Annals of Hematology

, Volume 86, Issue 9, pp 647–651

Higher prevalence of anemia among pregnant immigrant women compared to pregnant ethnic Danish women

  • Mads Nybo
  • Lennart Friis-Hansen
  • Peter Felding
  • Nils Milman
Original Article
  • 170 Downloads

Abstract

The aim of the study was to investigate whether the well-known high anemia prevalence in pregnant women from the eastern Mediterranean and Asian regions decreased when the women immigrated to a low-frequency region (Denmark). During 70 months, 1,741 pregnant immigrant women referred from primary care to an obligatory hemoglobinopathy screening were eligible for the study, as their screening was negative. To compare this group with a cohort of 205 pregnant ethnic Danish women, the groups were matched by gestational age, and a total of 406 immigrant women were included. Hemoglobin (Hb) and iron status parameters were examined in the two groups. The prevalence of anemia was higher in the immigrant group (20.0%) compared to the Danish women (4.9%) (P < 0.0001). Blood Hb concentration was 119 ± 12 g/l (mean ± SD) in the immigrant group compared to 122 ± 9 g/l in the Danish group (P = 0.01). Erythrocyte mean corpuscular volume (MCV) was also lower in the immigrant group (87 ± 7 fl vs 96 ± 4 fl) (P < 0.0001). A total of 13.1% of the immigrant women had an MCV <80 fl (the lower reference limit) compared to 0.0% in the Danish group, and plasma iron, ferritin, and transferrin saturation values indicated iron deficiency. Conclusively, the pregnant immigrant women had significantly higher prevalence of anemia compared to pregnant women of Danish origin. It indicates the need for an alternative routine screening procedure for this population group, which should also include nutritional counselling.

Keywords

Pregnant women Iron deficiency anemia Hemoglobinopathy screening Immigrants 

References

  1. 1.
    Milman N (2006) Iron and pregnancy—a delicate balance. Ann Hematol 85:559–565PubMedCrossRefGoogle Scholar
  2. 2.
    DeMaeyer E, Adiels-Tegman M (1985) The prevalence of anaemia in the world. World Health Stat Q 38:302–316PubMedGoogle Scholar
  3. 3.
    Milman N, Agger OA, Nielsen OJ (1991) Iron supplementation during pregnancy. Effect on iron status markers, serum erythropoietin and human placental lactogen. A placebo controlled study in 207 Danish women. Dan Med Bull 38:471–476PubMedGoogle Scholar
  4. 4.
    Smith R (1990) Asian rickets and osteomalacia. Q J Med 76:899–901PubMedGoogle Scholar
  5. 5.
    Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Thomsen J, et al (2000) Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med 247:260–268PubMedCrossRefGoogle Scholar
  6. 6.
    Meulmeester JF, van den Berg H, Wedel M, Boshuis PG, Hulshof KF, Luyken R (1990) Vitamin D status, parathyroid hormone and sunlight in Turkish, Moroccan and Caucasian children in The Netherlands. Eur J Clin Nutr 44:461–470PubMedGoogle Scholar
  7. 7.
    Sargent JD, Stukel TA, Dalton MA, Freeman JL, Brown MJ (1996) Iron deficiency in Massachusetts communities: socioeconomic and demographic risk factors among children. Am J Public Health 86:544–550PubMedCrossRefGoogle Scholar
  8. 8.
    Lehmann F, Gray-Donald K, Mongeon M, Di Tommaso S (1992) Iron deficiency anemia in 1-year-old children of disadvantaged families in Montreal. Can Med Assoc J 146:1571–1577Google Scholar
  9. 9.
    The Danish National Board of Health (1998) Svangreomsorg: retningslinier og redegørelse: sundhedsvæsenets indsats i forbindelse med graviditet, fødsel og barselsperiode. The Danish National Board of Health, Copenhagen, DenmarkGoogle Scholar
  10. 10.
    Milman N, Byg KE, Agger AO (2000) Hemoglobin and erythrocyte indices during normal pregnancy and postpartum in 206 women with and without iron supplementation. Acta Obstet Gynecol Scand 79:89–98PubMedCrossRefGoogle Scholar
  11. 11.
    WHO (1968) Nutritional anaemias. Report of a WHO Scientific Group. WHO Tech Rep Ser 405:1–40Google Scholar
  12. 12.
    Foglietta E, Deidda G, Graziani B, Modiano G, Bianco I (1996) Detection of α-globin gene disorders by a simple PCR methodology. Haematology 81:387–396Google Scholar
  13. 13.
    Macphail S, Thomas TH, Wilkinson R, Dunlop W, Davison JM (1991) Erythrocyte hydration in normal human pregnancy. Br J Obstet Gynaecol 98:1205–1211PubMedGoogle Scholar
  14. 14.
    Lesperance L, Wu AC, Bernstein H (2002) Putting a dent in iron deficiency. Contemp Pediatr 19:60–79Google Scholar
  15. 15.
    Wu AC, Lesperance L, Bernstein H (2002) Screening for iron deficiency. Pediatr Rev 23:171–177PubMedGoogle Scholar
  16. 16.
    Ezekowitz JA, McAlister FA, Armstrong PW (2003) Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12065 patients with new-onset heart failure. Circulation 107:223–225PubMedCrossRefGoogle Scholar
  17. 17.
    Collins AJ (2002) Influence of target hemoglobin in dialysis patients on morbidity and mortality. Kidney Int Suppl 80:44–48PubMedCrossRefGoogle Scholar
  18. 18.
    Nybo M, Kristensen SR, Mickley H, Jensen JK (2007) The influence of anaemia on stroke prognosis and its relation to N-terminal pro-brain natriuretic peptide. Eur J Neurol 14(5):477–482PubMedCrossRefGoogle Scholar
  19. 19.
    Dexter F, Hindman BJ (1997) Effect of hemoglobin concentration on brain oxygenation in focal stroke: a mathematical modelling study. Br J Anaesth 79:346–351PubMedGoogle Scholar
  20. 20.
    Bothwell TH, Charlton RW, Cook JD, Finch CA (1979) Iron metabolism in man. Blackwell, OxfordGoogle Scholar
  21. 21.
    Beguin Y (2003) Soluble transferrin receptor for the evaluation of erythropoiesis and iron status. Clin Chim Acta 329:9–22PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Mads Nybo
    • 1
    • 4
  • Lennart Friis-Hansen
    • 1
  • Peter Felding
    • 2
  • Nils Milman
    • 3
  1. 1.Department of Clinical BiochemistryRigshospitalet, University of CopenhagenCopenhagenDenmark
  2. 2.Copenhagen General Practitioners’ LaboratoryCopenhagenDenmark
  3. 3.Department of Medicine BRigshospitalet, University of CopenhagenCopenhagenDenmark
  4. 4.Department of Biochemistry, Pharmacology and GeneticsOdense University HospitalOdenseDenmark

Personalised recommendations