Parity as a Determinant of the Hematologic Response to Hematinics Supplementation in Underprivileged Pregnant Women in Malaysia

Abstract

The effect of parity on the hematological response to supplemental hematinics and the relationship between birth weight and Hb concentration were examined in 67 pregnant rural Kelantanese Malay women recruited at 20-24 weeks of gestation. Among initially anemic women (Hb concentration at recruitment <110 g/l), a significant supplementation effect was observed in the lower parae (3 or less children) but not in the higher parae. Among initially nonanemic women, a progressive decline in mean Mb concentration was observed in the higher parae; in the lower parae, however, an initial fall in mean Hb concentration was followed by a rise to almost the initial level. Birth weight was inversely related to initial Hb concentration. There was no association between birth weight and final measured Hb level, parity or any of the measured maternal characteristics. These observations suggest: a) women with initially lower Hb concentration might have experienced a greater acceleration of plasma volume expansion than those with initially higher Hb level; and b) hemopoiesis might be impaired in the higher multiparae.

Keywords

Pregnancy hemoglobin level parity Malaysia

Get full access to this article

View all access options for this article.

References

1. World Health Organization : Nutritional Anemias Geneva: WHO, 1968. WHO Tech. Rep. Ser. No. 405.

2. DeMaeyer EM , Adiels-Tegman M : The prevalence of anaemia in the world. World Health Stat Q 1985;38:302–316.

3. MacGregor MW : Maternal anaemia as a factor in prematurity and perinatal mortality. Scot Med J 1963;8:134–138.

4. Lourdenadin S : Hazards of anaemia in pregnancy in Malaysia. Intl J Gynecol obstet 1969;7:234–242.

5. Charoenlarp P , Dhanamitta S , Kaewvichit R , et al.: A WHO collaborative study on iron supplementation in Burma and in Thailand. Am J Clin Nutr 1988;47:280–297.

6. Sood SK , Ramachandran M , Gupta MK , et al.: WHO sponsored collaborative studies on nutritional anaemia in India. I. The effects of supplemental oral iron administration to pregnant women. Quart J Med 1975;44:241–258.

7. International Committee for Standardization of Haematology : Recommendations for haemoglobinometry in human blood and specifications for international haemoglobin cyanide reference preparation. J Clin Pathol 1978;31:139–143.

8. Rush D , Sloan NL , Leighton J , et al.: Longitudinal study of pregnant women. Am J Clin Nutr 1988;48:439–483.

9. Tasker PWG : Anaemia in pregnancy. Med J Malaya 1958;13:3–6.

10.

10. Lund CJ : Studies on the iron deficiency anemia of pregnancy. Amer J Obstet Gynec 1951;62:947–950.

11.

11. Cope I : Plasma and blood volume changes in late and prolonged pregnancy. J Obstet Gynaec Brit Emp 1958;65:877–881.