From the Guidelines
The correct answer is B. Iron. Pregnant patients who crave non-food substances like starch (a condition called pica) often have iron deficiency anemia. This craving for starch, clay, ice, or other non-nutritive substances is a symptom of iron deficiency, which is common during pregnancy due to increased iron demands for fetal development and maternal blood volume expansion. Iron deficiency leads to decreased hemoglobin production, resulting in anemia. Laboratory tests would show low serum iron levels, decreased ferritin, increased total iron binding capacity (TIBC), and possibly low hemoglobin and hematocrit values. Treatment involves iron supplementation, typically with ferrous sulfate 325 mg orally once or twice daily. The exact mechanism linking iron deficiency to pica behaviors isn't fully understood, but addressing the underlying iron deficiency typically resolves these unusual cravings, as supported by studies such as 1 and 1.
Some key points to consider:
- Iron deficiency anemia is a common condition during pregnancy, affecting approximately 18.6% of pregnant women in the United States, as reported in 1.
- The condition can lead to adverse maternal and infant health outcomes, including postpartum hemorrhage, preterm birth, low birthweight, and perinatal death, as discussed in 1 and 1.
- Screening for iron deficiency anemia typically involves measuring serum hemoglobin or hematocrit levels, although these tests may not be precise due to physiologic anemia during pregnancy, as noted in 1.
- Iron supplementation can improve hemoglobin and ferritin levels, reducing the risk of anemia and related complications, as demonstrated in studies such as 1 and 1.
Overall, iron deficiency anemia is a significant concern during pregnancy, and addressing it through supplementation and treatment can help improve maternal and infant health outcomes, as supported by the evidence from 1, 1, 1, and 1.
From the Research
Abnormal Lab Results in Pregnant Patients with Starch Cravings
- The most relevant lab result related to starch cravings in pregnant patients is associated with iron deficiency, as cravings for non-food items like starch can be a symptom of iron deficiency anemia 2.
- Iron deficiency anemia is a common condition in pregnancy, and it can be diagnosed through lab tests such as serum iron, total iron-binding capacity (TIBC), and ferritin levels 3, 4.
- However, serum iron and TIBC may not be the most accurate tests for diagnosing iron deficiency anemia, as they can give false-negative results 4.
- Ferritin levels are considered a more reliable indicator of iron deficiency anemia, and a low ferritin level can confirm the diagnosis 3, 4.
- In the context of the given options, the correct answer is:
- b. iron
Note: The other options (glucose, sodium, and potassium) are not directly related to starch cravings or iron deficiency anemia in pregnant patients, based on the provided evidence 2, 5, 3, 4, 6.