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Hans India
12 hours ago
- Health
- Hans India
Pregnancy Anemia linked to Congenital Heart Defects in New Born
Bengaluru: Anemia is a major global health concern, particularly affecting women of childbearing age, with prevalence rates between 20–40%, translating to over 500 million individuals worldwide. It is especially significant during pregnancy, where it can lead to complications for both mother and baby. The primary cause is iron deficiency, responsible for over half of the cases. In India, the situation is particularly alarming, with the National Family Health Survey-5 (NFHS-5) reporting that approximately 52.5% of pregnant women are affected by anemia. Addressing this issue involves improving nutritional intake, promoting iron supplementation, and implementing public health strategies to reduce the burden of anemia globally and within specific populations like India. Increased Requirement of Iron during pregnancy: During pregnancy, there is an increased need for iron to support the developing fetus and to accommodate the mother's expanding blood volume. Iron is essential for producing hemoglobin, the protein in red blood cells responsible for transporting oxygen throughout the body. Adequate iron intake ensures sufficient hemoglobin levels, which are critical for oxygen delivery to tissues and organs. As pregnancy progresses into the second and third trimesters, the demands for iron and vitamins become even higher. If these increased nutritional needs are not met, it can lead to iron deficiency anemia. This condition occurs when iron intake falls short of the body's requirements, resulting in fewer red blood cells and decreased oxygen transport. Managing iron intake through diet and supplementation is vital during pregnancy to prevent anemia and support the health of both mother and baby. Challenges of anaemia during pregnancy During pregnancy, there is an increase in blood volume—more than the increase in blood cells—leading to a condition known as hemodilution. This process helps ensure adequate blood flow to the developing fetus but can sometimes be mistaken for anemia. However, anemia in pregnancy is diagnosed when hemoglobin levels fall below 10.5 g/dL. Anemia poses several risks for both mother and fetus. For the mother, low hemoglobin levels can cause symptoms such as fatigue, weakness, and difficulty performing daily activities. In severe cases, it may lead to breathlessness and cardiac issues. For the fetus, maternal anemia can result in restricted growth (growth restriction or IUGR), low birth weight, and may affect placental development. Poor placental function is linked to complications like pre-eclampsia and gestational diabetes. Managing anemia effectively during pregnancy is crucial to reduce these risks and ensure better outcomes for both mother and child. New Evidence: Link to Congenital Heart Defects A recent study published in the British Journal of Obstetrics and Gynaecology highlights an even more concerning association. Researchers analyzed health records of women in the UK who became pregnant between January 1998 and October 2020, and found that anemia during pregnancy was linked to a 40–47% higher risk of the child being born with congenital heart defects. This finding suggests that maternal anemia may interfere with early fetal cardiovascular development, adding another dimension to the importance of timely diagnosis and treatment. Maternal Complications of Anemia Anemia affects a pregnant woman's health and resilience, particularly during labor and postpartum recovery. Key complications include: ● Fatigue and reduced physical capacity ● Increased susceptibility to infections, especially urinary tract infections (UTIs) ● Postpartum hemorrhage (PPH): Low hemoglobin levels reduce the body's ability to tolerate blood loss, increasing the risk of severe bleeding during or after delivery ● Need for blood transfusion: To restore hemoglobin levels in cases of significant blood loss ● Abnormal blood clotting: Severe anemia and blood loss can trigger Disseminated Intravascular Coagulation (DIC), a life-threatening condition where the blood's clotting ability becomes dysregulated What Are Congenital Heart Defects (CHDs)? Congenital Heart Defects (CHDs) are structural abnormalities of the heart that are present at birth. These defects can affect the heart's walls, valves, or major blood vessels, disrupting normal blood flow through the heart and to the rest of the body. CHDs range in severity: ● Mild cases may go unnoticed at birth and resolve on their own or require minimal treatment. ● Severe defects can be life-threatening and often require early surgical intervention or