A Tasmanian study reported prevalence of IDA at 18% among women in pregnancy using an Hb level of <115 g/L, 12 and a New South Wales population study reported rates of low ferritin, defined as <12 ng/ml, as 19.6% in the first trimester. 1 However, few studies have determined rates of IDA in an Australian pregnant population according to consistent definitions. Iron deficiency anaemia (IDA) accounts for approximately 50% of cases worldwide. 9–11 It is also vital to identify women at increased risk from the effects of anaemia, such as women at risk of haemorrhage at birth, who have bleeding disorders, are on anticoagulation therapy or who, for religious or cultural reasons, might decline blood products. As part of preconception counselling or early antenatal care, it is important to consider known risk factors for developing anaemia in pregnancy, which include younger age (<18 years), multiparity, previous iron deficiency, shortened pregnancy interval, disadvantaged socioeconomic status, poor nutrition, non-white ethnic origin, haemoglobinopathy, chronic blood loss and parasitic disease. The capacity to reduce rates within Australia depends on early diagnosis, risk detection and management. Therefore, a threshold of Hb <105 g/L in the second trimester is widely used throughout international guidelines in defining and directing management. 1 Physiological changes occur in the second trimester, increasing plasma volume alongside a smaller increase in red cell mass resulting in haemodilution – recognised as ‘physiological anaemia’. 5Īnaemia is defined by the World Health Organization as a haemoglobin (Hb) <110 g/L at any stage of pregnancy and <100 g/L postpartum. 4 Australian prevalence rates are estimated at 25%, 1 with elevated risk for Aboriginal and Torres Strait Islander women. 2,3 Geographic variation occurs with greater prevalence in less developed countries, 1 especially in households with low income. Other causes include nutritional deficiencies, haemoglobinopathies, infectious and chronic diseases and, rarely, malignancy. Anaemia in pregnancy is a significant global health problem, with 38.2% of women worldwide affected, 1 predominantly because of iron deficiency.
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