Anemia prevalence among pregnant women and birth weight in five areas in China

Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study

INTRODUCTION

Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan.

OBJECTIVE

The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group.

DESIGN

A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years.

METHOD

The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed.

RESULTS

In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14-18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia.

CONCLUSION

The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.

Prevalence of anemia among reproductive women in different social group in India: Cross-sectional study using nationally representative data

BACKGROUND

The common cause of anemia in the general population is iron deficiency. Anemia is adversely affecting women of reproductive age and child health which in turn results in increased morbidity and maternal death, and also hamper social-economic growth. Reproductive women are more prone to anemia due to inadequate dietary intake and iron loss during menstruation and pregnancy.

OBJECTIVES

This study examined the level and trend of anemia prevalence among the socially disadvantaged group (SC&ST, OBC) of women as compared to the other women (general) and identified the main responsible factors behind this.

DATA AND METHODS

The data for this analysis has been taken from three rounds of National Family Health Survey (NFHS) conducted during 2005-2006 (NFHS 3), 2015-16 (NFHS 4) and 2019-21 (NFHS 5). Univariate and bivariate analyses were used to assess the level of anemia among reproductive age group women of different social groups. The regression model represents the relative risk of different confounding factors on the occurrence of anemia. GIS technique used for graphical representation of anemia prevalence rate among different social groups of women in different states of India.

RESULT

In India more than 15 states belong to the high prevalence (>%55) of anemia among socially backward groups in 2019-21. The anemia prevalence was high (>55%) in all social groups (SC & ST, OBC, general) observed in 7 states in NFHS-3, 4 in NFHS-4 and 11 states in NFHS-5. The overall result reveals that the SC&ST women were more prone to any anemia than OBC and general women and the prevalence rate slightly increased from 2005-06 to 2019-21. Among all variables, economic status dominantly controls the anemia level in all social groups. Anemia prevalence of the poor and poorest group of general women were much worse than the women of richer and richest groups of SC&ST, OBC. The odds of women having anemia were lower among higher educated and urban women as compared to the non educated and rural women, irrespective of social group. The prevalence of anemia decreases with increased age of women and increases with the number of child bearing. All differences were statistically significant.

CONCLUSIONS

The problem of iron deficiency remains a major issue in India, where the majority of the states (eastern, north-eastern and central) suffer from high anemia prevalence rate and it increases over time. It is observed that multiple socio-demographic factors ranging from poor economic and educational status, rural residence to higher childbearing of women are responsible for predicting anemia levels among the social groups of women in India. To eradicate this problem India should improve women's overall nutrition status and their income. Meanwhile, GOI should be more focused on the existing policies related to anemia and on their actual implementation on grassroots level.

Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis

BACKGROUND

Anemia is one of the most critical health conditions affecting people worldwide. The disease is silent, with a slow progression and a few physical symptoms. Anemia during pregnancy carries the risk of premature birth, low birth weight, and fetus malformations and can impose additional costs on society and families. Therefore, the aim of this study is to conduct a systematic review and meta-analysis on the prevalence of anemia in pregnant women worldwide.

METHODS

In this work, we have conducted a systematic review and meta-analysis of the studies that have examined the prevalence of anemia in pregnant women globally. The Google Scholar, Cochrane, ScienceDirect, Medline (PubMed), and Web of Science (WoS) databases were searched for articles published between 1991 and 2021. The search keywords were anemia, pregnancy, prevalence, and meta-analysis. In order to analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies was examined using the I² index. Data analysis was performed within the Comprehensive Meta-Analysis software (Version 2).

RESULTS

The search resulted in 338 deduplicated studies, of which 52 studies with a total sample size of 1,244,747 people were included in this review. According to the results of the meta-analysis, the overall prevalence of anemia in pregnant women is 36.8% (95% confidence interval: 31.5-42.4%). The highest prevalence of anemia is mild at 70.8 (95% CI 58.1-81) and highest in the third trimester of pregnancy with the prevalence of 48.8 (95% CI 38.7-58.9), while the highest prevalence of anemia in pregnant women was in Africa with the prevalence of 41.7 (95% CI 32.3-49.4).

CONCLUSION

The results of this study show a high prevalence of anemia among pregnant women worldwide, and the highest of this prevalence is mild anemia. The prevalence of anemia in the third trimester was higher than in the first and second trimesters. Anemia in pregnant women in developing countries is significantly higher than in developed countries due to pregnancy's economic, sociological, and health factors.