ongoing cardiac care. CHDs: A Major Public Health Concern ● CHDs are among the leading causes of infant morbidity and mortality worldwide. According to data published in Indian Pediatrics, approximately 180,000–200,000 children are born with congenital heart disease each year in India alone. Unfortunately, a significant number of these cases remain undiagnosed or untreated, especially in rural and low-resource settings. Risk Factors for Anemia During Pregnancy Several pre-existing conditions and pregnancy-related factors can increase a woman's risk of developing anemia during pregnancy. Identifying these early allows for timely intervention and better outcomes for both mother and baby. Key Contributing Factors: 1. Hyperemesis Gravidarum o Severe and persistent nausea and vomiting during pregnancy o Leads to poor nutritional intake and dehydration, contributing to iron and folate deficiencies 2. Pre-existing Anemia ● Women with iron-deficiency anemia before conception are more likely to experience worsened anemia during pregnancy ● Often linked to poor dietary intake or chronic malnutrition 3, Congenital Hemoglobinopathies ● Conditions like thalassemia or sickle cell disease can cause chronic anemia, which may be exacerbated by pregnancy 4. Multiple Pregnancies ● Carrying twins or higher-order multiples increases demand for nutrients, especially iron and folic acid, heightening anemia risk 5. Short Interpregnancy Intervals ● A reduced gap between pregnancies can prevent the body from replenishing iron and nutrient stores, increasing susceptibility to anemia 6. Gynecological Conditions o Women with heavy menstrual bleeding due to conditions like fibroids or endometriosis may begin pregnancy with already low iron stores The Importance of Iron in Fetal Heart Development Iron plays a crucial role in the early development of the fetal heart. During embryogenesis, the heart is the first functional organ to begin forming—starting as early as the 7th week of gestation. On early ultrasound scans, this is often visualized as a faint pulsation, marking the onset of cardiac activity. However, the process of heart development begins even earlier and involves a highly coordinated sequence of events: Key Stages of Fetal Heart Formation: 1. Formation of Primitive Blood Vessels 2. Cardiac Looping – where the heart tube folds into its basic shape 3. Septation – the formation of walls (septa) separating the heart chambers 4. Chamber Differentiation – development of the four-chambered structure seen after birth These stages are highly sensitive to oxygen levels and nutrient availability, especially iron, which is vital for: ● Hemoglobin production (oxygen transport) ● Cell division and differentiation ● Mitochondrial energy metabolism needed for organ development Impact of Maternal Anemia on Fetal Cardiac Development When a pregnant woman is anemic, her blood carries less oxygen to the placenta and fetus. This hypoxic environment can interfere with the delicate processes involved in early heart formation, increasing the risk of congenital heart defects (CHDs) such as: ● Septal defects (holes in the heart walls) ● Outflow tract anomalies (malformations of the major vessels) These defects can have lifelong implications for the child's health and may require surgical correction or long-term cardiac care. The Role of Nutrition in Maternal and Fetal Development Maternal nutrition is one of the most critical factors influencing the health of both the mother and the developing fetus. Around the time of organogenesis—when vital organs like the heart, brain, spine, and kidneys begin forming—the need for adequate nutritional reserves becomes especially urgent. Nutritional Needs During Organogenesis Organogenesis typically occurs during the first trimester, a period during which many women may not yet realize they are pregnant. Key nutrients required during this time include: ● Iron – Essential for oxygen transport and cellular energy production ● Folic Acid (Vitamin B9) – Prevents neural tube defects and supports red blood cell production ● Vitamin B12 – Works with folic acid in red blood cell formation and neurological development ● Inadequate levels of these nutrients, particularly iron, can reduce the mother's oxygen-carrying capacity, leading to fetal hypoxia (low oxygen delivery to tissues). This increases the risk of developmental abnormalities, especially congenital heart defects. Causes of Anemia Beyond Diet ● While poor dietary intake is a common cause of anemia, there are several non-dietary causes that must also be addressed: ● Hemoglobinopathies such as: o Thalassemia o Sickle Cell Anemia ● These are inherited blood disorders where the structure or production of hemoglobin