregnant women in developing countries, specifically Indonesia.
Effective Dosage
90 iron tablets during pregnancy (exact dosage per tablet not specified).
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
iron supplementation program | decrease | anemia | pregnant women | - | is the main program for tackling | #1 |
90 iron tablets | neutral | - | expectant mothers | - | is recommended that expectant mothers ingest | #2 |
- | neutral | anemia | 37% of pregnant women in the country | - | experience | #3 |
iron deficiency | neutral | anemia | - | - | emerges as the primary etiology for diagnosing | #4 |
chronic illnesses and infections | increase | anemia | - | - | significantly contribute to the prevalence of | #5 |
malaria and HIV | increase | normocytic anemia | pregnant women | - | were the highest causes of | #6 |
worm/intestinal parasite infections, chronic diseases, and bleeding | increase | normocytic anemia | pregnant women | - | followed as causes of | #7 |
anemia of chronic disease and infection | neutral | iron deficiency anemia | pregnant women | - | coexists with | #8 |
anemia of chronic disease and infection | decrease | serum iron levels | - | - | show | #9 |
iron deficiency anemia | decrease | serum iron levels | - | - | show | #10 |
INTRODUCTION: The iron supplementation program for pregnant women is the main program for tackling anemia in various countries, especially in developing countries in which daily diets may lack sufficient iron intake. In Indonesia, it is recommended that expectant mothers ingest 90 iron tablets during their pregnancy; however, the World Health Organization reports that 37% of pregnant women in the country continue to experience anemia. Iron deficiency anemia consistently emerges as the primary etiology for diagnosing anemia; however, it is important to recognize that anemia can stem from various factors beyond just lack of iron. In addition to iron deficiency, chronic illnesses and infections significantly contribute to the prevalence of anemia worldwide. Consequently, this literature review endeavors to uncover the underlying factors responsible for normocytic anemia among pregnant women, focusing on developing countries. MATERIALS AND METHODS: Eight search engines, specifically Proquest, EbscoHost, Scopus, Cochrane Library, Science Direct, Wiley Online Library, PubMed, Google Scholar, and Garuda, were utilized to identify primary articles. Three independent reviewers assessed abstracts and full articles based on specific inclusion and exclusion criteria. The data collected encompassed information regarding the population under study, research methods employed, and primary findings pertinent to the review's objectives. Fifteen studies, published between 2014 and 2023, that met the eligibility criteria outlined in the PRISMA-ScR. RESULTS: Among the 15 studies on normocytic anemia in pregnant women, malaria and HIV were the highest causes of normocytic anemia, followed by worm/intestinal parasite infections, chronic diseases, and bleeding.. In pregnant women, anemia of chronic disease and infection often coexists with iron deficiency anemia, both show decrease serum iron levels. Hence, other investigations need to be carried out to diagnose with certainty the cause of anemia in pregnant women. CONCLUSION: Anemia is not a standalone disease but rather a symptom of various underlying diseases. Therefore, diagnosing anemia requires identifying the basic disease that causes anemia, rather than simply labeling it as anemia.