Gut microbiota in gastrointestinal diseases during pregnancy

Gut microbiota (GM) is a micro-ecosystem composed of all microorganisms in the human intestine. The interaction between GM and the host plays an important role in maintaining normal physiological functions in the host. Dysbiosis of the GM may cause various diseases. GM has been demonstrated to be associated with human health and disease, and changes during individual development and disease. Pregnancy is a complicated physiological process. Hormones, the immune system, metabolism, and GM undergo drastic changes during pregnancy. Gastrointestinal diseases during pregnancy, such as hepatitis, intrahepatic cholestasis of pregnancy, and pre-eclampsia, can affect both maternal and fetal health. The dysregulation of GM during pregnancy may lead to a variety of diseases, including gastrointestinal diseases. Herein, we review recent research articles on GM in pregnancy-related gastrointestinal diseases, discuss the interaction of the GM with the host under normal physiological conditions, gastrointestinal diseases, and pregnancy-specific disorders. As more attention is paid to reproductive health, the pathogenic mechanism of GM in gastrointestinal diseases during pregnancy will be further studied to provide a theoretical basis for the use of probiotics to treat these diseases.

Gut Microbiota Signatures in Gestational Anemia

Gestational diseases are associated with altered intestinal microbiota in pregnant women. Characterizing the gut microbiota of gestational anemia (GA) may describe a novel role of gut microbial abnormality in GA. In this study, we investigated differences in gut microbiota between GA patients and healthy pregnant women from the first trimester (n = 24 vs. 54) and the third trimester (n = 30 vs. 56) based on the 16S rRNA gene sequencing method. No statistically significant differences in α-diversity were identified between GA patients and controls in the first trimester of pregnancy, whereas the Shannon index and observed OTUs were significantly lower in GA patients than in healthy controls in the third trimester. Distance-based redundancy analysis revealed striking differences in microbial communities in the third trimester between GA patients and controls. Four genera were significantly different in relative abundance between GA patients and healthy controls, while 12 genera differentiated significantly between GA patients and healthy controls in the third trimester. At the operational taxonomic unit (OTU) level, 17 OTUs and 30 OTUs were identified to be different between GA patients and healthy controls in the first and third trimesters, respectively. Changes in gut microbial composition of GA patients suggest a potential relation with GA, and provide insights into the prediction and intervention of gestational anemia.

Determinant factors of anaemia among pregnant women attending antenatal care clinic in Northwest Ethiopia

Background

Anaemia is a low blood haemoglobin concentration and has been shown to be a public health problem affecting both developing and developed countries. Pregnant women are the most vulnerable groups to anaemia due to several factors, including parasitic infection and feeding habits during their pregnancy. The aim of this study was to assess the prevalence and determinant factors of anemia in pregnant women in Northwest Ethiopia.

Methods

A cross-sectional study was conducted among pregnant women from February, 2017 to June, 2017. The data on determinant factors were collected using a structured questionnaire. The hemoglobin level and intestinal parasites were determined using Hemocue HB 201 and formol ether concentration techniques, respectively. Data was entered and analyzed using SPSS version 23 statistical software. Bivariate and multivariate regressions were computed and odds ratio was determined at 95% confidence interval.

Results

The study consists of 743 participants with a median age of 25 years were included. The prevalence of anemia among pregnant women was 79 (10.6%). The prevalence of mild, moderate and severe anaemia were 78 (99.8%), 1 (0.1%) and 1 (0.1%), respectively. Pregnant women of rural dwellers (AOR = 3.72, CI =1.51-9.18), farmer in occupation (AOR = 3.51, CI = 1.75-7.01), and not educated (AOR = 2.25, CI = 1.13-4.48) were significantly associated with increased risk of anemia.

Conclusion

Anaemia is still a problem amongst pregnant women in the study area though much has been done to increase the hemoglobin level during pregnancy. Health education should be given on factors that aggravate anaemia during pregnancy.

Magnitude of Anemia and Associated Factors among Pregnant Women Attending Antenatal Care in Public Hospitals of Ilu Abba Bora Zone, South West Ethiopia: A Cross-Sectional Study

Background

Anemia is a global public health problem affecting all population particularly pregnant women. Hence, this study assessed the magnitude of anemia and associated factors among pregnant.

Methods

Institution based cross-sectional study was conducted among 416 pregnant women attending antenatal clinic in three public hospitals of Ilu Aba Bora zone. The study participants were selected by proportional allocation based on the number of pregnant women that the respective health facilities contain. Semistructured questionnaire was used for data collection. Midupper arm circumference was employed to assess the nutritional status and standard mood depression assessment tool was used to assess depression. Data were centered and analyzed using SPSS version 20.0. Logistic regression analyses were used to see the association of different variables.

