Objectives: to evaluate the impact of bariatric surgery (BS) on hematological status of women who got pregnant and the effect of iron supplemental therapy (IST) of these impacts.
Patients & Methods: 57 women had previous BS (group B) and 119 women (Group A) had no previous BS were evaluated at 1st trimester for their hemoglobin concentration (HB conc.) and serum levels of ferritin (SF), hepcidin and interleukin-6 (IL-6). Women had iron deficiency anemia (IDA) received IST in the form of sucrosomial oral cap 100 mg once daily. HB conc. and SF were re-evaluated at the 2nd and 3rd trimester and HB deficit was calculated. Study outcome included the impact of IST on frequency and severity of anemia.
Results: HB conc. and SF of all women decreased progressively during pregnancy course with significantly lower estimates in women of group B compared to group A. Frequency of anemic women was significantly higher in group B at the first two trimesters, but was non-significantly higher at 3rd trimester compared to group A, while frequency of women had ID was significantly higher at 1st trimester but was non-significantly higher at the 2nd and 3rd trimesters in group A than group B. At the 3rd trimester, 56 women had increased; while 116 women had decreased HB conc. with significantly higher frequency of women had increased HB conc. among women of group B. Serum hepcidin levels were significantly higher, while serum IL-6 levels were non-significantly higher in women of group B. Percentage of change of HB conc. at 3rd trimester was positively correlated with presence of BS, while negatively correlated with 1st trimester HB conc. and presence of chronic inflammatory anemia. Regression analysis defined presence of CIA, 1st trimester HB conc., the use of IST and previous BS as significant predictors for possible change of HB conc. at the 3rd trimester. Conclusion: Women had BS were always anemic and had micronutrient deficiencies that must be corrected prior getting pregnant to avoid aggravation. IST started since 1st trimester allowed improvement of anemia especially for women had BS. Sucrosomial oral iron allowed increased HB conc. in 31.8% of studied women. |
