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Jayalakshmi R, Gaidhane S, Ballal S, Kumar S, Bhat M, Sharma S, Ravi Kumar M, Rustagi S, Khatib MN, Rai N, Sah S, Lakhanpal S, Serhan HA, Bushi G, Shabil M. The Effect of Maternal Haemoglobinopathies and Iron Deficiency Anaemia on Foetal Growth Restriction: A Systematic Review and Meta-Analysis. MATERNAL & CHILD NUTRITION 2025; 21:e13787. [PMID: 40235159 DOI: 10.1111/mcn.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 09/26/2024] [Accepted: 11/22/2024] [Indexed: 04/17/2025]
Abstract
Maternal anaemia is a significant global health issue that adversely affects both maternal and foetal outcomes, particularly, intrauterine growth restriction (IUGR). This systematic review and meta-analysis aimed to consolidate existing evidence on the impact of maternal anaemia on the risk of IUGR. We conducted a comprehensive search across PubMed, Embase, Cochrane and Web of Science until 28 February 2024. Eligible studies included observational designs that reported maternal anaemia and its association with IUGR or small for gestational age (SGA) outcomes. The pooled odds ratios (ORs) were calculated using a random-effects model and heterogeneity was assessed with the I² statistic. The R software (version 4.3) was used for statistical analyses. A total of 38 studies involving 3,871,849 anaemic and 27,978,450 non-anaemic pregnant women were included. The pooled analysis demonstrated that anaemia in pregnancy is associated with a significantly increased risk of IUGR (OR = 1.30, 95% CI: 1.05-1.62, I² = 97%). Subgroup analyses by anaemia severity showed non-significant associations for mild (OR = 0.84, 95% CI: 0.58-1.23) and moderate anaemia (OR = 0.98, 95% CI: 0.48-1.98), while severe anaemia indicated a higher, though non-significant, risk of IUGR (OR = 1.42, 95% CI: 0.69-2.93). Maternal anaemia is associated with a heightened risk of IUGR, highlighting the critical need for effective management and early intervention strategies within prenatal care settings. Future research should focus on elucidating the effects of different severities of anaemia on birth outcomes, including IUGR and long-term effects later in life.
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Affiliation(s)
- Rajeev Jayalakshmi
- Department of Public Health and Community Medicine, Central University of Kerala, Tejaswini Hills, Periye, Kasaragod, Kerala, India
| | - Shilpa Gaidhane
- One Health Centre, Datta Meghe Institute of Higher Education, Jawaharlal Nehru Medical College, Wardha, India
| | - Suhas Ballal
- Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, India
| | - Sanjay Kumar
- Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan, India
| | - Mahakshit Bhat
- Department of Medicine, National Institute of Medical Sciences, NIMS University Rajasthan, Jaipur, India
| | - Shilpa Sharma
- Chandigarh Pharmacy College, Chandigarh Group of Colleges-Jhanjeri, Mohali, Punjab, India
| | - M Ravi Kumar
- Department of Chemistry, Raghu Engineering College, Visakhapatnam, Andhra Pradesh, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Nishant Rai
- Department of Biotechnology, Graphic Era (Deemed to be University), Dehradun, India
- Department of Allied Sciences, Graphic Era Hill University, Dehradun, India
| | - Sanjit Sah
- Department of Paediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed-to-be University), Pune, Maharashtra, India
- Department of Medicine, Korea Universtiy, Seoul, South Korea
| | - Sorabh Lakhanpal
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
| | | | - Ganesh Bushi
- Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospital, Saveetha University, Chennai, India
- Evidence for Policy and Learning, Global Center for Evidence Synthesis, Chandigarh, India
| | - Muhammed Shabil
- University Center for Research and Development, Chandigarh University, Mohali, Punjab, India
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, Iraq
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Khezri R, Askari S, Jahanian S, Ashayeri N. Preterm birth and public health challenges: Incidence and risk factors. Public Health 2025; 242:186-191. [PMID: 40107093 DOI: 10.1016/j.puhe.2025.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 01/24/2025] [Accepted: 03/09/2025] [Indexed: 03/22/2025]
Abstract
OBJECTIVES Preterm birth is a global problem, with most preterm births occurring in low and middle-income countries like Iran. This study determined the incidence and risk factors associated with preterm birth in rural areas of sardasht, Iran. STUDY DESIGN Case-control study. METHODS A case-control study was conducted among 414 pregnant women in rural areas (138 cases and 276 controls) in Sardashat, Iran. Data were extracted from medical records. Gestational age was estimated through ultrasound during the first trimester. Statistical analyses were performed with logistic regression. RESULTS Results of multivariable logistic regression analysis showed a significant association between preterm birth and the following factors: Education levels, antenatal care visits [AOR = 2.74 (95 % CI; 1.42-5.28)], maternal anemia in the first trimester [AOR = 4.92 (95 % CI; 1.30-18.71)], parity [AOR = 3.48 (95 % CI; 1.25-9.69)], premature rupture of membranes [AOR = 8.32 (95 % CI; 2.89-23.91)], gestational diabetes mellitus [AOR = 7.87 (95 % CI; 2.19-28.31)], preeclampsia [AOR = 6.14 (95 % CI; 1.74-21.7)], history of abortion [AOR = 2.69 (95 % CI; 1.23-5.90)] and maternal age. CONCLUSION Preterm birth was significantly associated with education level, antenatal care visits, premature rupture of membranes, gestational diabetes mellitus, preeclampsia, maternal anemia, parity, history of abortion and maternal age. High-risk pregnant women should receive more intensive prenatal care to prevent preterm birth.
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Affiliation(s)
- Rozhan Khezri
- Department of Biostatistics and Epidemiology, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Saeedeh Askari
- Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sepideh Jahanian
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Neda Ashayeri
- Ali Asghar Children Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Tsamantioti E, Alfvén T, Hossin MZ, Razaz N. Maternal anaemia and risk of neonatal and infant mortality in low- and middle-income countries: a secondary analysis of 45 national datasets. BMJ Glob Health 2025; 10:e014654. [PMID: 40032517 PMCID: PMC11877194 DOI: 10.1136/bmjgh-2023-014654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/08/2025] [Indexed: 03/05/2025] Open
Abstract
BACKGROUND Anaemia in pregnancy has been recognised worldwide as a growing public health concern and an important cause of adverse neonatal outcomes. However, only a limited number of studies have been done in low-income settings, which have the highest prevalence of anaemia. We aimed to investigate the association between maternal anaemia and neonatal and infant mortality in low- and middle-income countries. METHODS Secondary analysis of pooled data from 45 national demographic and health surveys (2010-2020). We included all women between 15 and 49 years old, who had singleton live birth within 1 year preceding the survey, with a valid maternal measurement of haemoglobin. We used logistic regression models to estimate the crude and adjusted OR (aOR) with 95% CIs of the association between maternal anaemia (measured at the time of the survey) and the risk of neonatal and infant mortality. RESULTS Among 106 143 women included in our analysis, there were 53 348 (50.5%) women with no anaemia, 24 670 (23.2%) with mild anaemia, 25 937 (24.3%) with moderate anaemia and 2188 (2.0%) with severe anaemia. Overall, there were 2668 (2.5%) neonatal and 3756 (3.5%) infant deaths. Moderate (aOR 1.20; 95% CI 1.06 to 1.35) and severe (aOR 1.89; 95% CI 1.46 to 2.44) maternal anaemia were associated with increased odds of neonatal mortality, respectively. Similar estimates were observed for moderate and severe anaemia and infant mortality. No increased risk was noted for mild anaemia. INTERPRETATION Moderate and severe maternal anaemia in low- and middle-income settings are associated with increased risks of neonatal and infant mortality. Future research should examine how targeted interventions for prepregnancy and antenatal treatment of anaemia in reproductive-age women can enhance maternal and child health in low- and middle-income settings.
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Affiliation(s)
- Eleni Tsamantioti
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Muhammad Zakir Hossin
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neda Razaz
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Marwa F, Konje E, Tupa T, Gwimile M, Basinda N. Providers' Practices and Associated Factors in Educating Pregnant Women on the Prevention of Maternal Anemia During Antenatal Care Visits in Ujiji Municipality, Kigoma Region, Tanzania. Healthcare (Basel) 2025; 13:327. [PMID: 39942516 PMCID: PMC11817453 DOI: 10.3390/healthcare13030327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 11/28/2024] [Accepted: 12/27/2024] [Indexed: 02/16/2025] Open
Abstract
BACKGROUND Anemia in pregnancy is among the preventable severe public health problems, responsible for around 14.5% of maternal mortality in Tanzania. Antenatal visits are among the pillars that aid in reducing the burden of anemia in pregnancy. However, there are discrepancies in adherence and performance across different domains of Antenatal care (ANC) by healthcare workers. Therefore, this study examined providers' practices and associated factors in educating pregnant women on preventing maternal anemia during antenatal care visits in Kigoma and Ujiji Municipal Council in the Kigoma region. METHODS This was a cross-sectional design involving a total of 430 client exit interviews across 18 facilities. The association between the provision of maternal anemia education and other factors such as health facility level, age group, sex, economic activities, and ANC visitation was analyzed using multivariate logistic regression. p-values less than 0.05 were considered significant throughout the study. RESULTS The study revealed that most participants (70.4%) reported receiving anemia information during ANC visits. The most common topics were insecticide-treated nets (ITNs) (76%) and types of food to prevent anemia (74%), while 20.8% and 24.8% reported receiving information about worm infestation and deworming, respectively. Only 34.4% (95%CI: 26.5-43.3%) of pregnant women were informed of at least five topics. CONCLUSIONS The study reveals limited education provision on anemia among pregnant women. There is a discrepancy in topic coverage among facilities and individuals.
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Affiliation(s)
- Fredy Marwa
- Tanzania Health Promotion Support, Dar es Salaam P.O. Box 32605, Tanzania;
| | - Eveline Konje
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Theckla Tupa
- Weill-Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (T.T.); (M.G.)
| | - Mlemile Gwimile
- Weill-Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (T.T.); (M.G.)
| | - Namanya Basinda
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
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Afifah A, Zuhairini Y, Ariyanto EF, Ghozali M, Fatimah SN, Pramatirta AY. The Potential Impact of Dietary Fiber Supplementation on Hemoglobin and Reticulocyte Hemoglobin Equivalent (RET-He) Levels in Pregnant Women with Anemia Receiving Oral Iron Therapy in Indonesia. J Multidiscip Healthc 2025; 18:183-193. [PMID: 39844923 PMCID: PMC11750942 DOI: 10.2147/jmdh.s497795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 12/15/2024] [Indexed: 01/24/2025] Open
Abstract
Purpose Anemia during pregnancy can lead to physical and cognitive impairments, fatigue, and postpartum depression. Dietary fiber, as a prebiotic, supports gut health by producing short-chain fatty acids, which enhance immunity and aid iron absorption. This study investigates the impact of fiber supplementation on hemoglobin and reticulocyte hemoglobin equivalent (RET-He) levels in anemic pregnant women receiving oral iron therapy. Patients and Methods This study used a quasi-experimental design with a control group. The subjects were anemic pregnant women between 14 and 32 weeks of gestation. Fifteen control subjects received iron tablets and skim milk (placebo), while 25 intervention subjects received iron tablets and a fiber supplement containing 7.2 grams of dietary fiber. Hemoglobin and RET-He levels were measured before and after the intervention with a Sysmex hematology analyzer. The differences in hemoglobin and RET-He changes were analyzed using the independent sample T-test. Results After 14 days of intervention, the average hemoglobin increase in the intervention group was 0.772±0.815, compared to 0.167±0.564 in the control group, with a p-value of 0.016. There was a significant decrease in the intervention group (p=0.018) and the control group (p=0.008) with normal RET-He values. The average change in RET-He values for the normal group with intervention was -1.44 ± 0.99 and control was -1.63 ± 1.19 (p=0.715), while for the low group with intervention it was 1.65 ± 3.024 and control was 0.55 ± 2.654 (p=0.402). Conclusion This study concludes that fiber supplementation for 14 days in pregnant women with anemia can significantly increase hemoglobin levels compared to the control group There was a decrease in RET-He values after the intervention in the normal group and an increase in the low group, although it was not statistically significant.
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Affiliation(s)
- Adilah Afifah
- Master Program of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Yenni Zuhairini
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Eko Fuji Ariyanto
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Mohammad Ghozali
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Siti Nur Fatimah
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Akhmad Yogi Pramatirta
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, West Java, 45363, Indonesia
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Huang R, Lu Z, Li X, Zhou D, Xu J, Lin D, Fu Y, Liang Y, Li X, Petersen F, Zhou Q, Yu X. Positive association between chronic hepatitis B virus infection and anemia in pregnancy in Southern China. Sci Rep 2025; 15:1980. [PMID: 39809824 PMCID: PMC11732989 DOI: 10.1038/s41598-024-84927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 12/30/2024] [Indexed: 01/16/2025] Open
Abstract
This observational investigation aimed to explore potential risk factors for anemia in pregnancy. Firstly, a cross-sectional study was conducted, encompassing a review of clinical data of 43,201 pregnant women admitted to the Hainan Women and Children's Medical Center between January 2017 and December 2020. Comparison between women with and without anemia in pregnancy revealed significant differences between the two groups concerning age, gestational diabetes, hypothyroidism, hyperthyroidism, chronic hepatitis B virus infection, syphilis infection, and human immunodeficiency virus infection. Multivariable logistic regression analysis showed that chronic hepatitis B virus infection was significantly associated with anemia during pregnancy (AOR 2.97, 95% CI 2.57-3.44, p < 0.0001). Subsequently, a retrospective cohort comprising 86 cases with chronic hepatitis B virus infection and 129 control subjects recruited from the Hainan Women and Children's Medical Center from November 2021 and January 2023 was examined. Results of the examination revealed a corroborative association between chronic hepatitis B virus infection and anemia in pregnancy (OR 2.13, 95% CI 1.20-3.79, p = 0.0092), particularly manifesting in the third trimester of gestation. Further analysis unveiled distinctive hematological alterations among cases with chronic hepatitis B virus infection, characterized by diminished erythrocyte size and reduced levels of corpuscular hemoglobin. Collectively, these findings underscore a positive association of chronic hepatitis B virus infection with anemia during pregnancy.