Results

In this study, 31.5% of pregnant women were anemic. In addition, having family size five and above [AOR = 2.97, 95% CI (1.69, 5.27)], being rural resident [AOR=2.74, (95%CI) (2.11, 5.06)], had a higher odds of anemia. Similarly, having soil transmitted helminthes infection [AOR= 3.19, 95% CI (1.5, 6.65)] and history of malaria infection in the last one year [AOR= 3.10, 95% CI (2.10, 5.06)] had also a higher odds anemia during pregnancy. Moreover, being undernourished [AOR= 2.74 95% CI (1.34, 5.57)] was negatively associated with magnitude of anemia.

Conclusions

The magnitude of anemia among pregnant women was found to be significant. Residence, family sizes, history of malaria infection during the last one year, and undernourishment were significantly associated with anemia during pregnancy.

Prevalence of anemia and its associated factors among pregnant women receiving antenatal care at Aymiba Health Center, northwest Ethiopia

INTRODUCTION

Anemia is a global public health problem in both developing and developed countries; ~1.62 billion people suffer from anemia, and pregnant women are the most susceptible to it. The main aim of the present study was to assess the prevalence of anemia and associated risk factors among pregnant women receiving antenatal care at Aymiba Health Center, northwest Ethiopia.

METHODS AND MATERIALS

An institution-based cross-sectional study was conducted at Aymiba Health Center from January to March 2015. Hemoglobin level and intestinal parasitic infections in pregnant women were assessed. Sociodemographic data were collected using a structured questionnaire. The data were entered and analyzed using the SPSS version 20. Odds ratio, p<0.05, and binary logistic regression were used to assess the association of pregnant women's sociodemographic characteristics with their hemoglobin levels and the prevalence of anemia.

RESULTS

The mean with ±2 standard deviation of hemoglobin value was 12±1.3 (95% confidence interval [CI] =11.9-12.5), and the prevalence of anemia from a total of 206 study subjects was 52 (25.2%). Of this anemic group, 50 (24%) were in the second and third trimesters. Anemia was significantly associated with rural residence and intestinal parasitic infections (adjusted odds ratio [AOR] =9.17, 95% CI =2.15-40, p<0.001) and (AOR =55.091, 95% CI =6.88-441.19, p<0.001), respectively.

CONCLUSION

In the present study, the prevalence of anemia was lower than in previous studies conducted in various countries, including Ethiopia. More studies are needed regarding the importance of regular maternal care and health education promotion programs, which have the potential to play a more significant role in health care.

Can anemia predict perinatal outcomes in different stages of pregnancy?

Objective:

To investigate the effect of anemia on perinatal outcomes as preterm delivery (PTD) and low birth weight (LBW) in the different stages of pregnancy.

Methods:

Medical records of 39,587 Turkish pregnant women who delivered between January 2011 and September 2014 were reviewed. Anemia during pregnancy was defined as hemoglobin (Hb)< 11 g/dl, low birth weight was defined as birth weight <2500 gr and PTD was defined as <37 weeks. The pregnant women were divided into three groups (Hb<10 gr/dl, Hb 10-11 gr/dl, Hb>11 gr/dl). Perinatal outcomes were compared between these anemic and non-anemic groups.

Results:

The anemia prevalence in our study was 25.1%. In the first and second trimester of Hb<10g/dl group LBW ratio was significantly higher (respectively 13.5%, 9.8%, p=0.03; 22.7%, 14.7%, p=0.01). In the second and third trimesters of Hb<10 g/dl group PTD ratio was significantly higher (respectively 29.1%, 19%, p=0.00; 17.7%, 15.4% p=0.02). In the first trimester Hb<10 g/dl group cesarean section rate was significantly higher (respectively 65.2%, 57.6%, p = 0.01).

Conclusions:

LBW infants and preterm birth rate was higher in Hb <10 gr/dl group than non-anemic in the first, second and third trimester. Hb <10 gr/dl group had higher cesarean rate in first trimester. The mean birth weight was significantly lower in anemic pregnant women in the second trimester. Preterm birth and cesarean section rate, in the group of anemic throughout pregnancy was higher than those of non-anemic in the whole pregnancy period.

Anemia and Associated Factors Among Pregnant Women Attending Antenatal Care Clinic in Wolayita Sodo Town, Southern Ethiopia

BACKGROUND

Anemia during pregnancy is a common problem which affects both the mother's and her child's health. The main aim of the study was to determine the prevalence and associated risk factors of anemia among pregnant women.

METHODS

We conducted a facility based cross-sectional study on 363 pregnant women attending antenatal care clinic in Wolayita Soddo Otona Hospital from January to March 2014. Sociodemographic data were collected through questionnaire based interview. Four milliliter of venous blood and five grams of fecal samples were collected from each pregnant woman. Hematological parameters were determined using CELL DYN 1800(®) (Abott, USA) Hematology analyzer. Stool samples were checked for intestinal parasites using both direct wet mount and formol-ether concentration techniques. Data were analyzed using SPSS version 20 software.