is abnormal, leading to chronic anemia. Women with known or suspected hemoglobin disorders should be referred to a hematologist early in pregnancy (or ideally, before conception) to ensure appropriate monitoring and management. The Fetal Dependence on Maternal Stores The developing fetus is entirely dependent on the mother's nutritional status, especially for: ● Iron – for building fetal blood supply and heart tissue ● Folic Acid – for neural development ● Vitamin B12 – for brain and nerve development If the mother's nutrient levels are low, the fetus may be at risk for: ● Low birth weight ● Preterm birth ● Congenital anomalies ● Long-term developmental delays Preventing Anemia in Pregnancy: The Power of Nutrition and Prenatal Care A nutritious, well-balanced diet during pregnancy is one of the most effective ways to prevent anemia and support both maternal and fetal health. Nutritional needs increase during this time, and iron becomes essential for building extra red blood cells to carry oxygen to the baby. Iron-Rich Foods to Include in Your Diet To reduce the risk of anemia, ensure your meals include iron-rich foods, such as: ● Green leafy vegetables (spinach, fenugreek,) ● Legumes and beans ● Fruits (especially dried fruits like dates, raisins, apricots) ● Meat and liver (excellent sources of heme iron) ● Fortified cereals and whole grains ● Milk (though not rich in iron, it's a valuable part of a balanced diet) Don't Forget Vitamin C ● Vitamin C is crucial for enhancing iron absorption from plant-based foods. Include: ● Citrus fruits (oranges, lemons) ● Tomatoes ● Bell peppers ● Berries and guavas Prenatal Vitamins Are Essential In addition to food, prenatal vitamins prescribed by your healthcare provider supply important nutrients like: ● Iron ● Folic acid ● Vitamin B12 These supplements help build up maternal stores and support the baby's development, especially when dietary intake is not enough. Antenatal Check-Ups: Early Detection Saves Lives Regular antenatal (prenatal) check-ups are critical. Your doctor can: ● Monitor your hemoglobin levels ● Identify signs and symptoms of anemia early ● Order tests if needed (e.g., iron studies, screening for thalassemia or sickle cell disease) ● Recommend appropriate dietary adjustments, iron supplements, or specialist referral Conclusion Anemia during pregnancy should not be seen as a minor nutritional issue. It is a systemic condition with far-reaching consequences and preventing anemia is a shared responsibility—of the mother, the healthcare provider, and the health system. A proactive approach that combines nutritional care, supplementation, and regular medical check-ups ensures better outcomes for both mother and baby. (Dr. Sunitha Mahesh, Medical Director and Senior Consultant - Infertility and Maternal Fetal Medicine, Milann- The Fertility and Birthing Hospital, Bengaluru)
The Hindu
4 days ago
- Health
- The Hindu
The politics of periods: why India cannot afford to ignore menstrual health
Imagine Priya, a bright 13-year-old in a village nestled miles from the nearest town. Her first period arrives not with understanding or support, but with hushed warnings and a palpable sense of shame, passed down through generations. Given a rough, inadequate piece of cloth, she's quietly instructed to avoid the kitchen, refrain from touching the shared water pot, and crucially, stay home from school during those five days each month. The school's basic toilet lacks water, privacy, and disposal facilities, making managing her period there an unthinkable ordeal. Fearful of leaks, whispers, and breaking unspoken rules, Priya isolates herself, her education disrupted, her potential dimmed with each recurring cycle. Priya's story, sadly, is not unique. It echoes the lived experience of countless girls and women across India, particularly in rural areas. As Menstrual Hygiene Day observed on May 28 prompts reflection, it is crucial to acknowledge that while awareness around menstruation is growing in India, it remains largely absent from the mainstream political agenda and public discourse. Menstrual health is often relegated as a 'women's issue,' shrouded in a pervasive culture of silence and coloured by patriarchal notions that limit knowledge and open conversation. This silence translates into a chronic health and social challenge, where many lack adequate information, access to necessary products, and face stigma, impacting their well-being and participation in society. While efforts to distribute sanitary pads are visible and sometimes feature in government schemes, we must recognise that true access demands a fundamental shift beyond products towards systemic policy change and robust infrastructure. A complex