IRON DEFICIENCY ANEMIA AS A RISK FACTOR OF HYPOGALACTION IN NURSING MOTHERS

Atadjanova Sh. X., Hakimov Sh. K., Mamarasulova D. Z., Nuritdinova G. T., Inakova B. B., Akhmadaliyev Sh. Sh.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Under our supervision was 241 nursing mothers with varying severity of anemia: The I degree (easy) at 132 (54,8%) with the content of hemoglobin (Hb) and erythrocytes of 96,7±0,32 g/l and 3,67±0,018 x 1012/l, the II degree (medium-weight) — at 84 women (34,9%) with the maintenance of Hb (78,4±0,91g/l) and erythrocytes (3,09±0,027x1012/l) and the III degree (heavy) — at 25 women (10,3%) with the maintenance of Hb (62,3±0,60г/л) and erythrocytes (2,74±0,22х1012/л). Weight of anemia identified by studying of a gematokrit – Ht ("effect of cultivation"), serumal iron (≤ 12,5 mmol/l), the general iron-binding ability of serum – GIBAS (≥ 72,0 mmol/l), a ferritina (≤ 12,0 mkg/l), saturation coefficient transferriny (≤ 16,0%), average concentration (ACHE ≤ 16,7 mmol/l) and the content of hemoglobin in one erythrocyte (CHOE, ≤ 1,67 fmоl), the average volume of one erythrocyte (AVOE, ≤ 75,0 fl). The control group of nursing mothers was made by 126 women without clinical laboratory signs of IDA. The examined mothers with IDA on age – till 20 years (17,4±2,44%), are also more senior than 21-29 years (66,8±3,03%) and 30 years (15,7±2,35%) there were proportional to those women control groups (16,7±3,32%, 66,6±4,2%, 16,7±3,32%, P>0,05), that does uniform their on age (24,0±0,03 and 24,5±0,27, P>0,05). The share the repeatedly giving birth among sick women with IDA (58,2±3,5%) also didn't differ from those women of control group (62,7±4,43%, P>0,05). Results of our researches shows that at nursing mothers in process of deterioration in severity of IDA it is steady the volume of the exhausted milk at one feeding -VEM, release of milk for a unit of time (VM, ml/min.) and number of applying’s of children to a breast (to ACHB, times/days) ACHB decreases (P<0,001). Close correlative connection between VEM and ACHB is found, respectively at I, II and III severity of IDA in nursing mothers (r =+0,562±0,05, r=+0,624±0,13 и r=+0,634±0,05, Р<0,05, <0,001). In the analysis of VEM values (ml) by us it is revealed that this indicator at nursing mothers with the I severity of IDA decreases (90,2±2,13 ml, P<0,05) and increases to the II degree of pathology (98,6±1,76, P <0,01), i.e. as if there comes "the effect of concoction" daily milk volume (DMV). Single volume of milk, feeding number, volume of single feeding of milk It should be noted that at I, and especially the II severity of IDA of nursing mothers the same "effect of concoction" and on protein content and fats (g/l) as a part of breast milk is noted. It is established that at nursing mothers, in process of aggravation of weight of anemia the general share of women with a gipogalaktiya, respectively 27,3%, 48,8% and 76,0% increases that considerably exceeds these healthy mothers (14,3%, Р φ <0,004, Р φ <0,001). At healthy nursing mothers rather easy degrees (I and II Art.) of weight of a gipogalaktiya – 7,94% and 3,97% often come to light, and sick mothers with IDA have her heavy degrees (III and IV), respectively at II (9,52% and 3,57%, Р φ <0,02, Р φ <0,003) and the III severity of IDA (28,0% and 8,0%, Р φ <0,001). Thus, nursing mothers in process of aggravation have severity of IDA, steady decrease in level of the daily volume (ml/days), allocation of breast milk for a unit of time (ml/min.) and numbers of applying’s of children to a breast is noted. During the laktatsion period at nursing mothers with IDA, the delayed gipogalaktiya forms (against laktatsion crisis and her late form), with deficiency of daily volume milk ≥ 50,0% most often come to light that is a basis of development of post-natal forms of chronic disorders of food on macro - and a micro nutriyentny basis.

nursing mothers, IDA, lactation, MDV, hypogalaction

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«Bulletin of problems biology and medicine» Issue 1 part 2 (127), 2016 year, 62-66 pages, index UDK 616.155.199+662.664.191