Objectives To study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes. Design Prospective observational cohort study. Setting Catchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India. Participants 72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH’s Global Network, enrolled from 2009 to 2016. Main outcome measures Mode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies. Results Over 90% of the women included in the study were anaemic and over a third were underweight (BMI Conclusion Maternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously. Trial registration number NCT01073475.

https://bmjopen.bmj.com/content/bmjopen/8/8/e021623.full.pdf

Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India.

Anemia is the most frequent derailment of physiology in the world throughout the life of a woman. It is a serious condition in countries that are industrialized and in countries with poor resources. The main purpose of this manuscript is to give the right concern of anemia in pregnancy. The most common causes of anemia are poor nutrition, iron deficiencies, micronutrients deficiencies including folic acid, vitamin A and vitamin B12, diseases like malaria, hookworm infestation and schistosomiasis, HIV infection and genetically inherited hemoglobinopathies such as thalassemia. Depending on the severity and duration of anemia and the stage of gestation, there could be different adverse effects including low birth weight and preterm delivery. Treatment of mild anemia prevents more severe forms of anemia, strictly associated with increased risk of fetal-maternal mortality and morbidity.

https://journals.sagepub.com/doi/pdf/10.2217/whe.15.35

Iron Deficiency Anemia in Pregnancy

Background Anemia in women of reproductive age is a major public health challenge for low- and middle-income countries with a long-term negative impact on the health of women, their children, and the economic growth of the society. Even though the world health organization targeted a 50% global reduction of anemia among women of reproductive age by 2025, with the current trend it is unlikely to achieve this goal. Objective This study aimed to assess the prevalence and associated factors of anemia among women of reproductive age in eastern Africa. Methods A secondary data analysis, using demographic and health survey (DHS) data of 10 eastern African countries, was conducted. For our study, a total weighted sample of 101524 women of reproductive age was used. We employed a multilevel mixed-effects generalized linear model (using Poisson regression with robust error variance). Both unadjusted and adjusted prevalence ratios with their 95% confidence interval were reported. Results The prevalence of anemia in eastern Africa was 34.85 (95%CI: 34.56-35.14) ranging from 19.23% in Rwanda to 53.98% in Mozambique. In the multivariable multilevel analysis, being older age, having primary and above education, being from households with second to highest wealth quantiles, being currently working, not perceiving distance as a big problem, use of modern contraceptive methods, and rural residence was associated with a lower prevalence of anemia. While, being married and divorced/separated/widowed, women from female-headed households, women from households with unimproved toilet facility and unimproved water source, ever had of a terminated pregnancy, having high parity, and being from large household size was associated with a higher prevalence of anemia. Conclusion The prevalence of anemia in eastern Africa was relatively high. Both individual level and community level factors were associated with the prevalence of anemia in women of reproductive age. Therefore, giving special attention to those women who are at a higher prevalence of anemia such as younger women, those who are from households with low socioeconomic status, unimproved toilet facility, and source of drinking water, as well as pregnant women could decrease anemia in women of reproductive age.

Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model

Anemia is a significant public health concern, especially among women and young children. An improved understanding of the complex etiology of anemia is crucial for developing appropriate prevention strategies. This paper examines the determinants of anemia in a large sample of Vietnamese women of reproductive age (WRA). We included baseline data from 4986 WRA participating in a randomized controlled trial (PRECONCEPT). Hemoglobin (Hb) concentrations were measured with Hemocue. Plasma ferritin (Fe), retinol binding protein (RBP) and markers of inflammation were assessed using the ELISA technique. We used multivariate logistic regression to describe associations with anemia and structural equation modeling (SEM) to characterize direct and indirect pathways influencing Hb concentrations. Prevalence of anemia, iron deficiency (Fe <12 μg/l), insufficient iron stores (Fe<30 μg/l) and iron deficiency anemia was 19.7, 3.5, 14.4 and 1.9%, respectively. Ferritin concentration (0.29 per log-mg/dl), being an ethnic minority (−0.24 compared with Kinh), number of children (−0.17) and socioeconomic status (0.09) were directly associated with Hb concentration (P<0.05). Similarly, RBP was directly (0.27 per mg/dl) associated with Hb and also indirectly (0.09 mg/dl) with ferritin. Hookworm infection was indirectly associated with Hb (−0.11) through RBP and ferritin. These findings illustrate the complex etiology of anemia and provide a useful framework for designing, targeting and evaluating appropriate strategies for the prevention and control of anemia. Contrary to expectations, iron deficiency accounted for a very small proportion of anemia in Northern Vietnam.