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Affiliation(s)
- Renliang Huang
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Zhe Lu
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Xinze Li
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Duo Zhou
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Jing Xu
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Dan Lin
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Yunxue Fu
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Yan Liang
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China
| | - Xuexia Li
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Frank Petersen
- Priority Area Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, 23845, Germany
| | - Qiaomiao Zhou
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China.
| | - Xinhua Yu
- Hainan Women and Children's Medical Center, Haikou, 571199, Hainan, China.
- Priority Area Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, 23845, Germany.
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Kassie GA, Hailegebireal AH, Gebrekidan AY, Woldegeorgis BZ, Adella GA, Haile KE, Asgedom YS. Anemia status and its determinants among reproductive-age women in Tanzania: A multi-level analysis of Tanzanian demographic and health survey data. PLoS One 2024; 19:e0311105. [PMID: 39556567 PMCID: PMC11573225 DOI: 10.1371/journal.pone.0311105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 09/12/2024] [Indexed: 11/20/2024] Open
Abstract
INTRODUCTION Anemia is significantly associated with morbidity and mortality in women of reproductive age. Determining the prevalence and identifying associated risk factors remains an important topic in public health. Therefore, this study aimed to estimate and identify the risk factors for anemia in women of reproductive age in Tanzania. MATERIALS AND METHODS A cross-sectional study utilizing secondary data from the Tanzania Demographic and Health Survey of 2022 was conducted. Weighted total samples of 8,921 reproductive-age women were included in the analysis. A multilevel Poisson regression model was employed to account for the hierarchical structure of the TDHS data. Deviance was used to compare the models. In the multivariable multilevel mixed-effects Poisson regression model with robust variance, adjusted prevalence ratios with corresponding 95% confidence intervals were used to identify the determinants of anemia. RESULTS The prevalence of anemia among women of reproductive age in Tanzania was 42.02% [95% CI: (40.79%-43.25%)]. Of these, 19.82%, 19.35%, and 2.84% had mild, moderate, and severe anemia, respectively. The regression results revealed that women from households with the poorest wealth quantiles, underweight, pregnant status, high community poverty level, and women from the eastern and Zanzibar administrative zones had a higher prevalence of anemia. While currently employed, moderate alcohol consumption and use of hormonal contraceptive methods were associated with a lower prevalence of anemia. CONCLUSION The findings of the study showed that anemia is a severe public health issue among women of reproductive age in Tanzania, affecting more than four in ten women. Interventions targeting the improvement of nutrition, access to healthcare services, and education on anemia prevention and management should be prioritized to reduce the burden of anemia effectively.
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Affiliation(s)
- Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Aklilu Habte Hailegebireal
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Beshada Zerfu Woldegeorgis
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Eshetu Haile
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatistics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Munyogwa MJ, Gibore NS, Ngowi AF, Mwampagatwa IH. Routine uptake of prenatal iron-folic acid supplementation and associated factors among pregnant women in peri-urban areas of Dodoma City, Tanzania: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:673. [PMID: 39402490 PMCID: PMC11475891 DOI: 10.1186/s12884-024-06871-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 09/30/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND The physiological requirements for iron and folic acid in pregnancy are a significant challenge to achieve through normal dietary intake, especially in low resource settings. The World Health Organization recommends daily oral iron and folic acid supplementation (IFAS) to prevent maternal anaemia and related adverse effects in community settings where the prevalence of anaemia during pregnancy is > 40%. The objective of this study was to assess the routine uptake of prenatal iron-folic acid supplementation and associated factors among pregnant women at peri-urban areas of Dodoma City, Tanzania. METHODS A cross-sectional study was conducted in peri-urban areas. Data was collected through face-to-face interviews and review of records from maternal clinic card (RCH 4 card). Routine uptake of iron-folic acid supplementation was defined as pregnant woman who reported taking iron-folic acid supplements at least once within the past seven days prior to data collection. Frequency and percentage were used to report respondents' characteristics and uptake of prenatal iron-folic acid supplementation. Chi-square test and logistic regression were conducted to determine the relationship and association of routine uptake of iron-folic acid supplementation with respondents' characteristics. RESULTS The total respondents were 452. Overall routine uptake of iron-folic acid supplementation was 35.6% (161). The majority of the respondents (66.5%) initiated iron-folic acid supplementation during the second trimester of pregnancy. Most of the respondents (86.3%) obtained IFA supplements at the health centers where they were receiving antenatal care. The prevalence of routine uptake of iron-folic acid supplementation was significantly higher among women in the third trimester of pregnancy (54.9%), those with more than a five-year interval since last pregnancy (40.6%), those with at least four antenatal care (ANC) visits (73.7%) and women who had undergone haemoglobin testing in the current pregnancy (63.0%). Factors associated with routine uptake of iron-folic acid supplementation were; frequency of ANC visits (AOR = 1.69) and haemoglobin testing (AOR = 3.02). CONCLUSION Approximately one third of the pregnant women took iron-folic acid supplementation at least once a week. The current frequency for intake of iron-folic acid supplementation can be described as intermittent. This practise is unacceptable for prevention of maternal anaemia and associated adverse pregnant outcomes. Frequency of ANC visits and haemoglobin testing during pregnancy were found to be associated with routine uptake of iron-folic acid supplements. Stakeholders are urged to consider novel systems for provision of prenatal IFAS in community settings with limited access to health-care professionals to ensure a timely and continuous supply of supplements.
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Affiliation(s)
- Mariam J Munyogwa
- Department of Community Medicine, The University of Dodoma, P. O. Box 395, Dodoma, Tanzania.
| | - Nyasiro S Gibore
- Department of Public Health and Community Nursing, The University of Dodoma, P. O. Box 395, Dodoma, Tanzania
| | - Agatha F Ngowi
- Department of Public Health and Community Nursing, The University of Dodoma, P. O. Box 395, Dodoma, Tanzania
| | - Ipyana H Mwampagatwa
- Department of Obstetrics and Gynecology, The University of Dodoma, P. O. Box 395, Dodoma, Tanzania
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Carboo JA, Ngounda J, Baumgartner J, Robb L, Jordaan M, Walsh CM. Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study. BMC Pregnancy Childbirth 2024; 24:650. [PMID: 39367334 PMCID: PMC11452952 DOI: 10.1186/s12884-024-06845-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 09/20/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. OBJECTIVE To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. METHODS In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. RESULTS The median (Q1, Q3) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median (Q1, Q3) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3-12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). CONCLUSION In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection.
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Affiliation(s)
- Janet Adede Carboo
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa.
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
| | - Jeannine Baumgartner
- Department of Nutritional Sciences, King's College, Waterloo Campus, 57 Waterloo Road, London, SE1 8WA, UK
| | - Liska Robb
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
| | - Marizeth Jordaan
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
| | - Corinna May Walsh
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
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Tesfaye S, Petros L, Tulu IA, Feleke FW. The magnitude of anemia and its associated factors among pregnant women in Hawela Tula Sub-city of Hawassa, Hawassa, Ethiopia. Front Nutr 2024; 11:1445877. [PMID: 39391683 PMCID: PMC11466050 DOI: 10.3389/fnut.2024.1445877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 09/09/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction Anemia is one of the most serious health problems impacting people worldwide. The disease is quiet, moving slowly and producing only a few physical symptoms. Anemia during pregnancy raises the risk of premature birth, low birth weight, and fetal anomalies, and it can have a substantial financial impact on society and families. However, there was a paucity of studies on the magnitude and associated factors of anemia among pregnant women in southern Ethiopia. Objective This study aimed to assess the magnitude and associated factors of anemia among pregnant women attending antenatal care in the Hawella Tula Sub-city of Hawassa City in 2021. Methods Institution-based cross-sectional study was done on 341 randomly selected pregnant women attending antenatal care clinics. Data were obtained using a standardized semi-structured questionnaire. To identify the associated factors for the magnitude of anemia logistic regression model was used with an adjusted odds ratio (AOR) with 95% confidence intervals (CI) was calculated. Results The prevalence of anemia among pregnant women attending antenatal care in health facilities of Hawella Tula Sub-city was 113 (33.7%) with a 95% confidence interval (CI) (28.8, 38.9). Male-headed household (AOR = 2.217, 95% CI: 1.146, 4.286), rural resident (AOR = 3.805, 95% CI: 2.118, 6.838), early marriage below 18 years (AOR = 2.137, 95% CI: 1.193, 3.830), and recurrent of illness during pregnancy (AOR = 3.189, 95% CI: 1.405, 7.241) were associated factors for anemia. Conclusion Anemia prevalence among pregnant women was 113 (33.7%). Anemia among pregnant women was associated with rural residents, early marriage age below 18 years, and repeated illnesses during pregnancy.
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Affiliation(s)
| | - Legese Petros
- Hosanna Health Science College, Department of Public Health, Hosanna, Ethiopia
- Department of Human Nutrition, School of Human Nutrition and Food Science Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | | | - Fentaw Wassie Feleke
- UNICEF/LONADD, Hawassa, Ethiopia
- Department of Human Nutrition, School of Human Nutrition and Food Science Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
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Adjei-Gyamfi S, Zakaria MS, Asirifi A, Issahaku S, Ibrahim MA, Aryee PA. Maternal anaemia and polycythaemia during pregnancy and risk of inappropriate birth weight for gestational age babies: a retrospective cohort study in the northern belt of Ghana. BMJ Open 2024; 14:e082298. [PMID: 39142669 PMCID: PMC11331998 DOI: 10.1136/bmjopen-2023-082298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 07/30/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Small for gestational age (SGA) and large for gestational age (LGA) births are topical issues due to their devastating effects on the life course and are also accountable for neonatal mortalities and long-term morbidities. OBJECTIVE We tested the hypothesis that abnormal haemoglobin levels in each trimester of pregnancy will increase the risk of SGA and LGA deliveries in Northern Ghana. DESIGN A retrospective cohort study was conducted from April to July 2020. SETTINGS AND PARTICIPANTS 422 postpartum mothers who had delivered in the last 6-8 weeks before their interview dates were recruited through a systematic random sampling technique from five primary and public health facilities in Northern Ghana. PRIMARY MEASURES Using the INTERGROWTH-21st standard, SGA and LGA births were obtained. Haemoglobin levels from antenatal records were analysed to determine their effect on SGA and LGA births by employing multinomial logistic regression after adjusting for sociodemographic and obstetric factors at a significance level of α=0.05. RESULTS Prevalence of anaemia in the first, second and third trimesters of pregnancy was 63.5%, 71.3% and 45.3%, respectively, and that of polycythaemia in the corresponding trimesters of pregnancy was 5.9%, 3.6% and 1.7%. About 8.8% and 9.2% of the women delivered SGA and LGA babies, respectively. After adjusting for confounders, anaemic mothers in the third trimester of pregnancy had an increased risk of having SGA births (adjusted OR, aOR 5.56; 95% CI 1.65 to 48.1; p<0.001). Mothers with polycythaemia in the first, second and third trimesters of pregnancy were 93% (aOR 0.07; 95% CI 0.01 to 0.46; p=0.040), 85% (aOR 0.15; 95% CI 0.08 to 0.64; p<0.001) and 88% (aOR 0.12; 95% CI 0.07 to 0.15; p=0.001) protected from having SGA births, respectively. Interestingly, anaemia and polycythaemia across all trimesters of pregnancy were not statistically significant with LGA births. CONCLUSION Anaemia during pregnancy increased from the first to the second trimester and subsequently decreased in the third trimester while polycythaemia consistently decreased from the first to the third trimester. LGA babies were more predominant compared with SGA babies. While anaemia in the third trimester of pregnancy increased the risk of SGA births, polycythaemia across the trimesters offered significant protection. Healthcare providers and stakeholders should target pressing interventions for anaemia reduction throughout pregnancy, especially during the third trimester to achieve healthy birth outcomes.
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Affiliation(s)
- Silas Adjei-Gyamfi
- Savelugu Municipal Hospital, Ghana Health Service, Savelugu, Northern Region, Ghana
| | - Mary Sakina Zakaria
- Savelugu Municipal Hospital, Ghana Health Service, Savelugu, Northern Region, Ghana
| | - Abigail Asirifi
- Department of Midwifery, Garden City University College, Kenyasi - Kumasi, Ashanti Region, Ghana
| | - Sulley Issahaku
- Nanton District Health Directorate, Ghana Health Service, Nanton, Northern Region, Ghana
| | | | - Paul Armah Aryee
- School of Allied Health Sciences, University for Development Studies, Tamale, Northern Region, Ghana
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Saeed MS, Adam GK, Hussein SM, AlHabardi N, Adam I. Prevalence and Factors Associated with Adherence to Iron-Folic Acid Supplementation Among Pregnant Women in Eastern Sudan: A Cross-Sectional Study. Patient Prefer Adherence 2024; 18:1665-1674. [PMID: 39131690 PMCID: PMC11317201 DOI: 10.2147/ppa.s476738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Abstract
Purpose The present study was conducted to determine the prevalence and factors associated with adherence to iron-folic acid supplementation (IFAS) among pregnant women in eastern Sudan. Methods A cross-sectional survey was conducted among pregnant women who obtained antenatal care (ANC) at Gadarif Maternal Hospital in eastern Sudan between May 1 and August 31, 2023. Face-to-face interview questionnaires were used to gather sociodemographic, obstetric, and clinical data (age, parity, education, residence, and previous medical diseases). Knowledge of anemia and IFAS was assessed. Multivariate analysis was performed to adjust for confounders. Results A total of 568 pregnant women were enrolled in the present study. Among them, 449 (79.0%) adhered to the IFAS. The multivariate analysis showed that the adjusted odds ratio (AOR) of IFAS adherence increased with ANC visits > 4 (AOR = 1.68, 95.0% CI = 1.01-2.77) and knowledge of anemia (AOR = 2.06, 95.0% CI = 1.437-3.276). In the univariate analysis, maternal occupation and knowledge of IFAS adherence were the only factors associated with IFAS adherence. Maternal age, parity, gestational age, education, residence, occupation, medical insurance, medical disease, and husband's occupation were not associated with IFAS. Forgetfulness (71.0%), frustration from taking many drugs (54.6%), and unpleasant tests of the supplement (50.7%) were the main reasons for not taking the IFAS. Conclusion About four out of five pregnant women adhered to the IFAS, indicating a good level of adherence, especially among women who attended more than four ANC visits and those with good knowledge of anemia. More attention is needed to encourage ANC to increase adherence to IFAS.
