SERUM IRON AND HAEMOGLOBIN LEVELS IN PREGNANT EAST AFRICAN WOMEN OF MIXED TRIBAL ORIGIN

To clarify the pattern of hemoglobin and serum iron response during pregnancy, 187 pregnant women from 14 tribal groups in the Nairobi area were studied. None of the women had received iron medication prior to presenting at the antenatal clinic and all were in a good nutritional state. 25 females and 23 males admitted to the Kenya National Hospital for minor surgical procedures were used as controls. The general incidence of anemia among the study subjects was 8.5%, which is lower than that noted in other studies of iron deficiency during pregnancy. The incidence of anemia was higher among primigravidae (11.3%) than among women in the para 3-5 (4%) or para 6+ (1%) groups. This could be due to a high incidence of adolescent pregnancies among primigravidae with a double demand on iron stores. However, further analysis of the data indicated that mean hemoglobin concentrations did not significatnly differ by age. An alternative explanantion is that pregnancy represents the 1st time many women attend a clinic and may therefore be the 1st opportunity for a diagnosis of treatable anemia. Serum iron and total iron binding capacity levels were higher in male controls than in the nonpregnant female controls, who in turn had higher levels than the pregnant cases. Finally, the study subjects demonstrated a rise in total iron binding capacity and a slight fall in serum iron concentration with advancing pregnancy, a pattern that has been noted in other studies. These data suggest that iron deficiency anemia during pregnancy is not a significant problem in Nairobi and the prescription of iron should be based on individual requirements.