I shivered as I walked through the foothills towards the city lights. The sun was quickly dropping below the horizon line, yet the fear of being alone in the dark was overshadowed by my inability to continue running. After only two miles – a third of what I set out to run – my head pounded and my legs ached. It was as though every element in my body was cooperatively focused on taking the next step. I had as much strength as a cooked noodle.
In preparing for the upcoming track season, I was training considerably slower than I was months earlier. After much frustration and a single blood test, the doctor reported I had sideropenia, meaning I was iron deficient. My hematocrit and hemoglobin levels were found to be normal, which in layman’s terms meant I had a sufficient amount of red blood cells and iron flowing through my bloodstream. However, the gauge measuring my ferritin level rested at nearly empty; I was drawing iron out of my bone marrow to supply the rest of my body. Although the medical term sounded like I had contracted a life-threatening disease, it was nothing iron supplements and the medication of time couldn’t remedy. For a high school senior who scheduled life around track and field, the news seemed like a catastrophe; but for many women, it actually is.
Sideropenic anemia is an advanced stage of iron deficiency, in which the body cannot produce the iron-containing molecule hemoglobin found in red blood cells. One can become iron deficient by excessive blood loss, a low dietary intake of iron, or an inability to properly absorb and process iron. The World Health Organization (WHO) released a report in 2000 estimating that almost twenty percent of women in industrialized countries are affected by iron deficiency anemia; a large number suffer weakness and fatigue without even knowing they have the condition [1]. I myself, and many other women in developed nations, are generally quickly relieved of our lethargic state after a few simple blood tests and over-the-counter iron tablets. However, for the women in developing nations, the problems are not only more severe, but the remedies are also much less accessible.
The WHO has found that, on average, approximately half of the female population in developing nations is anemic. Moreover, among pregnant women, the prevalence and the gravity of the condition are greatly increased. Amongst a list of tragic medical troubles such as AIDS, malaria, poverty, and tuberculosis, iron deficiency seems to fall out of the spotlight. However, according to a study published by the American Journal of Clinical Nutrition, maternal anemia can impair cognitive development and cause low birth weight among infants, and increase the chance of preterm delivery [1]. Although connections between anemia and maternal mortality rates are still unclear, most African countries have agreed to reduce anemia prevalence by thirty percent by the year 2010, as part of the United Nations Millennium Development Goals [2]. In 2002, WHO distributed their “Global Burden of Disease Report,” ranking iron deficiency as the 12th most important risk factor for all mortality globally [3].
Developing anemia becomes an even greater risk when bleeding occurs in high volume, or faster than the body can replenish lost red blood cells. This often happens when women menstruate or go through numerous childbirths. Although these are natural bodily functions, if women have minimal iron in their diet, losing more blood cells can tip them over the edge to dangerously low levels, compromising their ability to survive past childbirth. Blood loss can also result from contracting hookworm, a widespread concern in many developing nations. If contracted, the worms draw blood from the host’s intestinal walls. Hookworm is a leading cause of maternal mortality not because of the infection itself, but rather because of the severe blood loss and anemia which are often side effects. Malnutrition and the inability to access foods with high iron contribute to the presence of anemia among both women and young children. Consequently, Asia and Africa are among the nations most affected by iron-deficiency anemia [2].
Being anemic is a widespread condition but it is not life threatening in itself. However, in countries without accessible iron supplements, wide-spread malnutrition, high fertility rates and relatively little technology, anemia can be a fatal condition for both mothers and infants. Although iron deficiency anemia does not have a death toll as high as AIDS or malaria, it is one of the leading causes of maternal death and affects the mental and health problems of children born to anemic mothers. Personally, I was devastated by the implications of having too little iron. My performance on the track, my attention in school, and my general attitude all took a plunge. I was chronically exhausted even though my hemoglobin and hematocrit counts never even dropped to anemic levels, and never did my future prospects of this condition include death or preterm delivery, like so many women in the world today. While there is still much to be known about maternal anemia, the problem is large and the solution relatively simple. Whether by improving nutrition and food sources among developing nations or providing funding for free iron tablets, hopefully we will see future efforts to reduce the number of maternal deaths and increase the health of newborns throughout the world.
- Allen, Lindsay. “Anemia and Iron Deficiency: effects in pregnancy outcome.” American Journal of Clinical Nutrition. 2000.
- “Improving the Performance of Maternal Interventions in Africa.” MOST, USAID Micronutrient Program. 2004.
- “Maternal Anemia: A Preventable Killer.” USAID, FANTA Project. (2006), 1.
Tags: anemia, women's health