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Affiliation(s)
- Mustafa S Saeed
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Saudi Arabia
| | - Gamal K Adam
- Faculty of Medicine, Gadarif University, Gadarif, Sudan
| | - Samah M Hussein
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Saudi Arabia
| | - Nadiah AlHabardi
- Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
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Dufera T, Dheresa M, Dingeta T, Legesse M, Mesfin S, Balis B, Balcha T. Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study. Int Health 2024; 16:438-445. [PMID: 38226469 PMCID: PMC11218879 DOI: 10.1093/inthealth/ihad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. METHODS Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. RESULT The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14-4.8), no formal education (AOR = 4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0-12.7). CONCLUSION In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.
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Affiliation(s)
- Tadesse Dufera
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tariku Dingeta
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mezgebu Legesse
- School of Medicine, Department of Medical Biochemistry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tegenu Balcha
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Abu Shqara R, Chole S, Sgayer I, Rozano Gorelick A, Lowensetin L, Frank Wolf M. The utility of inpatient anemia workup in hemoglobin < 10 g/dL diagnosed randomly in the third trimester: a retrospective study. Arch Gynecol Obstet 2024; 309:1893-1901. [PMID: 37162561 DOI: 10.1007/s00404-023-07069-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/28/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE About 40% of pregnant women are anemic and at an increased risk for complications. We examined the efficacy of inpatient anemia workup and treatment in pregnant women diagnosed with moderate-severe anemia (hemoglobin < 10 mg/dL), during hospitalization in the late second-trimester and third-trimester. METHODS This retrospective study, conducted between March 2020 and November 2022, included women at ≥ 24 gestational weeks who were hospitalized due to various indications and diagnosed with anemia (hemoglobin < 10 mg/dL). The study group comprised women who underwent an inpatient anemia workup and initiation of anemia treatment. The comparison group comprised women who did not undergo an inpatient anemia investigation. The primary outcome was the rate of pre-delivery hemoglobin > 11 g/dL. RESULTS The most frequent etiology of anemia in the study group (n = 188) was iron-deficiency anemia (30.2%), followed by mixed anemia of iron, folate and vitamin-B12 deficiencies (20.7%). In the study vs. the comparison group (n = 179), the rate of pre-delivery hemoglobin > 11 g/dL was higher, and the increase in hemoglobin from intervention to delivery was greater. The ideal timing for anemia intervention for maximizing the increase in pre-delivery hemoglobin was 6-weeks or more prior to delivery. The rates of postpartum hemorrhage and blood transfusions were similar. The rate of postpartum hemoglobin < 10 g/dL was lower in the study than the comparison group. CONCLUSION Inpatient anemia investigation and treatment resulted in higher peri-delivery hemoglobin. In women randomly diagnosed with anemia at hospitalization, the rate of pre-delivery hemoglobin > 11 g/dL was increased among those who underwent a simple anemia investigation and treatment initiation.
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Affiliation(s)
- Raneen Abu Shqara
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Samuel Chole
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Inshirah Sgayer
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | | | - Lior Lowensetin
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Maya Frank Wolf
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel.
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
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Nuwabaine L, Kawuki J, Kamoga L, Sserwanja Q, Gatasi G, Donkor E, Mutisya LM, Asiimwe JB. Factors associated with anaemia among pregnant women in Rwanda: an analysis of the Rwanda demographic and health survey of 2020. BMC Pregnancy Childbirth 2024; 24:328. [PMID: 38678175 PMCID: PMC11055334 DOI: 10.1186/s12884-024-06528-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda. METHODS Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value < 11 g/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26). RESULTS Of the 435 pregnant women, 24.6% (95%CI: 21.1-29.3) were anaemic (1 in 4 pregnant women). Not working (AOR = 2.45; 95%CI: 1.14-5.26), being unmarried (AOR = 1.23; 95%CI: 1.24-3.57), low wealth index (AOR = 9.19; 95%CI: 1.64-51.56), having difficulty accessing a nearby health facility (AOR = 5.40; 95%CI: 2.21-13.23), and normal body mass index (AOR = 3.33; 95%CI: 1.46-7.59) were associated with higher odds of being anaemic. However, not taking iron supplements (AOR = 0.16; 95% CI: 0.04-0.67), having no exposure to television (AOR = 0.35; 95%CI: 0.14-0.91), being from the southern region (AOR = 0.14; 95% CI: 0.03-0.66), and low husband/partner's education (AOR = 0.08; 95% CI: 0.01-0.59) were associated with lower odds of being anaemic. CONCLUSIONS The study findings indicate a high prevalence of anaemia in pregnancy, which was associated with several socio-demographics. There is a need for setting up mobile clinics and health facilities in hard-to-reach areas for easy accessibility to early anaemia screening services. Conducting mass screening for anaemia targeting pregnant women who are not working, the unmarried, and those with a low wealth index would also be beneficial. The intake of locally available iron rich foods and/ or bio-fortified foods is also recommended.
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Affiliation(s)
- Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Livingstone Kamoga
- Department of Nursing, Makerere University College of Health Sciences, Makerere, Uganda
| | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
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Jejaw M, Teshale G, Yazachew L, Dellie E, Debie A. Adverse birth outcome among women who gave birth at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia. BMC Pregnancy Childbirth 2024; 24:285. [PMID: 38632514 PMCID: PMC11022324 DOI: 10.1186/s12884-024-06478-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND In Ethiopia, various maternal and child health interventions, including comprehensive and basic obstetric cares were conducted to curb high neonatal and infant morbidity and mortality. As such, adverse birth outcome has been a public health concern in the country. Thus, this study aimed to assess the burden and associated factors with adverse birth outcomes among women who gave birth at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS A health facility-based cross-sectional study was employed from 30 March to 01 May 2021 at the University of Gondar Comprehensive Specialized Hospital. A total of 455 women were interviewed using a structured questionnaire. A binary logistic regression model was fitted Adjusted Odds Ratio (AOR) with 95%CI and p-value < 0.05 were used to declare factors significantly associated with adverse birth outcomes. RESULTS In this study, 28% of women had adverse birth outcomes (8.4% stillbirths, 22.9% preterm births, and 10.11% low birth weights). Women aged 20-34) (AOR: 0.32, 95%CI: 0.14, 0.76), rural dwellers (AOR: 2.7, 95%CI: 1.06, 6.32), lack of ANC visits (AOR: 4.10, 95%CI: 1.55, 10.85), APH (AOR: 3.0, 95%CI: 1.27, 7.10) and fever (AOR: 7.80, 95%CI: 3.57, 17.02) were associated to stillbirths. Multiple pregnancy (AOR:7.30, 95%CI:1.75, 20.47), rural dwellers (AOR:4.60, 95%CI:1.36, 15.52), preterm births (AOR: 8.60, 95% CI: 3.88, 19.23), previous perinatal death (AOR:2.90, 95%CI:1.35, 6.24), fever (AOR:2.7,95%CI:1.17 ,6.23) and premature rupture of membrane (AOR:2.60, 95% CI:1.02, 6.57) were affecting low birth weights. In addition, previous antepartum hemorrhage (AOR: 2.40, 95%CI: 1.37, 4.10) and fever (AOR: 3.8, 95%CI: 2.13, 6.89) were also factors contributing to preterm births. CONCLUSION Adverse birth outcomes continue to pose a significant public health concern. Such high rates of adverse birth outcomes, such as preterm birth, low birth weight, and birth defects, can have serious and long-lasting effects on the health and well-being of both infants and their families, and the community at large. As such, public health efforts are crucial in addressing and mitigating the risk factors associated with adverse birth outcomes. This may involve implementing interventions and policies to improve maternal health, access to prenatal care and nutritional support, and reducing exposure to environmental risks.
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Affiliation(s)
- Melak Jejaw
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia.
| | - Getachew Teshale
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia
| | - Lake Yazachew
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia
| | - Endalkachew Dellie
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia
| | - Ayal Debie
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Asmare AA, Agmas YA. Determinants of coexistence of undernutrition and anemia among under-five children in Rwanda; evidence from 2019/20 demographic health survey: Application of bivariate binary logistic regression model. PLoS One 2024; 19:e0290111. [PMID: 38578819 PMCID: PMC10997128 DOI: 10.1371/journal.pone.0290111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/01/2023] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Undernutrition and anemia are significant public health issues among under-5 children, with potential long-term consequences for growth, development, and overall health. Thus, this study aims to conduct a bivariate binary logistic regression model by accounting for the possible dependency of childhood undernutrition and anemia. METHODS The data came from the DHS program's measurement. A total of 3,206 under-five children were involved in this study. A single composite index measure was calculated for stunting, wasting, and underweight using principal component analysis. A bivariate binary logistic regression model is used to assess the association between undernutrition and anemia given the effect of other predictors. RESULTS Among 3,206 under-five children considered in this study, 1482 (46.2%) and 658 (20.5%) children were agonized by anemia and undernutrition, respectively. In bivariate binary logistic regression model; Urban children [AOR = 0.751, 96% CI: 0.573-0.984; AOR = 0.663, 95% CI: 0.456-0.995] and anemic mothers [AOR = 1.160, 95% CI: 1.104-1.218; AOR = 1.663, 95% CI: 1.242-2.225] were significantly associated with both childhood anemia and undernutrition, respectively. Improved water sources [AOR = 0.681, 95% CI: 0.446-0.996], average-sized children [AOR = 0.567, 95% CI: 0.462-0.696], and diarrhea [AOR = 1.134, 95% CI: 1.120-2.792] were significantly associated with childhood anemia. Large-sized children [AOR = 0.882, 95% CI: 0.791-0.853] and those with fever [AOR = 1.152, 95% CI: 1.312-2.981] were significantly associated with under-five children's undernutrition. CONCLUSION The prevalence of both undernutrition and anemia among under-five-year-old children was high in Rwanda. The following determinants are statistically associated with both childhood undernutrition and anemia: place of residence; source of drinking water; maternal anemia; being a twin; birth size of children; diarrhea; fever; and child age. Anemia and nutritional deficiencies must be treated concurrently under one program, with evidence-based policies aimed at vulnerable populations.
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Affiliation(s)
| | - Yitateku Adugna Agmas
- Department of Rural Development and Agricultural Extension, Mekdela Amba University, Tuluawlyia, Ethiopia
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18
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Mankelkl G, Kinfe B. Factors associated with anemia among reproductive age women in Nigeria; evidenced by the Nigeria malaria indicators survey: spatial and multilevel model analysis. Contracept Reprod Med 2024; 9:12. [PMID: 38566232 PMCID: PMC10988975 DOI: 10.1186/s40834-024-00275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Anemia is a global public health problem among women of reproductive age group, especially in developing countries, which affect health, social and economic development that result in low physical activity, increased maternal morbidity and mortality and adverse neonatal outcome especially those with severe anemia. However, there is limited reliable and updated data on the spatial variations of anemia and its associated factors among reproductive-age women in Nigeria. METHODS Secondary data analysis was conducted using data from the recent Nigeria malaria indicators survey datasets. The study comprised a total of 14,476 reproductive-age women. Spatial and multilevel mixed effect analysis on determinants factors of anemia among reproductive age women in Nigeria evidenced by the recent Nigerian malaria indicators survey. Finally, the percentage and odd ratio, its 95% confidence intervals, and the result of spatial analysis were reported. RESULT This study includes a total weighted sample of 14,476 reproductive-age women from the Nigeria malaria indicators survey. The prevalence of anemia was 24.6% in Ethiopia. Being between the age range of 30-34 years [AOR: 0.217, 95% CI (0.171, 0.274)], Attending higher education [AOR: 0.848, 95%CI (0.740, 0.972)] and being male headed household [AOR: 0.540, 95% CI (0.471, 0.620)] were protective for anemia. On the other hand being poorest [AOR: 1.542 95%CI (1.299, 1.830)] and being listening radio less than once a week [AOR: 1.013, 95% CI (0.908, 1.131)] were risk for anemia. CONCLUSION In this study Individual level factors were associated with anemia and also there were spatial variations in anemia across the region among reproductive-age women. Empowering women to have better educational status, improving the wealth index, and promoting education about prevention and control strategies of anemia through media especially in developing regions were the key factors to reduce anemia among reproductive age women in Nigeria.
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Affiliation(s)
- Gosa Mankelkl
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Beletu Kinfe
- Department of occupational Health and safety, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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19
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Shumi L, Gedefa AG, Bidira K. Determinants of compliance to iron folate supplementation among pregnant women attending antenatal care in public health facilities of South West Ethiopia: A case-control study. Health Sci Rep 2024; 7:e1998. [PMID: 38567189 PMCID: PMC10985357 DOI: 10.1002/hsr2.1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 03/03/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background The prevalence of anemia among pregnant women remains high globally, particularly in low-income settings. Iron and folic acid supplementation (IFAS) during pregnancy is the most widely employed strategy to alleviate adverse pregnancy outcomes. This study aimed to explore the determinants of compliance with iron supplementation in the study area. Aim To identify determinants of IFAS compliance among pregnant women attending antenatal care (ANC) in Mettu town, South West Ethiopia, in 2021. Methods A facility-based, unmatched case-control study was conducted from May to July 2021 with a total sample size of 344 (115 cases and 229 controls). Cases and controls were selected using systematic random sampling. Data was collected using a structured, pretested interviewer-administered questionnaire, entered into Epi-data software version 3.1, and exported to SPSS version 23 for analysis. Variables with p < 0.25 during bivariate analyses were entered into a multivariable logistic regression model. Then, variables with a p < 0.05 at 95% confidence interval (CI) were declared to be statistically significant determinants of IFAS. The odds ratio was used to indicate the strength of the association. Result Having Previous history of anaemia (adjusted odds ratio [AOR] = 5.8, 95% CI [2.5-13.6], p < 0.01), having good knowledge about IFAS (AOR = 3.3, 95% CI [1.7-6.7], p < 0.001), being a government employee (AOR = 5.2 [2.4-11.5], p < 0.01], and receiving counseling service during ANC (2.495% CI [1.3-4.7] p < 0.01) were among determinants of adherence to IFAS. Conclusions Maternal knowledge about IFAS, counseling about IFAS, occupation, and history of anaemia were found to be significantly associated factors with compliance with iron folate supplementation during pregnancy. This implies that adherence to IFAS can be improved through improving maternal knowledge about importance of IFAS, quality counseling services and strengthening an overall ANC follow-up services.