reality Focusing solely on period product distribution dangerously simplifies this complex reality. While commendable progress has been made, with National Family Health Survey-5 data indicating that around 78% of individuals who menstruate in India may use commercial period products, this statistic masks a deeper infrastructural gap. The figure plummets dramatically when we consider those who have access to both products and essential water, sanitation and hygiene (WASH) facilities – clean, private toilets with water and soap. Shockingly, only about 27.7% benefit from this comprehensive access. This stark difference highlights a critical point: distributing pads achieves little genuine progress towards dignified menstrual health if individuals lack the basic infrastructure needed to manage their periods hygienically and privately, particularly in schools and public spaces. This lack of essential WASH facilities remains a persistent barrier, often highlighted during crises that disrupt normal life. The current political landscape shows some commendable, albeit limited, steps. Various Central and State government schemes, such as those under the National Health Mission or State-specific initiatives like 'Asmita Yojana' in Maharashtra or 'Swechcha' in Andhra Pradesh, aim to provide subsidised or free sanitary napkins, primarily targeting adolescent girls in schools. While valuable, these initiatives often face limitations. Their focus frequently excludes women outside the school system, those in the workforce, or other vulnerable groups. Additionally, distribution can be hampered by external factors like school closures, and the focus often remains narrowly on disposable pads, without adequately expanding knowledge on diverse, sustainable options like menstrual cups (despite pioneering efforts in States like Kerala and Karnataka) or addressing the crucial need for safe disposal and the environmental impact of sanitary pads. This lack of strong, consistent political backing, often stemming from the underrepresentation of women and their allies in decision-making spaces, means menstrual health remains a relatively neglected public health concern, susceptible to policy oversights like initial exclusion from essential items lists during emergencies or debates around taxation. Integration into national policy framework Therefore, building a truly stigma-free, inclusive menstrual health infrastructure demands its integration into the core of our national policy framework. This means legislating for mandatory, comprehensive, and scientifically accurate menstrual health education within school curricula for all students, treating it not just as biology but as essential for equity and empowerment. It requires prioritising and funding national standards for MHM-friendly WASH facilities in all public institutions – viewing this as critical infrastructure essential for public health, education continuity, and enabling of full economic participation. Health policy must be reformed to train healthcare providers for sensitive care, integrate MHM screening and treatment into primary healthcare, ensure insurance coverage, and use inclusive language for all who menstruate. Fair fiscal policies, such as eliminating discriminatory taxes on essential menstrual products and exploring targeted subsidies, are needed to ensure affordability is not a barrier to dignity. Policy levers should encourage supportive workplace environments with adequate facilities and understanding for menstrual health needs, recognising its impact on labour force participation. Crucially, these comprehensive interventions must be framed not as an expenditure, but as a strategic political and economic investment. Ensuring economic viability requires moving beyond siloed projects. Funding for MHM should be integrated into existing budgets for Health, Education, WASH, Gender Equality, and Rural/Urban Development, leveraging existing political and administrative structures. Smart fiscal tools like tax reform and targeted subsidies offer cost-effective ways to improve access. Supporting local social enterprises producing affordable, sustainable menstrual products can boost local economies, create jobs, and reduce import dependency, aligning with national development goals. Most importantly, policymakers must recognise and champion the significant return on investment: improved educational attainment, increased workforce participation, better public health outcomes, and accelerated gender equality far outweigh the costs. The economic and social cost of inaction – perpetuated by silence and policy neglect – actively undermines India's broader development objectives. This Menstrual Hygiene Day, the call