ABSTRACT
Background: Anemia during pregnancy is associated with oxidative
stress, which might expectedly provoke harmful consequences on maternal and
perinatal outcomes. Use of iron in women during pregnancy improves maternal
hematologic parameters, while likely to worsen oxidative status. Objectives: Our study thus aimed to assess adverse outcomes on all women having been
routinely iron supplemented during pregnancy. Methods: This is a
prospective observational cohort of 74 pregnant women with singleton pregnancy
whose baseline iron and oxidative status along with variations throughout
pregnancy have been recently assessed at university clinics of Kinshasa, DR
Congo. Obstetrical adverse outcomes were assessed according to the diagnosis of
anemia and oxidative stress considered at recruitment, at 28 - 32 weeks of
gestation and at term. For statistical calculations, we used t-test,
chi-square test, ANOVAR and regression, the significance being stated at p <
0.05. Results: Complications significantly associated with anemia at the
beginning of pregnancy were acute fetal distress (OR = 3.9, p < 0.03), prematurity
(OR = 7.3, p < 0.007), low birth weight or LBW (OR = 3.4, p < 0.05),
birth asphyxia (OR = 15.1, p < 0.002) and neonatal hypoglycemia (OR = 3, p
< 0.05). When the diagnosis of anemia was considered at 28 - 32 weeks of
gestation, significant associations were found with gestational diabetes mellitus
or GDM (OR = 3.8, p < 0.05), cesarean section (OR = 4.8, p < 0.003),
prematurity (OR = 5.3, p < 0.03), birth asphyxia (OR = 10.9, p < 0.008)
and neonatal hypoglycemia (OR = 4.7, p < 0.02). At term, the diagnosis of
anemia was significantly associated with GDM (OR = 9.2, p < 0.01), premature
rupture of membranes or PROM (OR = 2.8, p < 0.05), cesarean section (OR =
6.03, p < 0.01), birth asphyxia (OR = 2.9, p < 0.05) and neonatal
hypoglycemia (OR = 3, p < 0.05). As of oxidative stress diagnosed at recruitment,
significant associations were found with PROM (OR = 9, p < 0.02), cesarean
section (OR = 3.7, p < 0.05), prematurity (OR = 6.4, p < 0.02), birth
asphyxia (OR = 13.2, p < 0.004) and neonatal hypoglycemia (OR = 2.6, p <
0.05). The diagnosis of oxidative stress at 28 - 32 weeks of gestation was
found significantly associated with acute fetal distress (OR = 4.2, p <
0.02), cesarean section (OR = 2.9, p < 0.05), LBW (OR = 9.9, p < 0.002),
birth asphyxia (OR = 3.9, p < 0.05) and neonatal hypoglycemia (OR = 3.2, p
< 0.04). For oxidative stress diagnosed at term, significant associations
concerned GDM (OR = 11.4, p < 0.006), preeclampsia or PE (OR = 4.3, p <
0.03), acute fetal distress (OR = 8.3, p < 0.003), cesarean section (OR =
4.3, p < 0.007), prematurity (OR = 6, p < 0.02), LBW (OR = 4.3, p <
0.03), birth asphyxia (OR = 12.4, p < 0.005) and neonatal hypoglycemia (OR =
3.5, p < 0.04). Conclusion: Outcomes found significantly associated
with oxidative stress seem to overlap those linked to anemic condition. Similarity
between complications of anemia and that of oxidative stress is more observed
at 28 - 32 weeks of gestation. This strongly suggests that major correction in
both anemic and oxidative status should be initiated long before this landmark.