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Affiliation(s)
- Lensa Shumi
- Mettu Health Science CollegeMettu townOromia RegionEthiopia
| | - Abdi Geda Gedefa
- Public Health DepartmentCollege of Health Science, Mettu UniversityOromia RegionEthiopia
| | - Kebebe Bidira
- Nursing DepartmentCollege of Health Science, Mettu UniversityOromia RegionEthiopia
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20
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Charan GS, Kalia R, Khurana MS. Prevalence of anemia and comparison of perinatal outcomes among anemic and nonanemic mothers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:445. [PMID: 38464653 PMCID: PMC10920754 DOI: 10.4103/jehp.jehp_512_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/31/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND The prevalence of anemia is a significant public health challenge. Approximately half of all pregnant women in India experience anemia during pregnancy. This study aims to determine the prevalence of anemia and perinatal outcomes among anemic and nonanemic pregnant mothers. MATERIALS AND METHODS The quantitative research approach was adopted using a descriptive comparative design. The study was conducted in the Obstetrics and Gynecology and Pediatric departments of a tertiary care hospital. Hemoglobin (Hb) was recorded using antenatal records of pregnant mothers in their III trimester. Based on their Hb level, subjects were divided into two groups, anemic and nonanemic as per World Health Organization criteria. The subjects were followed up until the first week after birth. RESULTS The prevalence of anemia was 48% [N = 410]; 70.6% had mild, 13.7% had moderate, and 15.7% had severe. The anemic group had a significantly higher incidence of low birthweight (30.9% vs 10.3%, P = 0.001) and preterm births (24.2% vs 3.2%, P = 0.001) compared to the nonanemic group. Additionally, there were significant differences in various quantitative perinatal parameters such as weight (P = 0.001), length (P = 0.001), head circumference (P = 0.001), chest circumference (P = 0.034), APGAR score at one minute (P = 0.022), and APGAR score at five minutes (P = 0.001) between the anemic and nonanemic. CONCLUSION The maternal anemia is associated with increased risk of unfavorable perinatal outcomes. Identifying and managing anemia among pregnant women is critical to minimize adverse outcomes. Adequate antenatal care can play a significant role in preventing avoidable complications associated with anemia during the third trimester.
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Affiliation(s)
- Gopal Singh Charan
- Department of Pediatric Nursing, SGRD College of Nursing, Amritsar, Punjab, India
| | - Raman Kalia
- Department of Medical Surgical Nursing, Saraswati Nursing Institute, Kurali, Punjab, India
| | - Mandeep Singh Khurana
- Department of Pediatrics, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
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21
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Etemady M, Hajizadeh M, Gidaszewski B, Swain JA, Chua SC, Khajehei M. Use of iron in perinatal anaemia: Indications for women’s health care policies and procedure. World J Obstet Gynecol 2023; 12:33-44. [DOI: 10.5317/wjog.v12.i4.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/04/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
This paper reviews management of obstetric anaemia and the role of intravenous iron for the treatment of obstetric anaemia. Red blood cell transfusions are routinely used for haemoglobin restoration in anaemic women. The decision for red blood cell transfusion is made on a combination of haemoglobin level and clinical status, and it is suggested that transfusions are not necessary in those who are well compensated or when alternative therapy is available. To reduce the risk, intravenous iron infusion is proposed as a bloodless therapeutic approach. There are a variety of iron preparations. Intravenous iron infusion can reduce the requirement for blood transfusion in hemodynamically stable women with perinatal anaemia, especially in resource-scarce settings. It a cost-effective bloodless approach for the treatment of anaemia than can enhance patient outcomes. According to the literature, when haemoglobin is greater than 90 g/L, blood transfusion is not often required. In perinatal women with anaemia, the decision whether to administer blood or iron is based on patient preferences, haemoglobin levels, clinical symptoms, past and present medical conditions and the clinician’s judgement. Nevertheless, due to the lack of rigid criteria for blood transfusions in the majority of clinical settings, it is considered the default treatment for anaemia in perinatal women.
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Affiliation(s)
- Mike Etemady
- School of Health Sciences, University of Sydney, Sydney, Australia, Sydney 2000, NSW, Australia
| | - Melika Hajizadeh
- Stotts College, Acknowledge Education, Sydney 2000, NSW, Australia
| | - Beata Gidaszewski
- Department of Women’s and Newborn Health, Westmead Hospital, Westmead 2145, NSW, Australia
- Westmead Clinical School, University of Sydney, Sydney 2000, NSW, Australia
| | - Julie Ann Swain
- Women's and Newborn Health, Westmead hospital, Westmead 2145, NSW, Australia
| | - Seng Chai Chua
- Department of Women’s and Newborn Health, Westmead Hospital, Westmead 2145, NSW, Australia
- Clinical School, Western Sydney University, Sydney 2145, NSW, Australia
| | - Marjan Khajehei
- Department of Women’s and Newborn Health, Westmead Hospital, Westmead 2145, NSW, Australia
- Westmead Clinical School, University of Sydney, Sydney 2000, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney 2145, NSW, Australia
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22
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Anabire NG, Aculley B, Pobee A, Kyei-Baafour E, Awandare GA, Del Pilar Quintana M, Hviid L, Ofori MF. High burden of asymptomatic malaria and anaemia despite high adherence to malaria control measures: a cross-sectional study among pregnant women across two seasons in a malaria-endemic setting in Ghana. Infection 2023; 51:1717-1729. [PMID: 37300587 DOI: 10.1007/s15010-023-02058-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Anaemia remains a serious concern among pregnant women, and thus, it is closely monitored from the onset of pregnancy through to delivery to help prevent adverse maternal and neonatal outcomes. In malaria-endemic settings, continuous low-level carriage of P. falciparum parasites is common and its contribution to maternal anaemia should not be underestimated. In this study, we evaluated the impact of adherence to malaria control measures [number of antenatal clinics (ANC) attended, supervised intake of sulphadoxine pyrimethamine (SP), and use of insecticide treated bed nets (ITNs)] on asymptomatic malaria and anaemia outcomes among pregnant women on ANC in hospitals in the Central region of Ghana. METHODS The study was conducted during two seasons; October-November 2020 (dry season, n = 124) and May-June 2021 (rainy season, n = 145). Among the women, there was a high adherence to the control measures for both seasons (ANC ≥ 3 visits; ~ 82.0%, intake of SP; ~ 80.0% and ITNs use; ~ 75.0%). RESULTS Asymptomatic P. falciparum carriage was high for both seasons (44.4% for the dry season; 46.9% for the rainy season). Correspondingly, the occurrence of anaemia was high for both seasons (57.3% for the dry season; 68.3% for the rainy season) and was strongly predicted by carriage of P. falciparum parasites. Despite the high adherence to ANC protocols, asymptomatic P. falciparum infection was common and contributed to the high burden of maternal anaemia. CONCLUSIONS Our findings emphasize the need for improved control measures that can clear asymptomatic/sub-microscopic P. falciparum infection and protect against malaria-induced anaemia among pregnant women attending ANC in malaria endemic-settings.
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Affiliation(s)
- Nsoh Godwin Anabire
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Belinda Aculley
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Abigail Pobee
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Eric Kyei-Baafour
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Maria Del Pilar Quintana
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Michael F Ofori
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana.
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
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23
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Zangeneh FZ, Hantoushzadeh S. The physiological basis with uterine myometrium contractions from electro-mechanical/hormonal myofibril function to the term and preterm labor. Heliyon 2023; 9:e22259. [PMID: 38034762 PMCID: PMC10687101 DOI: 10.1016/j.heliyon.2023.e22259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Background Most labor-related problems can be attributed to the uterine myometrium muscle, as this irritable tissue must suppress its irritability potential during pregnancy. Unfortunately, fewer studies have investigated the causes of this lack of suppression in preterm labor. Methods We conducted a scoping narrative review using three online databases (PubMed, Scopus, and Science Direct). Results The review focused on ion channel functions in the myometrium, including sodium channels [Na K-ATPase, Na-activated K channels (Slo2), voltage-gated (SCN) Na+, Na+ leaky channels, nonselective (NALCN) channels], potassium channels [KATP (Kir6) channels, voltage-dependent K channels (Kv4, Kv7, and Kv11), twin-pore domain K channels (TASK, TREK), inward rectifier Kir7.1, Ca2+-activated K+ channels with large (KCNMA1, Slo1), small (KCNN1-3), intermediate (KCNN4) conductance], and calcium channels [L-Type and T-type Ca2+ channels, calcium-activated chloride channels (CaCC)], as well as hyperpolarization-activated cation channels. These channels' functions are associated with hormonal effects such as oxytocin, estrogen/progesterone, and local prostaglandins. Conclusion Electromechanical/hormonal activity and environmental autocrine factors can serve as the primary practical basis for premature uterine contractions in term/preterm labor. Our findings highlight the significance of.1.the amplitude rate of hyperpolarization and the frequency of contractions,2.changes in the estrogen/progesterone ratio,3.Prostaglandins E/F involvement in initiating potential spikes and the increase of intracytoplasmic Ca2+.This narrative study highlights the range of hyperpolarization and the frequency of myometrium contractions as crucial factors. The synchronized complex progress of estrogen to progesterone ratio and prostaglandins plays a significant role in initiating potential spikes and increasing intracytoplasmic Ca2+, which further influences the contraction process during labor. Insights into myometrium physiology gained from this study may pave the way for much-needed new treatments to reduce problems associated with normal and preterm labor.
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Affiliation(s)
- Farideh Zafari Zangeneh
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedighe Hantoushzadeh
- Department of Fetal-Maternal Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
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Mengistu T, Lencha B, Mekonnen A, Degno S, Yohannis D, Beressa G. Compliance to iron folic acid supplementation and its associated factors among pregnant women attending Antenatal clinic in Wondo district: a cross-sectional study. Sci Rep 2023; 13:17468. [PMID: 37838766 PMCID: PMC10576767 DOI: 10.1038/s41598-023-44577-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023] Open
Abstract
Pregnant women are at high risk for iron deficiency anemia due to increased nutrient requirements during pregnancy. Despite high coverage of iron and folic acid supplementation (IFAS), low compliance is reported. The study aimed to assess compliance with IFAS and its associated factors among antenatal care (ANC) attendees in Wondo District, Southern Ethiopia. A facility-based cross-sectional study was conducted among 400 pregnant women. Pregnant women were selected through systematic random sampling. Pre-tested structured questionnaire was used to collect data through face to face interview. Data were entered into Epi-info and exported to Statistical Package for Social Sciences for analysis. The variables with p-value < 0.25 in the bivariable analysis were entered into the multivariable logistic regression model. P values less than 0.05 were considered significant. Results were reported as crude and adjusted odds ratios with 95% confidence intervals. The prevalence of compliance to IFAS was (177, 44.3%). Factors significantly associated with compliance to IFAS were maternal age ≥ 25 years [AOR 2.27, 95% CI (1.21, 4.28)], maternal education [AOR 2.62, 95% CI (1.43, 4. 79)], husband's education [AOR 3.60, 95% CI (2.07, 6.25)], knowledge of anemia [AOR 4.40, 95% CI (2.65, 7.30)], and knowledge of IFA [AOR 2.21, 95% CI (1.40, 3.50)]. This study showed that compliance to IFAS was low. Maternal age, maternal education, husband's education, knowledge about anemia and iron folic acid was found to be significantly associated with adherence to IFAS. Emphasis should be placed on young, uneducated mothers and their husbands.
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Affiliation(s)
- Taye Mengistu
- Wondo District Health Office, Wondo West Arsi Zone, Oromia, Ethiopia
| | - Bikila Lencha
- Department of Public Health, Madda Walabu University, Shashemene, Oromia, Ethiopia.
| | - Ashenafi Mekonnen
- Department of Midwifery, Madda Walabu University, Shashemene, Oromia, Ethiopia
| | - Sisay Degno
- Department of Public Health, Madda Walabu University, Shashemene, Oromia, Ethiopia
| | - Daniel Yohannis
- Department of Midwifery, Madda Walabu University, Shashemene, Oromia, Ethiopia
| | - Girma Beressa
- Department of Public Health, Madda Walabu University, Bale Goba, Oromia, Ethiopia
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Lema EJ, Seif SA. Prevalence of anemia and its associated factors among pregnant women in Ilala Municipality - Tanzania: Analytical cross-sectional study. Medicine (Baltimore) 2023; 102:e33944. [PMID: 37335672 PMCID: PMC10256418 DOI: 10.1097/md.0000000000033944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/16/2023] [Indexed: 06/21/2023] Open
Abstract
Anaemia during pregnancy is still 1 of the leading causes of maternal and neonatal mortality in low and middle-income countries. Initiatives to address this need evidence on trends and their relevant factors, as they vary from 1 area to another. This study determined the prevalence of anemia and its associated factors among pregnant women in Ilala, Tanzania. This community-based, analytical cross-sectional study was conducted in April 2022 involving 367 randomly selected pregnant women. An interviewer-administered questionnaire and a HemoCue analyzer were used for data collection The data was described using descriptive statistics (frequency distributions, percentages, etc) and inferential statistics (Chi-square tests and logistic regression) were used to explore the associations between the study's outcome and its explanatory variables, with a significance level of P < .05. The mean age of participants was 26.2 (standard deviation = 5.2) years, 58.0% had a secondary education level, and 45.2 were prime-para. About half (57.2%) of all participants had low hemoglobin level, among which, 36.2% had moderate anemia. Having a primary education level (adjusted odds ratio [AOR] = 2.3, confidence interval [CI] = 1.1-4.7), having an inter-pregnancy interval of <18 months (AOR = 2.6, CI = 1.2-5.5), being in the third trimester (AOR = 2.4, CI = 1.2-4.7), not taking Intermittent Prophylaxis Treatment (AOR = 3.7, CI = 1.3-10), not taking iron supplement and folic acid (AOR = 3.7, CI = 1.3-10), and having a moderate appetite(AOR = 1.6, CI = 1.0-2.6) were predictors of anemia. Nutritionally related factors were not consuming on a daily basis dairy food (AOR = 3.7, CI = 1.4-9.3), meat/fish (AOR = 6.6, CI = 3-14), dark green and other vegetables (AOR = 6.6, CI = 3.1-14), fruits (AOR = 4.2, CI = 1.4-12) and having a lower dietary diversity score (AOR = 84, CI = 37-188). Approximately half of pregnant women in Ilala municipality were anemic with 1 third of them having moderate anemia. The associated factors varied from nutritional, obstetric, and socio-demographic factors. The targeted interventions should focus on health promotion campaign to sensitize the population on the dangers of anemia in pregnancy and preventive measures that must be adhered to.