Multicausal etiology of anemia among women of reproductive age in Vietnam.

Background Anaemia remains a major cause of morbidity and mortality among women and children worldwide. Because deficiencies in essential micronutrients such as iron, folate and vitamin B12 prior to and during gestation increase a woman's risk of being anaemic, adequate dietary intake of such nutrients is vital during this important phase in life. However, information on the dietary micronutrient intakes of pregnant women in Ghana, particularly of those resident in rural areas is scanty. Thus, this study aimed to assess anaemia prevalence and dietary micronutrient intakes in pregnant women in urban and rural areas in Ghana. Methods A comparative cross sectional study design involving 379 pregnant women was used to assess the prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. Anaemia status and mid upper arm circumference (MUAC) were used as proxy for maternal nutritional status. Haemoglobin measurements were used to determine anaemia prevalence and the dietary diversity of the women were determined with a 24-hour dietary recall and a food frequency questionnaire. Results Overall, anaemia was present in 56.5% of the study population. Anaemia prevalence was higher among rural residents than urban dwellers. Majority of the respondents had inadequate intakes of iron, zinc, folate, calcium and vitamin A. The mean dietary diversity score (DDS) of the study population from the first 24-hour recall was 3.81 ± 0.7. Of the 379 women, 28.8% met the minimum dietary diversity for women (MDD-W). The independent predictors of haemoglobin concentration were, gestational age, maternal age and dietary diversity score. Such that respondents with low DDS were more likely to be anaemic than those with high DDS (OR = 1.795, p = 0.022, 95% CI: 1.086 to 2.967). Conclusions A large percentage of pregnant women still have insufficient dietary intakes of essential nutrients required to support the nutritional demands during pregnancy. Particularly, pregnant women resident in rural areas require interventions such as nutrition education on the selection and preparation of diversified meals to mitigate the effects of undernutrition.

/pdf/prevalence-of-anaemia-and-low-intake-of-dietary-nutrients-in-2ujxcy0pbc.pdf

Prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana.

Background: Anemia has been a very important nutritional disorder in the world. India has reported high prevalence of anemia in pregnancy. Most of the articles have reported an adverse pregnancy outcome related to anemia. Of late, reports are emerging suggesting anemia could be indeed beneficial. Apart from that, there was no consistency in the timing of hemoglobin considered for analysis. Hence, we designed an observational study to look into these aspects. Methods: 1000 mothers admitted for delivery were recruited and their hemoglobin was measured. Hemoglobin in previous trimesters was noted from their antenatal record. We followed up these mothers till delivery and looked into the gestation and birth weight of the babies. Descriptive statistics was used for baseline characteristics. Comparison of means was done using Student’s t-test. Qualitative variables were compared using Fisher’s exact te st. Results: More than 50% of the mothers were anemic at some point of time during their pregnancy and 39% of the mothers were anemic throughout. Mean birth weight of babies born to anemic mothers was marginally lower compared to that of babies born to nonanemic mothers. This difference was statistically significant. There was 6.5% increase in the incidence of low birth weight babies and 11.5% increase in preterm deliveries in mothers who were anemic in their third trimester.

/pdf/maternal-anemia-in-various-trimesters-and-its-effect-on-4xejmwc11n.pdf

N Asha

Papers

Maternal anemia in various trimesters and its effect on newborn weight and maturity: an observational study.