清水 三紀子

This study aimed to clarify the temporal changes in transcutaneous hemoglobin levels up to 1 month postpartum and the influencing factors in postpartum women using a noninvasive transcutaneous hemoglobin measuring device. The study participants were pregnant women recruited at an outpatient clinic. We collected information on their dietary history using a concise self-administered questionnaire and an agreement document when they were hospitalized for delivery. Transcutaneous hemoglobin levels of the mothers were measured using Pronto (Masimo) at 1 day, 4 days, 2 weeks, and 1 month postpartum. We included 135 mothers (mean age, 31.7 years) who delivered at full term. The mean transcutaneous hemoglobin levels decreased slightly from day 1 (11.9 ± 1.6 g/dL) to day 4 postpartum (11.8 ± 1.7 g/dL), followed by a significant increase from day 4 to 2 weeks postpartum (13.8 ± 1.0 g/dL; p < 0.01), and no change from 2 weeks to 1 month postpartum (13.8 ± 0.9 g/dL). Iron intake in the third trimester of pregnancy affected transcutaneous hemoglobin levels from day 4 postpartum to recovery by 2 weeks postpartum. The rapid increase in hemoglobin levels from day 4 to 2 weeks postpartum was a novel finding. Evaluation of hemoglobin levels in women at 2 weeks postpartum is important for postpartum recovery. Furthermore, health guidance regarding iron intake in the third trimester of pregnancy has been suggested to be effective in restoring postpartum hemoglobin levels.

OBJECTIVE: This review will identify the effectiveness of non-pharmacological interventions in preventing iron deficiency anemia in pregnant women with a normal course of pregnancy. INTRODUCTION: The global prevalence of anemia among pregnant women is 36.5%, posing risks to women and fetuses. This underscores the need for effective prevention; however, the effectiveness of non-pharmacological approaches in preventing pregnancy anemia remains unclear. INCLUSION CRITERIA: This review will encompass experimental and quasi-experimental studies on the following approaches to prevent anemia during pregnancy: recommendations for dietary supplements, oral iron supplements (over the counter), provision of supplements to promote iron absorption, participation in anemia prevention education, and provision of information. There will be no restrictions on the duration or frequency of intervention, and longitudinal intervention studies will be included. In studies with a control group, the comparator may be usual care or pharmacological interventions; in studies without, it may involve no intervention, temporal comparisons, or baseline periods without non-pharmacological interventions. Evaluation of hemoglobin, hematocrit, and ferritin will be included as primary outcomes. Low birth weight, preterm birth, amount of blood loss at delivery, small for gestational age, and Apgar scores will be included as secondary outcomes. METHODS: A search will be conducted in MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), Scopus, Australian New Zealand Clinical Trials Registry, Cochrane Central Register of Controlled Trials, and ICHUSHI-Web. Researchers will screen studies, extract data, assess the quality of studies, and analyze the data in accordance with the JBI guidance for systematic reviews of effectiveness. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to assess the certainty of the findings. REVIEW REGISTRATION: PROSPERO CRD42022344155.