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Affiliation(s)
- Eunice Justin Lema
- Department of Clinical Nursing, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania
| | - Saada Ali Seif
- Department of Nursing Management and Education, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania
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26
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Sappani M, Mani T, Asirvatham ES, Joy M, Babu M, Jeyaseelan L. Trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age during the last 15 years in India. PLoS One 2023; 18:e0286464. [PMID: 37262022 DOI: 10.1371/journal.pone.0286464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Anaemia is a serious global public health problem that disproportionally affects children, adolescent girls, and women of reproductive age, especially pregnant women. Women of reproductive age are more vulnerable to anaemia, particularly severe and moderate anaemia leads to adverse outcomes among pregnant women. Despite continuous Government efforts, anaemia burden still poses a serious challenge in India. The objective of this study is to assess the trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age between 15 and 49 years. METHOD We used three rounds of the large-scale National Family Health Survey (NFHS) India, conducted on a representative sample of households using a cross-sectional design across the country in 2005-06, 2015-16 and 2019-2021. We included all the women aged 15 to 49 years in our analysis. We used the same haemoglobin (Hb) cut-off values for all the three rounds of surveys to ensure comparability. Generalized linear regression analyses with log link were done. Survey weights were incorporated in the analysis. RESULTS The prevalence of severe or moderate Anaemia (SMA) in non-pregnant women was 14.20%, 12.43% and 13.98%; it was 31.11%, 25.98% and 26.66% for pregnant women in 2006, 2016 and 2021 respectively. The decline in SMA prevalence was 1.54% in non-pregnant women, whereas it was 14.30% in pregnant women in 15 years. Women who were poor, and without any formal education had a higher risk for severe and moderate Anaemia. CONCLUSION Despite the intensive anaemia control program in India, SMA has not declined appreciably in non-pregnant women during the last two decades. Despite the decline, the prevalence of SMA was about 26% in pregnant women which calls for a comprehensive review of the existing anaemia control programmes and there must be targeted programmes for the most vulnerable and high-risk women such as rural, poor and illiterate women of reproductive age to reduce the burden of anaemia among them.
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Affiliation(s)
- Marimuthu Sappani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thenmozhi Mani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Melvin Joy
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Malavika Babu
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Lakshmanan Jeyaseelan
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, UAE
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Araujo Costa E, de Paula Ayres-Silva J. Global profile of anemia during pregnancy versus country income overview: 19 years estimative (2000-2019). Ann Hematol 2023:10.1007/s00277-023-05279-2. [PMID: 37233775 DOI: 10.1007/s00277-023-05279-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
Anemia is a worldwide public health problem that is worst in low- and middle-income countries (LMICs), reaching 60% of prevalence. The etiology of anemia is diverse and multifactorial, with iron deficiency being the most prevalent, and often found in pregnant women. Iron is indispensable for the production of red blood cells and approximately 80% of the available heme iron is used for hemoglobin synthesis in mature erythroblasts. Iron deficiency affects oxygen transport, compromising energy and muscle metabolism and can occur with depletion of iron storage, defective erythropoiesis, and low hemoglobin levels. We analyzed anemia prevalence in pregnant women from 2000 to 2019 worldwide correlating them with current (2022) country income, with especial attention to LMICs using WHO dataset. Our analysis indicates that pregnant women from LMICs had a higher probability (40%) of anemia during pregnancy especially those from Africa and South Asia. Africa and the Americas showed a higher decrease in the prevalence of anemia from 2000 to 2019. The Americas and Europe have a lower prevalence, concentrated in 57% of most upper-middle- and high-income countries. Black women are also more prone to develop anemia during pregnancy, especially if they are from LMICs. However, the prevalence of anemia appears to decrease with an increase in educational level. In conclusion, anemia prevalence fluctuated from 5.2 to 65.7% worldwide in 2019, validating it as a public health problem.
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Affiliation(s)
- Evelyn Araujo Costa
- Distance Education Center of Rio de Janeiro State (CEDERJ), Rio de Janeiro, Brazil
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Kumari U, Sharma RK, Keshari JR, Sinha A. Environmental Exposure: Effect on Maternal Morbidity and Mortality and Neonatal Health. Cureus 2023; 15:e38548. [PMID: 37273345 PMCID: PMC10239284 DOI: 10.7759/cureus.38548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/06/2023] Open
Abstract
Environmental factors are important causes that impair global pregnancy outcomes and are, importantly, responsible for maternal morbidity and mortality. However, apart from the direct reasons for maternal deaths, mainly obstetric and neonatal complications, such factors are ignored or given less importance. The recent surge in research on the impact of various environmental factors on pregnancy outcomes suggests the need for immediate attention to such factors and device-specific policies to counter the situation. Moreover, the recent coronavirus disease of 2019 (COVID-19) pandemic, global warming, and climate change showed a lack of preparedness to counter the impact of such events on maternal survival and safe and successful pregnancy outcomes. In the present review, we have emphasized the specific factors responsible for increased maternal and neonatal deaths and their association with specific environmental factors. Increased attention on maternal healthcare, preparedness to counter sudden environmental challenges and improvement of the conventional requirement for better maternal healthcare access and nutrition at a global level may improve the scenario.
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Affiliation(s)
- Usha Kumari
- Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | | | - J R Keshari
- Biochemistery, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Archana Sinha
- Obstetrics and Gynaecology, Indira Gandhi Institute of Medical Sciences, Patna, IND
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Adeyemi EO, Ojo TO, Quinn M, Brooks B, Oke OA. What factors are associated with anaemia in pregnancy among Nigerian women? Evidence from a national survey. Afr Health Sci 2023; 23:373-383. [PMID: 37545905 PMCID: PMC10398454 DOI: 10.4314/ahs.v23i1.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background Anaemia in pregnancy remains a severe public health problem in sub-Saharan African countries including Nigeria. Objectives To assess factors associated with anaemia in pregnancy among Nigerian women. Methods A secondary analysis of the 2018 Nigeria demographic health survey was conducted to determine the predictors of anaemia among Nigerian pregnant women (N=1522). SAS 9.4 was used for the analysis. Results The prevalence of anaemia in pregnancy was 61.1%. On multivariable logistic regression analysis, women in the North-central (AOR=2.52, CI=1.46-4.35) and South-south (AOR=2.21, CI=1.06-4.59) had increased odds of anaemia in pregnancy, compared to those in the Northwest. Women with no education (AOR=2.38, CI=1.28-4.44), primary education (AOR=3.06, CI=1.58-5.96) and secondary education (AOR=1.75, CI=1.04-2.94) had increased odds of anaemia in pregnancy compared to women with teriary education. Also, women not in marital union had increased odds of anaemia in pregnancy compared to women in a union (AOR=2.56, CI=1.15-5.72). Women in the second (AOR=2.42, CI=1.79-3.29) and third trimesters of pregnancy (AOR=2.83, CI=2.07-3.89) had increased odds of anaemia. Conclusion These findings are important for the control of anemia among pregnant Nigerian women. Women in the Northcentral and Southsouth zones are particularly at risk for anaemia in pregnancy and should receive special attention during antenatal care.
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Affiliation(s)
| | | | - Megan Quinn
- East Tennessee State University, Department of Biostatistics and Epidemiology
| | - Bill Brooks
- East Tennessee State University, Department of Biostatistics and Epidemiology
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Muluye G, Gashaw A, Woretaw L, Girma B, Tumebo T. Risk factors of primary postpartum hemorrhage among postnatal mothers in the public hospital of southern Tigray, Ethiopia, 2019: A case-control study. Front Glob Womens Health 2023; 4:1039749. [PMID: 36865926 PMCID: PMC9971984 DOI: 10.3389/fgwh.2023.1039749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
Background Postpartum hemorrhage is the most common direct cause of maternal mortality and morbidity; among them, primary postpartum hemorrhages are an enormous element. Although it has an incredible impact on maternal lifestyle, this is the most neglected area in Ethiopia and there is a lack of studies achieved within the study area. So this study aimed to identify the risk factors of primary postpartum hemorrhage among postnatal mothers in public hospitals in southern Tigray, Ethiopia, 2019. Methods Institution-based unmatched case-control study design was conducted on 318 (106 case and 212 controls) postnatal mothers in public hospitals of Southern Tigray from January to October 2019. We used a pretested, structured interviewer-administered questionnaire and a chart review to collect the data. Bivariate and multivariable logistic regression models were used to identify the risk factors. P-value ≤ 0.05 was considered statically significant for both steps and an odds ratio with a 95% confidence level was used to see the strength of association. Results Abnormal third stage of labor [adjusted odds ratio = 5.86, 95% confidence interval (2.55-13.43), P = 000], cesarean section [adjusted odds ratio = 5.61, 95% confidence interval (2.79-11.30), P = 0.000], lack of active management of third-stage labor [adjusted odds ratio = 3.88; 95% confidence interval (1.29-11.60), P = 0.015], absence of labor monitoring by partograph [adjusted odds ratio = 3.82, 95% confidence interval (1.31-11.09), P = 0.014], lack of antenatal care [adjusted odds ratio = 2.76, 95% confidence interval (1.13-6.75), P = 0.026] and complications during pregnancy [adjusted odds ratio = 2.79, 95% confidence interval (1.34-5.83), P = 0.006] were found to be risk factors for primary postpartum hemorrhage. Conclusion In this study complications and lack of maternal health interventions in the course of the antepartum and the intrapartum period were found to be risk factors for primary postpartum hemorrhage. A strategy for improving essential maternal health services and detecting and handling complications in a timely manner will help to prevent primary postpartum hemorrhage.
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Affiliation(s)
- Getachew Muluye
- Department of Midwifery, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abeba Gashaw
- Department of Maternal and Child Health, Amdework Primary Hospital, Amdework, Ethiopia
| | - Lebasie Woretaw
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Biniam Girma
- Department of Maternal and Child Health, Amdework Primary Hospital, Amdework, Ethiopia
| | - Tarekegn Tumebo
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
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Ariyanti R, Febrianti S, Qasim M, Jalilah NH. The Effect of Anemia in Pregnancy on Postpartum Hemorrhage. JURNAL INFO KESEHATAN 2022. [DOI: 10.31965/infokes.vol20.iss2.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Eighty percent of maternal deaths are caused by complications during pregnancy and childbirth. Furthermore, twenty-five percent of maternal deaths is affected by postpartum hemorrhage which is estimated 100,000 deaths annually. Indonesia places at the second ranks of the highest maternal deaths country after Laos. The cause of death in Indonesia is 28% by hemorrhage. The hemorrhage in maternity is due to anemia in pregnancy. It occurs because when the mother gives birth, there will be adequate uterine contractions so that the hemorrhage is inevitable. The objective of the study is to identify the effect of anemia in pregnancy on the incidence of postpartum hemorrhage. The type of research employed is an analytic survey with a retrospective design. The research location was at Juata Tarakan Health Center. The population in this study were all pregnant women who visited the obstetrics and gynecology polyclinic in 2020 which was obtained from secondary data, the patient's medical record book at the Juata Public Health Center with a sample of 271 on June 23 to August 31, 2021. Sampling employed a non-probability sampling technique, total sampling, and the data analysis was administered univariately, and bivariate with chi-square test. The incidence of postpartum hemorrhage in women giving birth in the working area of the Juata Tarakan Health Center is 12.9%. Anemia in pregnancy possesses a significant effect on the risk of postpartum hemorrhage with p value (OR=11,253, 95%CI 5,120-24,732). Meanwhile, parity, age, type of delivery did not possess significant effect on postpartum hemorrhage. Mothers with anemia in pregnancy own a higher risk of postpartum hemorrhage which was 11.253 times greater than mothers who were not anemic in pregnancy. Therefore, it is necessary to perform proper handling of anemia in pregnant women to prevent postpartum hemorrhage.
