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Tamil Nadu

Tamil Nadu

Full-blooded awareness, need of the hour

Ramya Kannan

National Family Health Survey 3 reported a high prevalence of anaemia

Over 60% of pregnant women come with a haemoglobin count of less than 12 gm/dl
Of them, 40 per cent come with clear symptoms, seeking treatment for their anaemia

CHENNAI: If your blood ain’t red enough, it ain’t good enough. That said, we are talking about haemoglobin, the pigment that gives the red colour to blood. It also carries oxygen in the blood and a scarcity of red cells (anaemia) will, believe it or not, lead to a host of problems — especially for pregnant women.

The National Family Health Survey 3 reported a high prevalence of anaemia — over 75 per cent of women in India suffer from iron deficiency. It is iron that gives blood its healthy red cells. The NFHS 3 figures further state that more than 56 per cent of married women and 58 per cent of pregnant women are anaemic.

A figure that tallies so well with our own statistics at the Institute of Obstetrics and Gynaecology here. Over 60 per cent of pregnant women come with a haemoglobin count of less than 12 gm/dl to the IOG, its director K. Saraswathy says.

Of this, 40 per cent come with clear symptoms, seeking treatment for their anaemia. Anaemia causes chronic energy deficiency and among pregnant women, bearing a child in the womb, the ramifications are much more serious.

In her practice, Duru Shah, obstetrician and gynaecologist affiliated to Breach Candy, Jaslok and Sir Hurkisondas Hosptials in Mumbai, says she has seen a woman come in with merely 1.1 gm/dl. She was seven months pregnant when she walked into the hospital, “pale as a ghost.” Though she was given red blood component transfusion, she was so weak, her heart could not stand the strain and collapsed.

“That is a one off case, but women with 3-7 gm/dl do come to our clinics,” Dr. Duru Shah says. While once it was pregnant women from the lower socio economic group that came in with chronic anaemia due to undernutrition, these days, even women from affluent classes are reporting with anaemia due to changing food habits.

“If women/girls from rural areas and lower socio economic groups get very little nutrition because there is a general tendency to feed the boys better than the girls, the urban affluent women are driven to anaemia by the kind of foods they consume,” Dr. Saraswathy explains. This includes fast foods and fatty foods poor on nutrient components consumed at irregular hours. Though anaemia does have other causes, nutrition-related anaemia, which can be reduced with lifestyle alterations, is a big source of worry for doctors.

Obstetric Society of Southern India president Jayashree Gajaraj says it has definitely become a problem even with women from affluent group over the last 5-10 years.

Among ethnic groups such as Jains and Marwaris, chronic anaemia is high because of their high wheat intake and wheat reduces absorption of iron. The lack of a balanced diet among affluent groups is primarily to blame, she says.

Classic symptoms include hair fall, loss of apettite, dry skin, hair and brittle nails and excessive bleeding during menstruation, Dr. Shah points out. With pregnant women, they are more prone to abortions, pre-term labour, heart failure, more prone to infections and cannot handle even the normal blood loss during labour. If women come to the gynaecologist within two to three months of conception, the anaemia can be detected early and treated, Dr. Gajaraj says. Iron tablet supplements and injects can set right the imbalance over the course of the pregnancy.

However, that is not always the case with rural women and women from low in come groups, Dr. Saraswathy says. At any rate, all pregnant women, even normal anaemic women, should include a diet of green vegetables, particularly spinach, and jaggery. A nonvegetarian diet is naturally rich in iron, Dr. Shah says. Gynaecologists recommend that supplements of iron and folic acid be given to adolescent girls to avoid problems.

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