PATHOGENETIC MECHANISMS OF ANEMIA AND MICROELEMENT DEFICIENCIES IN WOMEN OF REPRODUCTIVE AGE: A SYSTEMATIC REVIEW
Abstract
Background: Anemia and microelement deficiencies represent globally pervasive public health challenges that disproportionately affect women of reproductive age (WRA). These conditions contribute significantly to maternal morbidity, adverse pregnancy outcomes, and diminished quality of life. Understanding their pathogenesis is critical for formulating effective prevention and treatment strategies. Objective: This systematic review aims to comprehensively elucidate the pathogenetic mechanisms underlying anemia and microelement deficiencies in women aged 15–49 years by synthesizing evidence from clinical, nutritional, physiological, and molecular studies. Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science databases (2000–2024) using keywords such as "anemia," "iron deficiency," "microelement deficiency," "women of reproductive age," "menstruation," "pregnancy," and "pathogenesis." Both original research articles and reviews relevant to pathogenetic mechanisms were included. Results: The etiology of anemia in WRA is multifactorial, with iron deficiency as the predominant cause. Pathogenesis involves inadequate dietary intake, increased physiological requirements (menstruation and pregnancy), chronic and parasitic blood loss, inflammation-associated alterations in iron metabolism mediated by hepcidin, and concomitant folate and vitamin B12 deficiencies affecting erythropoiesis. Microelement deficiencies of zinc, copper, selenium, and iodine interplay with anemia through their essential roles in enzymatic functions related to hematopoiesis, antioxidant defense, and thyroid function. Socioeconomic factors, infectious diseases, and gastrointestinal disorders aggravate these deficiencies. Conclusion: The complex and overlapping pathogenetic mechanisms underscore the necessity for integrated nutritional, clinical, and public health interventions targeting women of reproductive age to mitigate the burden of anemia and microelement deficiencies.