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Erasmus CR, Chuturgoon AA, Maharaj NR. Maternal overweight and obesity and its associated factors and outcomes in human immunodeficiency virus (HIV)-infected and HIV-uninfected black South African pregnant women. J Obstet Gynaecol Res 2022; 48:2697-2712. [PMID: 36054675 DOI: 10.1111/jog.15392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 01/07/2023]
Abstract
AIM This study aimed to investigate various variables between maternal overweight and/or obesity versus normal-weight pregnant black South African women living with and without human immunodeficiency virus (HIV). METHODS A cross-sectional study design was employed. A total of 200 pregnant women were enrolled in the study, categorized according to body mass index (BMI) (kg/m2 ) into two groups: (1) overweight/obese (≥25 kg/m2 ) (n = 97); and (2) nonoverweight/nonobese (<25 kg/m2 ) (n = 103), where 90 were HIV-infected and 110 were HIV-uninfected. The differences between the maternal BMI categories were assessed using Fisher's exact t-test and the χ2 test. Simple and multiple logistic regression analyses were used to determine factors associated with maternal overweight and obesity. RESULTS Multiple logistic regression analysis showed that maternal age (odds ratio [OR]: 1.061; 95% confidence interval [CI] 1.008-1.117; p = 0.023) and gestational age (OR: 1.121; 95% CI 1.005-1.251; p = 0.041) were significantly associated with maternal overweight/obesity in both HIV-infected and HIV-uninfected. For maternal health outcomes, multiple logistic regression analysis showed that hypertensive disorders (OR: 0.273; 95% CI 0.124-0.601; p = 0.001) and anemia (OR: 2.420; 95% CI 1.283-4.563; p = 0.006) were significantly associated with maternal overweight/obesity in both HIV-infected and HIV-uninfected. The overweight/obese HIV-infected participants (OR: 0.233; 95% CI 0.075-0.717; p = 0.011) had increased odds for developing hypertensive disorders compared to HIV-uninfected overweight/obese participants (OR: 0.471; 95% CI 0.172-1.291; p = 0.143). CONCLUSIONS Maternal overweight/obesity in both HIV-infected and HIV-uninfected pregnant black South African women was significantly associated with maternal age, gestational age, HPT disorders, and anemia. Maternal overweight/obesity decreased the odds for anemia, but increased the odds for the development of HPT disorders, especially in the HIV-infected pregnant women.
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Affiliation(s)
- Christen R Erasmus
- Department of Dietetics and Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Anil A Chuturgoon
- Department of Medical Biochemistry, University of KwaZulu-Natal, Durban, South Africa
| | - Niren R Maharaj
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, Durban, South Africa
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Dejene BE, Abuhay TM, Bogale DS. Predicting the level of anemia among Ethiopian pregnant women using homogeneous ensemble machine learning algorithm. BMC Med Inform Decis Mak 2022; 22:247. [PMID: 36138398 PMCID: PMC9494842 DOI: 10.1186/s12911-022-01992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than 115,000 maternal deaths and 591,000 prenatal deaths occurred in the world per year with anemia, the reduction of red blood cells or hemoglobin in the blood. The world health organization divides anemia in pregnancy into mild anemia (Hb 10-10.9 g/dl), moderate anemia (Hb 7.0-9.9 g/dl), and severe anemia (Hb < 7 g/dl). This study aims to predict the level of anemia among pregnant women in the case of Ethiopia using homogeneous ensemble machine learning algorithms. METHODS This study was conducted following a design science approach. The data were gathered from the Ethiopian demographic health survey and preprocessed to get quality data that are suitable for the machine learning algorithm to develop a model that predicts the levels of anemia among pregnant. Decision tree, random forest, cat boost, and extreme gradient boosting with class decomposition (one versus one and one versus rest) and without class decomposition were employed to build the predictive model. For constructing the proposed model, twelve experiments were conducted with a total of 29,104 instances with 23 features, and a training and testing dataset split ratio of 80/20. RESULTS The overall accuracy of random forest, extreme gradient boosting, and cat boost without class decompositions is 91.34%, 94.26%, and 97.08.90%, respectively. The overall accuracy of random forest, extreme gradient boosting, and cat boost with one versus one is 94.4%, 95.21%, and 97.44%, respectively. The overall accuracy of random forest, extreme gradient boosting, and cat boost with one versus the rest are 94.4%, 94.54%, and 97.6%, respectively. CONCLUSION Finally, the researcher decided to use cat boost algorithms with one versus the rest for further use in the development of artifacts, model deployment, risk factor analysis, and generating rules because it has registered better performance with 97.6% accuracy. The most determinant risk factors of anemia among pregnant women were identified using feature importance. Some of them are the duration of the current pregnancy, age, source of drinking water, respondent's (pregnant women) occupation, number of household members, wealth index, husband/partner's education level, and birth history.
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Adequacy of antenatal care services utilisation and its effect on anaemia in pregnancy. J Nutr Sci 2022; 11:e80. [PMID: 36304821 PMCID: PMC9554427 DOI: 10.1017/jns.2022.80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 07/11/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022] Open
Abstract
Anaemia in pregnancy remains a critical public health concern in many countries including Ghana and it poses severe consequences in the short to long-term for women and their unborn babies. Although antenatal care (ANC) is largely provided for pregnant women, the extent its utilisation protects against anaemia in pregnancy remains largely understudied. The study assessed the adequacy of ANC services utilisation and its effect on anaemia among pregnant women in the Wa Municipality of Ghana. A facility-based cross-sectional survey was conducted. Probability proportionate to size sampling and systematic random sampling were used to select the facilities and 353 respondents. While 80⋅2 % of the pregnant women reported having received a sufficient number of ANC services provided, the prevalence of the overall ANC adequacy was only 44⋅2 %. After adjusting for potential confounders, pregnant women who could not achieve adequate ANC attendance were 2⋅3 times more likely to be anaemic in the third trimester of gestation AOR = 2⋅26 (95 % CI 1⋅05, 4⋅89), compared to their counterparts who maintained adequate ANC attendance. Adequate ANC attendance was a consistent and significant predictor of anaemia in pregnancy in the third trimester. Health and nutrition education on the need for early initiation of ANC attendance and support for the consumption of diversified diets are two possible interventions that can help contain anaemia in pregnancy.
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Bukhari IA, Alzahrani NM, Alanazi GA, Al-Taleb MA, AlOtaibi HS. Anemia in Pregnancy: Effects on Maternal and Neonatal Outcomes at a University Hospital in Riyadh. Cureus 2022; 14:e27238. [PMID: 36039215 PMCID: PMC9400921 DOI: 10.7759/cureus.27238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Anemia in pregnancy has a number of adverse effects. This study aims to estimate anemia prevalence in pregnant women and examine the associations between maternal anemia with maternal characteristics, maternal outcomes during pregnancy and delivery, and neonatal outcomes at a university hospital in Riyadh. Materials and methods: A cross-sectional study was undertaken among 400 women who delivered at the hospital. Data were collected through a data extraction sheet. Multivariate analysis was adopted according to the results of univariate analysis. Results: Overall anemia prevalence was 39% (including 21% moderate anemia and 18% mild anemia); the rest, 61%, were normal. Non-intake of intravenous iron was more common among mothers with mild anemia (65.3%) compared to normal and moderately anemic (p=0.001). Significant differences between groups were found in relation to maternal outcomes such as pregnancy-induced hypertension (p=0.019), antepartum hemorrhage (p=0.001), postpartum hemorrhage (p=0.002), and non-intake of blood transfusion during pregnancy (p=0.012) and emergency cesarean section (p=0.017). Neonatal outcomes, including congenital malformations (p=0.003) and admission to the neonatal intensive care unit (NICU) (p<0.001), were higher in mildly anemic mothers. Statistically significant relationships were found between anemia in pregnancy and postpartum hemorrhage (odds ratio [OR] = 3.61; confidence interval [CI] 1.52-8.58; p=0.004), congenital malformations (OR = 5.09; CI 1.81-14.29; p=0.002), NICU admissions (OR=8.32; CI 2.77-24.96; p=0.001), and low birth weight (LBW; OR=1.833; CI 1.021-3.294; p=0.042). Conclusions: The study highlights the association of maternal anemia with adverse events in mothers, such as postpartum hemorrhage. Among neonates, congenital malformations, low birth weight, and higher admissions to the NICU have been reported.
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Zhang YJ, Zhu Y, Zhu L, Lu CQ, Chen C, Yuan L. Prevalence of preterm birth and risk factors associated with it at different gestational ages: A multicenter retrospective survey in China. Saudi Med J 2022; 43:599-609. [PMID: 35675930 PMCID: PMC9389891 DOI: 10.15537/smj.2022.43.6.20220210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of preterm birth (PTB) and the risk factors for different gestational age subgroups of preterm birth in China. METHODS We carried out a descriptive cross-sectional study encompassing all singleton live births (24+0 to 41+6 weeks) with completed data in 23 provinces in China from 2010 to 2017 during investigation period. We compared both the preterm group (24+0 to 36+6 weeks) and preterm subgroups (<32 weeks, 32+0 to 33+6 weeks, and 34+0 t0 36+6 weeks) with the term group (37+0 to 41+6 weeks). We collected information on maternal and fetal characteristics from medical records. Logistic regression was use. RESULTS The prevalence of PTB was 7.4% (15,833/215,254) in singleton births. After adjusting for maternal age, parity, and potential risk factors in univariate analysis, the high-risk factors for PTB at <32 weeks were placental abruption (aOR=41.52; 95% CI, 25.89-66.58), placenta previa (aOR=40.04; 95% CI, 32.00-50.09), chorioamnionitis (aOR=11.06; 95% CI, 8.738-14.02), and hypertension disorders in pregnancy (HDP) (aOR=3.564; 95% CI, 2.930-4.335). Intrahepatic cholestasis of pregnancy (ICP) was significantly associated with PTB at 34-36 weeks (aOR=5.763; 95% CI, 5.049-6.577), particularly with spontaneous PTB (aOR=10.04; 95% CI, 8.79-11.47). Gestational diabetes mellitus (GDM) was significantly associated with PTB at 34-36 weeks only (aOR=1.156; 95% CI, 1.054-1.267). CONCLUSION Placental abruption, placenta previa, chorioamnionitis, and HDP were more predictive of early PTB; GDM and ICP were more predictive of late PTB.
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Affiliation(s)
- Yi-Jie Zhang
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Yan Zhu
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Li Zhu
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Cheng-Qiu Lu
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Chao Chen
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Lin Yuan
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
- Address correspondence and reprint request to: Dr. Lin Yuan, Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China. E-mail: ORCID ID: https://orcid.org/0000-0003-3540-7428
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Dodzo RC, Ogunsakin RE, Ginindza TG. Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini. Afr J Prim Health Care Fam Med 2022; 14:e1-e9. [PMID: 35532109 PMCID: PMC9082230 DOI: 10.4102/phcfm.v14i1.3339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Anaemia is a global health problem affecting about a third of the world's population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries (LICs), 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy. AIM This study aimed to determine the prevalence and risks associated with anaemia amongst pregnant women attending antenatal clinic (ANC) in three health facilities in Eswatini. SETTING This study was conducted in three health facilities in Eswatini, namely Mankayane, Raleigh Fitkin Memorial (RFM) and Mbabane Hospital. METHODS This cross-sectional study used non-probability sampling in three hospitals of Eswatini, to select 550 pregnant women, aged 15-49 years. Data were collected from January to March 2021, using face-to-face interviews with a structured questionnaire. Logistic regression was used for statistical analysis. RESULTS A total of 550 pregnant women were included in the study. Anaemia prevalence amongst pregnant women was 43.1% with mild, moderate and severe cases of 21.3%; 21.1% and 0.7%, respectively. Prevalence was high amongst women aged 15-19 years (53.3%). Factors associated with anaemia included living in urban areas (odds ratio [OR]: 1.8; confidence interval [CI]: 1.19-2.72), having anaemia 6 months before pregnancy (OR: 4.64; CI: 1.15-18.71), and gestational age at first ANC: third trimester (OR = 10.42; CI: 4.27-25.4) and second trimester (OR: 1.62; CI: 1.02-2.60). CONCLUSION Anaemia remains prevalent amongst pregnant women in Eswatini. A comprehensive anaemia prevention programme would be justified and could lower the country's burden of anaemia.
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Affiliation(s)
- Rumbidzai C Dodzo
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Ministry of Health.
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Hatem G, Hjort L, Asplund O, Minja DTR, Msemo OA, Møller SL, Lavstsen T, Groth-Grunnet L, Lusingu JPA, Hansson O, Christensen DL, Vaag AA, Artner I, Theander T, Groop L, Schmiegelow C, Bygbjerg IC, Prasad RB. Mapping the Cord Blood Transcriptome of Pregnancies Affected by Early Maternal Anemia to Identify Signatures of Fetal Programming. J Clin Endocrinol Metab 2022; 107:1303-1316. [PMID: 35021220 PMCID: PMC9016468 DOI: 10.1210/clinem/dgac010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Anemia during early pregnancy (EP) is common in developing countries and is associated with adverse health consequences for both mothers and children. Offspring of women with EP anemia often have low birth weight, which increases risk for cardiometabolic diseases, including type 2 diabetes (T2D), later in life. OBJECTIVE We aimed to elucidate mechanisms underlying developmental programming of adult cardiometabolic disease, including epigenetic and transcriptional alterations potentially detectable in umbilical cord blood (UCB) at time of birth. METHODS We leveraged global transcriptome- and accompanying epigenome-wide changes in 48 UCB from newborns of EP anemic Tanzanian mothers and 50 controls to identify differentially expressed genes (DEGs) in UCB exposed to maternal EP anemia. DEGs were assessed for association with neonatal anthropometry and cord insulin levels. These genes were further studied in expression data from human fetal pancreas and adult islets to understand their role in beta-cell development and/or function. RESULTS The expression of 137 genes was altered in UCB of newborns exposed to maternal EP anemia. These putative signatures of fetal programming, which included the birth weight locus LCORL, were potentially mediated by epigenetic changes in 27 genes and associated with neonatal anthropometry. Among the DEGs were P2RX7, PIK3C2B, and NUMBL, which potentially influence beta-cell development. Insulin levels were lower in EP anemia-exposed UCB, supporting the notion of developmental programming of pancreatic beta-cell dysfunction and subsequently increased risk of T2D in offspring of mothers with EP anemia. CONCLUSIONS Our data provide proof-of-concept on distinct transcriptional and epigenetic changes detectable in UCB from newborns exposed to maternal EP anemia.
