How does iron deficiency anemia affect maternal and infant mortality?

Anemia and Use the HemoCue TM years old and older iron deficiency anemia has been associated with poor school achievement. Supplementation has been show to improve school measurements of verbal and other skills among these older children. In addition, if anemic children are exposed to lead, they are at higher risk of lead poisoning than nonanemic children, as iron deficiency increases the absorption of metals including lead. Lead poisoning can cause irreversible neurological damage and learning and behavioral problems such as reduced intelligence, shortened attention span, and hyperactivity. Lead exposure is an increasing problem in urban areas in developing countries and near lead-related industries e.g., gasoline, paint, plumbing, food cans, ceramic glaze, cosmetics due to inadequately controlled industrial and vehicle emissions and unregulated cottage industries. 35 Children may chew on objects that are covered with dust and soil containing lead. Lead poisoning can also occur by breathing lead in the air or by drinking contaminated water or eating contaminated food. Lead also crosses the placenta and is toxic for fetuses. 2 5.3. How does iron deficiency anemia affect labor productivity? Mild to moderate iron deficiency anemia hinders the ability to carry out physical work because energy use by the muscles is adversely affected. Numerous studies of male workers and a few studies of female workers have shown that iron deficiency anemia is associated with reduced physical work capacity. One study of female tea plantation workers who were anemic and received iron supplements showed that they were significantly more productive than anemic female workers who did not receive iron supplementation. 36 This has important implications for economic development because a large proportion of both men and women living in poverty in developing countries devote long hours to physically demanding work, including, for women, farming, gardening, collecting water, gathering firewood, preparing food, and caring for young children. In addition, many of the jobs that provide cash income in developing countries are physically demanding. Table I-4 on the following page includes questions and answers about iron deficiency, iron deficiency anemia, and anemia, that summarize the key information in this chapter. 11 12 Table I-4. Questions and answers about iron deficiency, iron deficiency anemia, and anemia. Question Answer Which is more common, iron deficiency anemia or iron deficiency? Why? Iron deficiency. Severe iron deficiency can eventually result in anemia as iron stores become increasingly depleted. What causes iron deficiency? • Low intake of bioavailable iron during periods of rapid growth in infancy, early childhood, and adolescence. • Excessive loss of blood from menstruation, hemorrhage and due to certain parasitic infections schistosomiasis, whipworm, hookworm. What causes anemia? • Iron deficiency. • Hemoglobinopathies. • Other nutritional deficiencies such as folic acid, vitamin A, and vitamin B 12 . • Malaria. Why do women need more iron when they are pregnant? Pregnant women need more iron for plasma volume expansion, for placental development, for the transfer of iron to the fetus. Besides pregnancy, what other stages of life increase the need for iron? Lactation beyond six months and periods of rapid growth during early childhood and adolescence. What group of infants is most at risk of having or developing iron deficiency anemia? Why? Infants who are born prematurely. Most of the iron is transferred to the fetus and stored during the last trimester of pregnancy. If the infant is born prematurely, he or she may not have had enough time to develop adequate iron stores before birth to prevent anemia during the first six months of life. What are the benefits of iron supplementation during pregnancy? Iron supplementation can prevent anemia during pregnancy. Severely anemic women are less likely to die. Are infants whose mothers are anemic due to iron deficiency born with anemia? No. But they may be at increased risk of developing iron deficiency anemia earlier because their iron stores may be low at birth. At what age are infants most likely to start developing iron deficiency anemia? When they first start eating complementary foods, if they are switched from breast milk to other milks as a substitute, or when they are abruptly weaned from the breast. Generally infants do not develop anemia before they are six months old unless they are born prematurely. What are the adverse effects of iron deficiency among infants and young children? Development may be delayed and learning might be impaired. What are the adverse effects of iron deficiency among school age children? Learning and school performance may be poor. What are the adverse affects of iron deficiency among women who are not pregnant and men? They have less energy to carry out physical demanding work such as farming, gardening, collecting water, gathering firewood, preparing food, and caring for their young children.