RESULTS

Overall, the prevalence of anemia was 39.94% (95% CI: 34.7 - 45.2%), of which the majority (60%) had moderate anemia. The mean hemoglobin concentration was 11.55±2.97 g/dl. Age 15-24 years (AOR: 9.89, 95%CI:2.68-21.41), family size >5 (AOR:7.74, 95%CI:4.15-16.47), multigravida (AOR:2.66, 95%CI:1.1.31-4.53), having low income (AOR:5.81, 95%CI:2.93-14.11), current clinical illness (AOR: 6.38, 95%CI:3.13-13.00), intestinal parasitic infection (AOR:2.41, 95%CI:1.08-5.81), no history of contraceptive usage (AOR:5.02 95%CI:2.21-11.47), being in third trimesters (AOR:11.37, 95%CI:4.56-24.82), history of excess menstrual bleeding (AOR:9.82, 95%CI:3.27-21.35) and low body mass index (AOR:9.44, 95%CI:7.79-22.18) were identified as independent predictors of anemia among pregnant women.

CONCLUSION

Anemia prevalence was found out to be moderate public health importance. Identified risk factors should be considered for prevention and control of anemia among pregnant women.

Concentrations of Serum Zinc, Hemoglobin and Ferritin among Pregnant Women and their Effects on Birth Outcomes in Kashan, Iran

OBJECTIVES

Zinc and Iron are essential micronutrients in fetus growth and development. The aim of this study was to assess the relationship of maternal serum Zinc, Hemoglobin and Ferritin levels with their newborns weight, height and head circumference.

METHODS

This cross sectional-analytical study carried out among pregnant women referred to Naghavi Polyclinic, Kashan, Iran from November 2009 to October 2010. One hundred and twenty-nine pregnant women in the third trimester were selected and anthropometric factors of their newborns (weight, height and head circumference) and their relation to serum Zn, Hemoglobin and Ferritin concentrations were assessed.

RESULTS

Serum Hemoglobin deficiency (<11g/dl), serum Ferritin deficiency (<12 µg/L) and serum Zn deficiency (<66 µg/dl) were present in 11 (8.5%), 9 (7%) and 9 (7%) women, respectively. The proportion of newborns with birth weight of 2500-2999 g was greater among mothers with lower Hemoglobin (<11 g/dl) compared to mothers with normal Hemoglobin (≥11 g/dl; p=0.04). Multiple regression analysis showed that among biochemical characteristics of pregnant women, serum Hemoglobin levels were positively correlated with low birth weight (β=0.26; p=0.04). But serum Zn and Ferritin levels were not significantly associated with weight, height and head circumference.

CONCLUSION

Low maternal serum hemoglobin levels are associated with low birth weight and does not have any association with birth height or head circumference; but there was no significant association between maternal serum zinc and Ferritin levels with weight, height and head circumference.

Supplementation of iron alone and combined with vitamins improves haematological status, erythrocyte membrane fluidity and oxidative stress in anaemic pregnant women

Pregnancy is a condition exhibiting increased susceptibility to oxidative stress, and Fe plays a central role in generating harmful oxygen species. The objective of the present study is to investigate the changes in haematological status, oxidative stress and erythrocyte membrane fluidity in anaemic pregnant women after Fe supplementation with and without combined vitamins. The study was a 2 months double-blind, randomised trial. Pregnant women (n 164) were allocated to four groups: group C was the placebo control group; group I was supplemented daily with 60 mg Fe (ferrous sulphate) daily; group IF was supplemented daily with Fe plus 400 μg folic acid; group IM was supplemented daily with Fe plus 2 mg retinol and 1 mg riboflavin, respectively. After the 2-month trial, Hb significantly increased by 15.8, 17.3 and 21.8 g/l, and ferritin by 2.8, 3.6 and 11.0 μg/l, in the I, IF and IM groups compared with placebo. Polarisation (ρ) and microviscosity (η) decreased significantly in other groups compared with placebo, indicating an increase in membrane fluidity. Significant decreases of ρ and η values compared with group C were 0.033 and 0.959 for group I, 0.037 and 1.074 for group IF and 0.064 and 1.865 for group IM, respectively. In addition, significant increases of glutathione peroxidase activities and decreases of malondialdehyde were shown in all treated groups, as well as increases of plasma retinol and urine riboflavin in group IM. The findings show that supplementation with Fe and particularly in combination with vitamins could improve the haematological status as well as oxidative stress and erythrocyte membrane fluidity.