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Affiliation(s)
- Gad Hatem
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, 205 02, Malmö, Sweden
| | - Line Hjort
- Department of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Endocrinology (Diabetes and Bone-Metabolic Research Unit), 2100 Copenhagen, Denmark
| | - Olof Asplund
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, 205 02, Malmö, Sweden
| | - Daniel T R Minja
- National Institute for Medical Research, Tanga Center, 0255 Tanga, Tanzania
| | - Omari Abdul Msemo
- National Institute for Medical Research, Tanga Center, 0255 Tanga, Tanzania
| | - Sofie Lykke Møller
- Section of Global Health, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Thomas Lavstsen
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Louise Groth-Grunnet
- Department of Endocrinology (Diabetes and Bone-Metabolic Research Unit), 2100 Copenhagen, Denmark
- Section of Global Health, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
| | - John P A Lusingu
- National Institute for Medical Research, Tanga Center, 0255 Tanga, Tanzania
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Ola Hansson
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, 205 02, Malmö, Sweden
| | - Dirk Lund Christensen
- Section of Global Health, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Allan A Vaag
- Steno Diabetes Center Copenhagen, 2730 Gentofte, Denmark
| | - Isabella Artner
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, 205 02, Malmö, Sweden
| | - Thor Theander
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Leif Groop
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, 205 02, Malmö, Sweden
- Finnish Institute of Molecular Medicine (FIMM), 00290 Helsinki, Finland
| | - Christentze Schmiegelow
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Ib Christian Bygbjerg
- Section of Global Health, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Rashmi B Prasad
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, 205 02, Malmö, Sweden
- Finnish Institute of Molecular Medicine (FIMM), 00290 Helsinki, Finland
- Correspondence: Rashmi B Prasad, PhD, Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Clinical Research Centre, Lund University Diabetes Centre, Jan Waldenströms gata 35, 205 02 Malmö, Sweden.
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Santosa A, Novanda Arif E, Abdul Ghoni D. Effect of maternal and child factors on stunting: partial least squares structural equation modeling. Clin Exp Pediatr 2022; 65:90-97. [PMID: 33957035 PMCID: PMC8841971 DOI: 10.3345/cep.2021.00094] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/27/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Stunting is affected by various factors from mother and child. Previous studies assessed only one or more influencing variables. Unfortunately, nor the significant influence of maternal and child factors nor the indicators contributing to maternal and child factors that affect the stunting incidence have ever been analyzed. PURPOSE This study analyzed the effect of maternal and child factors on stunting and the significant indicators that shape the maternal and child factors that impact stunting. METHODS This was a case-control study. Overall, 132 stunted children and 132 nonstunted children in Purbalingga Regency, Central Java Province, participated in the research. Direct interviews and medical record reviews were conducted to assess the studied variables. The research data were tested using the partial least squares structural equation with a formative model. RESULTS Maternal factors directly affected the occurrence of stunting (t=3.527, P<0.001) with an effect of 30.3%. Maternal factors also contributed a significant indirect effect on stunting through child factors (t=4.762, P<0.001) with an effect of 28.2%. Child factors affected the occurrence of stunting (t= 5.749, P<0.001) with an effect of 49.8%. The child factor was influenced by maternal factor with an effect of 56.7% (t=10.014, P<0.001). The moderation analysis results demonstrated that maternal and child factors were moderate predictive variables of stunting occurrence. CONCLUSION Child factors have more significant and direct effects on stunting than maternal factors but are greatly affected by them.
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Affiliation(s)
- Agus Santosa
- Universitas Muhammadiyah Purwokerto, Purwokerto, Indonesia
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Bankanie V, Moshi FV. Factors associated with the use of deworming drugs during pregnancy in Tanzania; an analysis from the 2015–16 Tanzanian HIV and malaria indicators survey. BMC Pregnancy Childbirth 2022; 22:60. [PMID: 35065622 PMCID: PMC8783498 DOI: 10.1186/s12884-021-04291-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background The use of deworming drugs is one of the important antenatal strategies in preventing anaemia in pregnancy. Little is known about the factors associated with the use of deworming drugs, which accounts for the aim of this study. Method The study used data from the 2015–16 Tanzania HIV Demographic and Health Survey and Malaria Indicators Survey (2015–16 TDHS-MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple logistic regression analyses were used. Results The majority of interviewed women 3864(60.1%) took deworming drugs. In a weighed multiple logistic regression, women residing in urban areas reported greater use of deworming drugs than women residing in rural areas [AOR = 1.73, p = 0.01, 95% CI (1.26–2.38)]. In the four areas of residence, compared to women residing in mainland rural areas, women residing in mainland urban areas and Pemba islands reported greater use of deworming drugs [mainland urban (AOR = 2.56 p < 0.001,95% CI(1.78–3.75), and Pemba Island (AOR = 1.18, p < 0.001, 95% CI(1.17–1.20)]. However, women residing in Zanzibar Island (Unguja) were less likely to use deworming drugs compared to women in mainland rural women (AOR = 0.5, p < 0.001, 95% CI (0.45–0.55). Similarly, compared to women under 20 years of age, women between 20 to 34 years reported significantly greater use of deworming drugs [20 to 34 years (AOR = 1.30, p = 0.03, 95% CI(1.02–1.65). Likewise, greater use of deworming drugs was reported in women with a higher level of education compared to no education [higher education level (AOR = 3.25, p = 0.01,95% CI(1.94–7.92)], rich women compared to poor [rich (AOR = 1.43, p = 0.003, 95% CI (1.13–1.80)] and in women who initiated antenatal care on their first trimester of pregnancy compared to those who initiated later [AOR = 1.37, p < 0.001, 95% CI (1.17–1.61)]. Conclusion Women who were more likely to use the deworming drugs were those residing in urban compared to rural areas, aged between 20 and 34 years, those with a higher level of formal education, wealthier, and women who book the antenatal clinic (ANC) within their first trimester of pregnancy. Considering the outcomes of anaemia in pregnancy, a well-directed effort is needed to improve the use of deworming drugs.
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Loa M, Hidayanty H, Arifuddin S, Ahmad M, Hadju V. Moringa oleifera leaf flour biscuits increase the index of erythrocytes in pregnant women with anemia. GACETA SANITARIA 2022; 35 Suppl 2:S206-S210. [PMID: 34929813 DOI: 10.1016/j.gaceta.2021.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Moringa Oleifera leaves contain nutrients such as proteins, iron, and vitamin C that potentially prevent anemia more common in pregnant women. In the manufacture of cookies that are substituted Moringa Oleifera leaf flour substitution, 40% obtained Fe levels 22.68ppm so that it can be developed to prevent anemia. The purpose of this research is to know the effect of giving biscuits (cookies) Moringa Oleifera leaf flour to index erythrocytes (MCH, MCHC, MCV) of pregnant women with anemia. METHOD It was a quasi-experiment research with design nonequivalent Control Group design. The research was conducted at Antang, Mamajang, and Batua Public Health Center in Makassar, examination of hematology analyzer in the Clinic Pathology Laboratory of Universitas Hasanuddin Hospital. Sampling techniques using purposive sampling. Samples were pregnant women with trimester I and III anemia amounted to 25 samples on the biscuit moringa group and 25 samples in the control group. Data were analyzed using test Paired T-Test, T-Test Independent, Wilcoxon, and Mann - U Withney. RESULT Characteristics of age, gestational age, income, physical activity, education, and parity of both groups has been comparable before the treatment with the value p>0.05, with most of the samples aged 20-35 years having a pregnancy age of 4-8 weeks, income IDR 1 million - IDR. 2 million, activity score Baecke 6.00-7.25, Senior High School education, parity >1. A significant average increase in the value of MCH from 27.55 to 28.00 and MCV from 78.57 to 78.93 in the group provided biscuits (cookies) of Moringa Oleifera leaf flour with p-value <0.05, in the control group, occurred an average but insignificant increase with p-value >0.05. The MCHC Group control and biscuit moringa group had an average increase, but both were not statistically significant, p>0.05. There is a significant difference in increased MCH and MCV erythrocyte indices between the biscuit moringa and control groups with a p-value <0.05. As for the MCHC value, the two groups do not differ meaningfully with p-value=0.611, p>0.005. CONCLUSION There is the effect of giving biscuits (cookies) Moringa Oleifera leaf Flour Against the index of erythrocytes MCH and MCV in pregnant women with anemia. However, it has no effect on the MCHC value of pregnant women with anemia. It is recommended for pregnant women to utilize local plants, the Moringa Oleifera leaves to fulfill the intake of nutrients that can help pregnant women from anemia.
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Affiliation(s)
- Monika Loa
- Department of Midwifery, Graduate School, Hasanuddin University, Indonesia.
| | - Healthy Hidayanty
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Indonesia
| | | | - Mardiana Ahmad
- Department of Midwifery, Graduate School, Hasanuddin University, Indonesia
| | - Veni Hadju
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Indonesia
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Debella A, Eyeberu A, Getachew T, Atnafe G, Geda B, Dheresa M. OUP accepted manuscript. Int Health 2022; 15:274-280. [PMID: 35474135 PMCID: PMC10153563 DOI: 10.1093/inthealth/ihac021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/11/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anemia is a worldwide problem with serious effects for mothers and their babies. Although efforts have been made to lessen the burden of anemia, it has remained a problem. Moreover, there is a paucity of information regarding the perinatal outcomes of anemia in the study area. Thus this study aimed to assess the perinatal outcomes in anemic pregnant women in eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted among 407 systematically selected pregnant women. Data were collected by interview and entered into EpiData version 3.1 and then exported into SPSS for Windows version 20 for analysis. Bivariate and multivariate analyses were employed to determine the association between independent variables and the outcome variable. RESULTS Among pregnant women, 61.9% had an adverse perinatal outcome. The most common reported adverse perinatal outcomes were preterm birth, congenital anomalies and stillbirths. Furthermore, variables such as educational status (adjusted odds ratio [AOR] 2.11 [95% confidence interval {CI} 1.245 to 3.58]), antenatal care follow-up (AOR 2.75 [95% CI 1.47 to 5.18]) and hemoglobin level (AOR 4.1 [95% CI 2.609 to 6.405]) were significantly associated with perinatal outcomes. CONCLUSIONS Nearly three-fourths of anemic pregnant women experienced adverse perinatal outcomes. In general, this study identified that educational status, antenatal follow-up and hemoglobin level were associated with perinatal outcomes among anemic pregnant women. To prevent adverse perinatal outcomes, efforts must be made to ensure that all pregnant women receive antenatal care and have adequate maternal nutritional status.
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Affiliation(s)
- Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | | | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Genanaw Atnafe
- Department of Pediatrics, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing, College of Medicine and Health Sciences, Madda Walabu University, Bale-Robe, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Darmawati D, Siregar T, Kamil H, Husna C, Tahlil T. Husband’s Perception on Anemia among Pregnant Women based on Cultural Perspective: A Qualitative Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Anemia is one of the most common nutritional problems during pregnancy. Husbands have an important role in supporting their wives in pregnancy to prevent complications. Husband’s culture and beliefs will affect support for the health status of pregnant women.
AIM: This study aims to explore husbands’ perceptions regarding anemia and cultural beliefs related to pregnancy.
METHODS: This qualitative study was conducted using twelve in-depth interviews (IDIs) with husbands who have pregnant wives who were recruited through a purposive sampling method. Data were collected through IDIs using open-ended questions to gain insight about Husband’s Perception on Anemia among Pregnant Women based on Cultural Perspective. Data analysis was conducted by an inductive content analysis method to evaluate, encode, and analyze the interview’s result.
RESULTS: Four themes emerged from interviews: (1) Husbands’ happiness and support to their wives during pregnancy; (2) Husbands’ perceptions and actions related to anemia symptoms; (3) Cultural beliefs during pregnancy believed by Acehnese people; and (4) the importance of local wisdom-based counseling.
CONCLUSIONS: Our findings provide new insights into how husbands’ perceptions on anemia during pregnancy, how they support their pregnant wives, and what their believed in cultural views about pregnancy. These findings would assist in developing/adapting more strategic policies to prevent anemia in pregnancy.
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Abdallah F, John SE, Hancy A, Paulo HA, Sanga A, Noor R, Lankoande F, Chimanya K, Masumo RM, Leyna GH. Prevalence and factors associated with anaemia among pregnant women attending reproductive and child health clinics in Mbeya region, Tanzania. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000280. [PMID: 36962486 PMCID: PMC10021601 DOI: 10.1371/journal.pgph.0000280] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 09/12/2022] [Indexed: 03/26/2023]
Abstract
Anaemia is a global public health issue, disproportionately affecting vulnerable populations such as pregnant women. The aim of this study was to assess the prevalence of anaemia and to identify factors associated with the condition among pregnant women attending antenatal clinics in the Mbeya Region of Tanzania. A cross sectional study was conducted with 420 pregnant women (<28 weeks of gestation) attending antenatal visits in the 7 districts of the Mbeya Region. A structured questionnaire was used to collect demographic information and eating habits using a 24hours dietary recall. A blood sample was collected and tested for hemoglobin content using the HemoCue 201+. Multivariate analysis was performed using standard logistic regression to explore the association between anaemia status with socio-demographic, reproductive and nutritional factors. Overall prevalence of anaemia in pregnant women was 25.5%. Out of 107 pregnant women diagnosed with anaemia and, sixty six had mild anaemia. In a multivariate logistical regression analysis anaemic women was associated with pregnant women coming from lower socio-economic status [adjusted OR = 2.40, 95%CI (1.05, 5.48)]. Moreover, anaemia was less associated with pregnant women who were living in Mbeya district council [adjusted OR = 0.28, 95%CI (0.11, 0.72)], consume at least once a day dark green leafy vegetables [adjusted OR = 0.53, 95% CI (0.30, 0.94)], and vegetable liquid cooking oil [adjusted OR = 0.56, 95% CI (0.34, 0.98)]. The prevalence of anaemia among the pregnant women falls in the category of moderate public health problem according to the WHO classification. Low socio-economic status, consumption of green leafy vegetables and vegetable liquid cooking oil were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are in lower socio-economic status and those not consuming vegetables. Interventions that integrate health and nutrition education in reproductive and child health clinics are needed to combat anaemia.