must be for decisive political action. We need political leaders and parties to champion menstrual health not as a marginal issue, but as fundamental to human rights, public health, and national progress. It requires integrating MHM robustly into national development plans, legislative agendas, and resource allocation. While the efforts of NGOs and local champions are vital, sustainable change at scale hinges on political will. It is time to break the silence in our policy chambers and build an India where everyone can manage their menstruation with dignity, safety, and informed choice – unlocking the full potential of half our population. (Karan Babbar is an incoming assistant professor at Plaksha University. Email: phd17karanb@
India Today
5 days ago
- Health
- India Today
How generic medicines can add scale to maternal care
India has made notable strides in maternal health over the past decade. According to the Union ministry of health and family welfare, the maternal mortality ratio has dropped significantly, from 130 deaths per 100,000 live births in 2014-16 to 97 in 2018-2019. Girish Agarwal, co-founder and chief operating officer of Zeno Health, a medicine delivery brand, explains how maternal health can be improved yet TO BASIC MEDICINESadvertisementDespite all the progress, maternal survival should no longer be the goalpost. It is time to pivot towards long-term maternal strength, stability and dignity. This means moving beyond emergency responses to building sustained systems of care that support every stage of the maternal journey. One of the most practical and impactful levers in this shift is improving access to essential supplements and medicines—especially during the pre- and post-natal RETHINK Maternal nutrition involves more than just caloric intake. It includes access to vital micronutrients that aid foetal development, strengthen maternal immunity and support recovery after childbirth. Yet, nutritional deficiencies continue to undermine outcomes, particularly for low-income households. According to the National Family Health Survey-5 (2019-21), 52.2 per cent of pregnant women in India are anaemic—a figure that reflects not only nutritional gaps but systemic inequities in affordability and access. The consequences—preterm birth, low birth weight, postpartum fatigue—are often preventable when timely and consistent care are within GENERICS HELP?While antenatal care in India has seen measurable improvements, post-natal care remains fragmented and inconsistent, particularly in rural regions. A 2023 NITI Aayog report highlights that women in rural areas are nearly twice as likely to experience postpartum complications compared to their urban counterparts. This disparity isn't simply about infrastructure; it points to deeper issues related to affordability, sustained access and trust in the healthcare generic medicines and supplements offer a powerful solution. These products can significantly reduce the financial burden on families while ensuring that essential care continues well beyond ISN'T INFERIORBut affordability cannot stand alone. It must be embedded within a broader ecosystem of trust and continuity. That means empowering pharmacists as health educators, integrating generics into everyday community health conversations, and creating delivery models that are consistent, scalable and built for the realities of is not merely a matter of availability. It's about building resilient systems that function under pressure, equipping local caregivers with the right tools and fostering public confidence that affordable doesn't mean inferior quality. Generics, then, are not simply a low-cost alternative. They are a powerful instrument in transforming maternal healthcare from a fragmented intervention to a continuous, quality-driven BEGUN, WHAT'S STILL NOT DONE?India has already laid critical groundwork through initiatives such as Anemia Mukt Bharat, the Pradhan Mantri Surakshit Matritva Abhiyan and the Rice Fortification Initiative. These programmes illustrate what's possible when awareness is matched by access. To deepen and scale up their impact, we need stronger alignment between public initiatives and private innovation. That includes investing in robust digital infrastructure, decentralised distribution systems and empowering community health workers and pharmacists alike to serve as trusted access have succeeded in reducing maternal mortality. But the challenge ahead is to eliminate maternal vulnerability. That means ensuring no woman is denied care because of cost, no village is left behind due to distribution gaps, and no family has to choose between essential treatment and financial to India Today Magazine
New Indian Express
6 days ago
