الفهرس 
Iron deficiency anemiaOnly 14 pages are availabe for public view
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Abstract
Iron deficiency anemia (IDA) is the most common nutritional
deficiency around the globe, yet universal standards of practice
guidelines for diagnostic and treatment modalities are riddled with
inconsistencies and disagreements among practitioners.
The estimated prevalence of iron deficiency in pregnancy
varies from 30% in industrialized countries to >60% in other less
developed parts of the world. The disparity likely represents
myriad effects of access to health care, dietary quality and
quantity, and reproductive frequency. Iron fortification and
supplementation programs have reduced the prevalence of iron
deficiency and anemia in pregnancy in developed countries, but a
residual prevalence of around 10–20% in the United States
suggests there is still room for more progress. An inspection of the
NHANES III national survey data shows the lower quartile for
median iron intakes of reproductive age women is only between
8.4 and 9.9 mg/day, far below the habitual intakes that could
sustain the very large increase in requirements with pregnancy.
Nonenzymatic glycation of proteins increases in diabetic
patients. Of these glycated proteins, HbA1C is widely used as the
current standard marker for monitoring chronic glycemic control
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105
and represents an important target for treatment of diabetic
patients.
HbA1c is defined as irreversible non-enzymatic glycation at
one or both NH2- terminal valines of the b-chain. Hemoglobin
(Hb) subfractions, formed by glycation of a- and b-chains in HbA,
are collectively the glycohemoglobins (GHb). The actual extent of
glycation and the relative involvement of the a- and b-chains still
remain unclear.
GA level in vivo depends on the prevailing glucose
concentration, duration of exposure to elevated glucose; and
biological half-life of albumin (17 days). Therefore, GA level in
serum is thought to indicate the condition of blood glucose over
the most recent 2 to 4 weeks, while HbA1c indicates glycemic
state over the most recent 1 to 2 months.
In pregnant women displaying diabetes and women with
gestational diabetes mellitus, intensive glycemic control during
pregnancy is needed to lower the risk of intrauterine fetal death,
fetal growth disorders, and maternal complications.
In this study a case control study was done in the department
of obstetrics and gynecology in Ain Shams University Maternity
Hospital on 80 non diabetic pregnant women in the third trimester
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divided into 2 groups, first (study) group and second (control)
group.
Laboratory investigations including the following: Complete
blood count which is the most important investigation in anemia. It
should include Hb, Hct, RBCs count, MCV, MCH, HbA1c and
GA.
In our study we could conclude that iron deficiency increases
HbA1C in non diabetic pregnant women.
HbA1C was shown to be inversely associated with MCV and
MCH.
By contrast, serum GA levels are unaltered during the
pregnancy period. Therefore, we proposed that serum GA is a
better index for monitoring glycemic control in pregnant women.
The present study also showed that serum GA levels were not
influenced by iron metabolism indices in pregnant women.
This suggests that serum GA, rather than HbA1C, may offer
a suitable marker for chronic glycemic control in pregnant women.
Further studies will be needed to confirm the present results on
much more subjects.