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Affiliation(s)
- Fatma Abdallah
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Sauli E John
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Adam Hancy
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Heavenlight A Paulo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, MUHAS, Dar es Salaam, Tanzania
| | - Abraham Sanga
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Ramadhan Noor
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Fatoumata Lankoande
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Kudakwashe Chimanya
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Ray M Masumo
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Germana H Leyna
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, MUHAS, Dar es Salaam, Tanzania
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Sámano R, Chico-Barba G, Flores-Quijano ME, Godínez-Martínez E, Martínez-Rojano H, Ortiz-Hernandez L, Nájera-Medina O, Hernández-Trejo M, Hurtado-Solache C. Association of Pregestational BMI and Gestational Weight Gain with Maternal and Neonatal Outcomes in Adolescents and Adults from Mexico City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:280. [PMID: 35010540 PMCID: PMC8750657 DOI: 10.3390/ijerph19010280] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/13/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.
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Affiliation(s)
- Reyna Sámano
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico; (L.O.-H.); (O.N.-M.)
| | - Gabriela Chico-Barba
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
- Escuela de Enfermería, Facultad de Ciencias de la Salud, Universidad Panamericana, Mexico City 03920, Mexico
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - María Eugenia Flores-Quijano
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
| | - Estela Godínez-Martínez
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
| | - Hugo Martínez-Rojano
- Sección de Posgrado e Investigación de la Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - Luis Ortiz-Hernandez
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico; (L.O.-H.); (O.N.-M.)
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City 04960, Mexico
| | - Oralia Nájera-Medina
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico; (L.O.-H.); (O.N.-M.)
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City 04960, Mexico
| | - María Hernández-Trejo
- Departamento de Neurobiología del Desarrollo, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico;
| | - Cristopher Hurtado-Solache
- Escuela de Ciencias de la Salud, Universidad del Valle de México-Chapultepec, Mexico City 11810, Mexico;
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Ahmed RH, Yussuf AA, Ali AA, Iyow SN, Abdulahi M, Mohamed LM, Mohamud MHT. Anemia among pregnant women in internally displaced camps in Mogadishu, Somalia: a cross-sectional study on prevalence, severity and associated risk factors. BMC Pregnancy Childbirth 2021; 21:832. [PMID: 34906104 PMCID: PMC8670163 DOI: 10.1186/s12884-021-04269-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anemia in pregnancy is a serious global public health problem in most developing countries and a major cause of maternal morbidity and mortality. Somalia which already had very high maternal mortality ratio of 829 per 100,000 live births, pregnant women in internally displaced camps (IDPs) remain at most exposed. The aim of the study was to determine the prevalence, severity and associated risk factors of anemia among pregnant women in internally displaced camps in Mogadishu, Somalia. METHODS A community based cross-sectional study was conducted among 383 households in the most IDP settled districts in Mogadishu. Every pregnant mother in these sampled households who was voluntarily consented was targeted. A sample of blood was also taken by pricking the fingertip and inserted into hemoglobin meter. Those with Hb < 11 g/dl from hemoglobin meter had been taken another sample of 3 cc blood and put into EDTA tube for CBC analysis to identify the type of anemia. Data on risk factors were collected using structured pretested questionnaire via an interview. Collected data was coded and entered in SPSS- Version 22 for analysis. Descriptive analysis, bivariate chi-square and multivariate logistic regression were done. RESULTS The overall prevalence of anemia among study participants was 44.4% (95%CI: 39.5-49.3%), where severe and moderate anemia were 11.8 and 47.0% respectively. In addition all anaemic cases were microcytic hypochromic anemia. Young maternal age, low Family income, fewer/zero parity, being at third or second trimesters, lack of ANC attendance during pregnancy, lack of iron supplementation during pregnancy, taking tea immediately after meal during pregnancy, lower/zero frequency of daily meat and vegetables consumption during pregnancy were associated risk factors of anemia. CONCLUSION The anemia prevalence from this study was severe public health problem. Several factors were found to be associated with anemia during pregnancy. Measures has to be taken to curb the problem by including them mass iron supplementation and health education towards identified risk factors.
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Affiliation(s)
| | | | | | - Sowdo Nuur Iyow
- Faculty of Medicine & Surgery, Jazeera University, Mogadishu, Somalia
| | - Maryan Abdulahi
- Obstetrics and Gynaecology Department, Dr Sumait Hospital, Mogadishu, Somalia
- Faculty of Medicine & Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Lul Mohamud Mohamed
- Faculty of Medicine & Surgery, Jazeera University, Mogadishu, Somalia
- Paediatric Department, Jazeera University Hospital, Mogadishu, Somalia
| | - Mohamed Hayir Tahlil Mohamud
- Faculty of Medicine & Surgery, Jazeera University, Mogadishu, Somalia.
- Research Unit, Jazeera University, Mogadishu, Somalia.
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Turawa E, Awotiwon O, Dhansay MA, Cois A, Labadarios D, Bradshaw D, Pillay-van Wyk V. Prevalence of Anaemia, Iron Deficiency, and Iron Deficiency Anaemia in Women of Reproductive Age and Children under 5 Years of Age in South Africa (1997-2021): A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312799. [PMID: 34886524 PMCID: PMC8656986 DOI: 10.3390/ijerph182312799] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 12/15/2022]
Abstract
Using a systematic review method, the prevalence of anaemia, iron deficiency (ID), and iron deficiency anaemia (IDA) in women of reproductive age (WRA) and children under 5 years of age was obtained to inform priorities in health planning and policy in South Africa. We searched electronic databases for articles published between 1997 and 2021. A total of 713 articles were identified, of which 14 articles comprising 9649 WRA and 4085 children were included. Since most of the included studies were of low quality, we did not pool data in a meta-analysis due to heterogeneity (I2 > 75%). In WRA, anaemia prevalence ranged from 22.0% to 44.0%; ID from 7.7% and 19.0%; and IDA from 10.5% to 9.7%. The prevalence of anaemia in pregnancy was 29.0% to 42.7%; and 60.6% to 71.3% in HIV-infected pregnant women. Three national surveys reported anaemia in children at 28.9%, 10.7%, and 61.3%, respectively. Overall, among the children under 5 years old, anaemia was more prevalent in 1-year-olds (52.0%) compared to the other age groups. Between 2005 and 2012, ID increased by 3.8% and IDA decreased by 83.2% in children. Anaemia in WRA and children under 5 years in South Africa was a moderate public health concern. Therefore, interventions addressing anaemia should be intensified, and policies on iron supplementation and food fortification need to be revised and aligned to the WHO multiple micronutrient supplementation recommendations.
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Affiliation(s)
- Eunice Turawa
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (O.A.); (M.A.D.); (A.C.); (D.B.); (V.P.-v.W.)
- Correspondence: ; Tel.: +27-219380802
| | - Oluwatoyin Awotiwon
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (O.A.); (M.A.D.); (A.C.); (D.B.); (V.P.-v.W.)
| | - Muhammad Ali Dhansay
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (O.A.); (M.A.D.); (A.C.); (D.B.); (V.P.-v.W.)
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Annibale Cois
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (O.A.); (M.A.D.); (A.C.); (D.B.); (V.P.-v.W.)
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa
| | - Demetre Labadarios
- Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa;
| | - Debbie Bradshaw
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (O.A.); (M.A.D.); (A.C.); (D.B.); (V.P.-v.W.)
- Division of Epidemiology and Biostatistics, Department of Family Medicine and Public Health, University of Cape Town, Cape Town 7925, South Africa
| | - Victoria Pillay-van Wyk
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (O.A.); (M.A.D.); (A.C.); (D.B.); (V.P.-v.W.)
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Ngimbudzi EB, Massawe SN, Sunguya BF. The Burden of Anemia in Pregnancy Among Women Attending the Antenatal Clinics in Mkuranga District, Tanzania. Front Public Health 2021; 9:724562. [PMID: 34926366 PMCID: PMC8674738 DOI: 10.3389/fpubh.2021.724562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The burden of anemia in pregnancy is of global health importance. Tanzania is no exception. Its effects vary from one region to another due to the differing causes. Overall, it is a significant cause of maternal mortality. This study sought to assess the prevalence and factors associated with anemia among pregnant women attending the antenatal clinic (ANC) in the Mkuranga district of the Pwani region of Tanzania. Methodology: This cross sectional study was conducted among 418 pregnant women aged 15-49 years attending the Mkuranga District Hospital and Kilimahewa Health Center. The outcome variable of interest was anemia in pregnancy defined as a hemoglobin concentration of 11 g/dl or less. Data was collected using face-to-face interviews with a standardized pretested questionnaire, and through blood samples collected for hemoglobin testing. Descriptive analysis was used to determine the prevalence of anemia while multiple logistic regression was used to determine factors associated with anemia in pregnancy. Results: Anemia was prevalent among 83.5% of pregnant women attending the two major ANCs in Mkuranga district. Categorically, the hemoglobin of 16.3% of the included women was normal, 51.9% had moderate anemia, 24.4% had mild anemia, and 7.2% had severe anemia. Factors associated with anemia included being in the third trimester (AOR = 2.87, p = 0.026), not consuming vegetables (AOR = 2.62, p = 0.008), meat (AOR = 2.71, p = 0.003), eggs (AOR = 2.98, p = 0.002), and fish (AOR = 2.38, p = 0.005). The finding of unadjusted analysis revealed that women with inadequate minimum dietary diversity were having significantly greater odds of being anemic as compared with those with adequate dietary diversity (OR = 1.94, P = 0.016). Conclusion: More than 80% of pregnant women attending ANC in Mkuranga districts were anemic. Such unprecedented burden of anemia is associated with several factors, which include poor dietary practices such as not consuming iron-rich foods, for example vegetables, meat, eggs, and fish. Women in their third trimester were also more likely to suffer from anemia. This unprecedented burden of anemia in pregnancy can be addressed if efforts to improve feeding practices and early monitoring at the ANCs are sustained.
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Affiliation(s)
- Evelyine B. Ngimbudzi
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Siriel N. Massawe
- School of Medicine (S.N.M.), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno F. Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Sun Y, Shen ZZ, Huang FL, Jiang Y, Wang YW, Zhang SH, Ma S, Liu JT, Zhan YL, Lin H, Chen YL, Shi YJ, Ma LK. Association of gestational anemia with pregnancy conditions and outcomes: A nested case-control study. World J Clin Cases 2021; 9:8008-8019. [PMID: 34621857 PMCID: PMC8462208 DOI: 10.12998/wjcc.v9.i27.8008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gestational anemia is a serious public health problem that affects pregnant women worldwide. Pregnancy conditions and outcomes might be associated with the presence of gestational anemia. This study investigated the association of pregnancy characteristics with anemia, exploring the potential etiology of the disease.
AIM To assess the association of pregnancy parameters with gestational anemia.
METHODS A nested case-control study was conducted based on the Chinese Pregnant Women Cohort Study-Peking Union Medical College Project (CPWCS-PUMC). A total of 3172 women were included. Patient characteristics and gestational anemia occurrence were extracted, and univariable and multivariable logistic regression models were used to analyze the association of pregnancy parameters with gestational anemia.
RESULTS Among the 3172 women, 14.0% were anemic, 46.4% were 25-30 years of age, 21.9% resided in eastern, 15.7% in middle, 12.4% in western 18.0% in southern and 32.0% in northern regions of China. Most women (65.0%) had a normal prepregnancy body mass index. Multivariable analysis found that the occurrence of gestational anemia was lower in the middle and western regions than that in the eastern region [odds ratio (OR) = 0.406, 95% confidence interval (CI): 0.309-0.533, P < 0.001)], higher in the northern than in the southern region (OR = 7.169, 95%CI: 5.139-10.003, P < 0.001), lower in full-term than in premature births (OR = 0.491, 95%CI: 0.316-0.763, P = 0.002), and higher in cases with premature membrane rupture (OR=1.404, 95%CI: 1.051-1.876, P = 0.02).
CONCLUSION Gestational anemia continues to be a health problem in China, and geographical factors may contribute to the situation. Premature birth and premature membrane rupture may be associated with gestational anemia. Therefore, we should vigorously promote local policy reformation to adapt to the demographic characteristics of at-risk pregnant women, which would potentially reduce the occurrence of gestational anemia.
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Affiliation(s)
- Yin Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Zhong-Zhou Shen
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Fei-Ling Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ya-Wen Wang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Su-Han Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Shuai Ma
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Tao Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Yong-Le Zhan
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hang Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Yun-Li Chen
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ying-Jie Shi
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Liang-Kun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
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Faris A, Abdullah MT, Hadju V. The Impact of Multiple Micronutrient Supplementation on Hemoglobin Concentration in Pregnant and Neonatal Birth Wight. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Anemia during pregnancy is a public health problem especially in developing countries and it is associated with maternal and perinatal adverse outcomes. Global data shows that 56% of pregnant women in low- and middle-income countries have anemia. Every year more than 20 million infants are born with low birth weigh t(LBW) worldwide.
Objective: To analyze the impact of Multi Micronutrients (MM) supplementation on hemoglobin (Hb) levels of pregnant women and infant birth weight.
Method: The databases used to obtain the literature were PubMed, ScienceDirect, MEDLINE, and PubMed Central. The keywords used were Multiple Micronutrien Supplementation, Hemoglobin, Pregnant and Neonatal Birth Weght in studies published from 2010 to 2020. A total of 14 articles were used in this review.
Results: Seven articles obtained about the effects of multiple micronutrients on hemoglobin levels in pregnant women. Six studies support that MM supplementation increases hemoglobin levels or prevents pregnant women from anemia. One study showed a significant increase in serum ferritin One study reported ferritin levels in the MM group as well as the fe-folic acid group did not experience a significant decrease. There is only one study that shows the opposite results, which the mean maternal hemoglobin level significantly decreased during study, being the lowest in second trimester. Ferritin and serum iron levels were decreased at trimester one and two, also the zinc and vitamin D level declined. Seven articles show the effect of MM supplementation on pregnancy outcomes is better than Fe-folic acid supplementation. This can be seen in the results reported from various studies that have been carried out, which are reduce the incidence of LBW, small for gestational age, preterm labor. stillbirths, and NTD anomaly.
Conclusion: Various empirical evidence that has been described in this paper confirms the plausibility that the provision of micronutrient supplementation in the periconceptional period is more important than only given during advanced pregnancy. Multi micronutrient administration increases hemoglobin levels in pregnant women and improves pregnancy outcomes
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