- Health
- New Indian Express
New scheme to curb anaemia in adolescent girls
HYDERABAD: With an objective to prevent anaemia among adolescent girls, the state government has decided to launch a new scheme, Indiramma Amrutam, under which millet and peanut chikkis (energy bars made with nuts and jaggery) will be distributed among girls aged between 14 to 18. Women & Child Welfare Minister Danasari Anasuya alias Seethakka will be launching this scheme in Bhadradri Kothagudem district on Thursday, Initially, the government will implement this scheme in Bhadradri-Kothagudem, Kumurambheem-Asifabad and Jayashankar-Bhupalpally districts on a pilot basis through Anganwadi centres. Under this scheme, the government will distribute 30 chikkis, in two instalments, per girl per month. Each chikki will contain 600 calories, 18 to 20 grams of protein and micronutrients. According to officials, the government decided to launch this scheme as 64.7 per cent of adolescent girls in Telangana are suffering from anaemia as per the National Family Health Survey-5. 'The government is already providing iron and folic acid tablets for girls after conducting Hb tests. Now, it has come out with a new scheme that will help in curbing anaemia among adolescent girls,' the officials added. Seethakka, meanwhile, asserted that Indiramma Amrutham scheme will become a game-changer for girls' health. 'Initially, this scheme will be implemented in three districts where the prevalence of anaemia is relatively high. It will be extended to other districts in the future,' she added.
Hindustan Times
27-05-2025
- Politics
- Hindustan Times
Bengal govt to build awareness among boys, girls on harmful effects of child marriage
Kolkata, West Bengal Minister Shashi Panja said the state government will emphasise building awareness among girls and boys about the harmful effects of child marriage. Panja, the minister for women and child development and social welfare, said it is not just girls alone, boys also have to be educated about the ill effects of early marriage. "They should be demotivated from marrying before their legal age of marriage too," Panja said on Monday at a 'State Level Consultation on Adolescent Empowerment' attended by government officials from various departments working together to end child marriage. She urged the officials assembled in the programme to share their experiences in fighting the menace since the launch of the District Action Plan three years ago, and later the Child Marriage Reporting and Tracking Mechanism. The state reported more than 41 per cent of girls getting married underage in the National Family Health Survey-5 released in 2020-21. "Building awareness in society is the key to stopping this. Also include men and boys more in the meetings on child marriage with girls and women," Panja told officials after releasing 'Guidelines for Implementation of the Prohibition of Child Marriage Act 2006 in West Bengal'. The state government, in collaboration with UNICEF, prepared a District Action Plan in 2022 to counter child marriage. Panja, women and child development department's principal secretary Sanghamitra Ghosh, Dr Monjur Hossain, chief of UNICEF in West Bengal and other officials listened to the successes and challenges faced by the district officials, UNICEF said in a press release. The minister asked the officials from the departments of health and family welfare, school education, panchayat and rural development, technical education, training and skill development to deal with the problem more empathetically as present-day adolescents are exposed to many lures and distractions, including online and social media platforms on mobile phones, according to the release. Panja also emphasised that 'Kanyashree Prakalpa' has now been empowering adolescent girls on online safety, besides motivating them to remain in school and not get married. In NFHS-5, the maximum child marriages were reported from Purba Medinipur followed by Purba Bardhaman and Jalpaiguri being the lowest at 18 per cent. The state government, with the help of UNICEF, launched the Child Marriage Reporting and Tracking Mechanism in 2023 to collect data from the districts and portray the real-time situation, Ghosh said, urging the officials to use the resources regularly. Describing this consultation as "A renewed call to action", Hossain said the holistic development of adolescents requires concerted, coordinated and multi-sectoral actions by all stakeholders concerned. "The involvement of key community influencers, panchayat members, SHGs, religious leaders, teachers, students, youths and adolescents is necessary to challenge harmful norms and support girls' and boys' empowerment," he added.
