Maternal iron status and neonatal outcomes in women with pica during pregnancy

Abstract

Pica (from the Latin pica, a magpie), or the compulsive intake of nonnutritive substances, has been associated with iron deficiency during pregnancy [1][2][3][4]. This study was conducted at a hospital in suburban Buenos Aires, Argentina, to determine whether there were differences in iron concentration between women with pica and controls during the postpartum period. Biochemical indicators of iron status and anthropometric characteristics of neonates were compared.After calculating sample size needed to estimate pica prevalence with a 95% confidence interval (CI), 324 women were randomly selected postpartum. The 71 women diagnosed as having pica were then compared with a control group of 71 women without the disorder. Both groups were similar in prepregnancy body mass index, height, parity, educational level, marital status, and employment status.Women with pica revealed ingesting ice (70%); dirt (18%); soap, (4%); chalk (3%); or thread, nail polish, or salt (4%), and most consumed the substance on a daily basis. Table 1 shows data regarding pregnancy outcomes and biochemical indicators of pica as well as neonates' anthropometric characteristics. The prevalence of prematurity was the same in both groups, 1.5% (95% CI, 0.0%-4.2%) in the pica group and 1.4% (95% CI, 0.0%-4.3%) in the control group. The prevalence of neonates with a birth weight less than 2500 g was 7.6% (95% CI, 1.2%-14.0%) in the pica group and 8.6% (95% CI, 2.0%-15.2%) in the control group.Differences in mean corpuscular volume, erythrocyte protoporphyrin, and erythrocyte protoporphyrin/hemoglobin were observed (Table 1). As serum ferritin concentration increases as a consequence of inflammatory processes naturally occurring in the last quarter of pregnancy and during labor and delivery, it was assessed for all study participants to determine whether there was a difference between the 2 groups. The mean serum ferritin concentration was found to be higher in the pica group. The Creactive protein levels were also assessed to check for inflammatory processes; the test results were positive for 84% of the women in the pica group and 87% in the control group, however.Iron nutritional status was also assessed, using a model that defined iron deficiency as abnormal values for at least 2 of 3 of the following indicators: high concentration of red-blood-cell erythrocyte protoporphyrin (N 70 μg/dL), low transferrin saturation (b 16%), and low hemoglobin concentration (b 11 g/dL). The ⁎ Corresponding author.

Hematobiochemical profiles, mineral concentrations and oxidative stress indicators in beef cattle with pica

“…In another study performed on 15 lambs having pica symptoms; iron deficiency was found and it was related to the aetiology of pica in lambs (Aytekin et al 2010). Similar findings were also reported for human beings (Lopez et al 2007). Furthermore, Nikvand et al (2018) reported that low serum iron concentrations appear to prompt chronic nutritional iron inadequacy, which increase the risk of pica in cattle due to iron deficiency.…”

“…In contrast to our results, Naci et al (2008) investigated 30 cattle that suffered from pica and had normal amounts of calcium, copper and zinc but slightly elevated iron concentration. Although many researches (Lopez et al 2007;Aytekin et al 2010;Nikvand et al 2018) with regard to low serum iron value in animals with pica are in agreement with the present study, some papers (Akg€ ul et al 2000;Naci et al 2008) do not agree with each other or with us about the role of the other elements, especially iron and copper, in the occurrence of pica. To determine the main causes of pica, several studies were carried out on cattle, horses and lambs.…”

Da ópera-bufa ao caos nosológico: pica

“…Estudo recente em 71 gestantes argentinas apontou as manifestações mais comuns de pica: 70% de gelo, 18% de terra, 4% de sabão, 3% de giz e 4% de linha, esmalte e sal. O artigo ainda ressalta a periodicidade diária do comportamento, além do fato de que a prevalência de anemia ferropriva no grupo estudado (30%) foi muito maior do que aquela encontrada no grupo-controle (14%) 4 . Em estudo realizado no Quênia, foi encontrada prevalência de 45,7% de geofagia, que diminuía para 34% e 29% após 3 e 6 meses de puerpério, respectivamente 30 .…”

“…Walker et al 2 expandem o conceito, descrevendo a pica não apenas como um transtorno manifestado pela ingestão inusual de determinadas substâncias, mas também que ocorre em grandes quantidades. Outros autores ainda falam em ingestão compulsiva de alimentos não nutritivos 3,4 . Ao longo da história, o comportamento de pica tem sido um enigma fascinante para seus estudiosos, uma vez que não existe consenso a respeito de sua etiologia, invocando fatores sociais, culturais, psicológicos, biológicos e comportamentais, embora, sem dúvida nenhuma, possua um componente ambiental importante 5 .…”

From edible clay to a clay-containing formulation for optimization of oral delivery of some trace elements: a review

“…It occurs most commonly in pregnant women (Vermeer and Ferrell 1985;Rainville 1997;Kikouama et al 2007Kikouama et al , 2009López et al 2007). There are several explanations for this use of clays.…”