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Terfassa TG, Wirtu D, Egata G. Gestational weight gain and its determinants among pregnant women attending antenatal care at West Shawa Hospitals, Oromia, Ethiopia. PLoS One 2025; 20:e0323725. [PMID: 40489558 DOI: 10.1371/journal.pone.0323725] [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: 12/02/2024] [Accepted: 04/15/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Gestational Weight Gain (GWG) is a crucial factor influencing maternal and neonatal health outcomes. Identifying the determinants of GWG can help develop targeted interventions to improve pregnancy outcomes. OBJECTIVE This study aimed to assess the magnitude of gestational weight gain and identify its determinants among pregnant women attending antenatal care (ANC) services at West Shoa Hospital, Ethiopia, in 2024. METHODOLOGY A bidirectional cohort study was conducted among 885 pregnant women attending antenatal care (ANC) services at West Shoa Hospitals, Ethiopia, before 12 weeks of gestation. Data were collected through face-to-face interviews using the CesPro application and document review. The determinants of GWG were analyzed using an ordinal logistic regression model, assuming the proportional odd assumptions. The Brant test was used to determine whether the parallel assumption was held. The STATA "ologit" command was used for ordinal regression, and the "brant" test was applied to verify the validity of the model. Odds ratios (OR) with 95% confidence intervals (CI) were estimated, and statistical significance was declared at p < 0.05. RESULTS Approximately 69% of pregnant women experienced insufficient weight gain, 26% had adequate weight gain, and 5% had excessive weight gain during pregnancy. Pre-pregnancy Body Mass Index was a significant determinant of gestational weight gain. Compared to underweight women, overweight women had 10.58 times higher odds (95% CI: 5.24-21.37) of being in a higher weight gain category, while obese women had 10.64 times higher odds (95% CI: 1.87-60.57) of achieving normal or excessive gestational weight gain. Partner education significantly influenced gestational weight gain, with those who could only read and write having 0.22 times lower odds (95% CI: 0.05-0.98) of excessive weight gain compared to those with higher education. Maternal occupation also played a role, as daily laborers had 0.26 times lower odds (95% CI: 0.08-0.87) of adequate weight gain than employed women. The normal hemoglobin category was associated with increased odds of being in a higher weight gain category (adequate or excessive) compared to a lower category, with an odds ratio (OR) of 1.04 (95% CI: 1.01-1.08). Conversely, alcohol consumption was associated with lower odds of being in a higher weight gain category, with an OR of 0.49 (95% CI: 0.25-0.99), suggesting that alcohol drinkers had lower odds of experiencing normal or excessive weight gain compared to non-drinkers. CONCLUSION A significant proportion of pregnant women experienced inadequate gestational weight gain. