The consequences of depletion of the essential body pools of iron include anemia, altered hormone metabolism, altered energy metabolism, depressed immune functioning, and changes in behavior and cognition [18, 23]. The impact of each of these consequences on maternal and fetal survival, fetal growth, and postnatal development are still being examined. The possible causal routes include direct and indirect effects of anemic hypoxia, placental delivery of iron, and alterations in hormonal control of pregnancy due to alterations in the stress: hypothalamic-pituitary-adrenal axis system . Maternal anemia has been related to maternal mortality, fetal mortality, fetal growth retardation, pregnancy complications, and a small amount on infant growth [2, 3, 24, 25]. A vast majority of the studies on anemia and pregnancy outcome have not delineated effects of iron deficiency from effects of anemia.
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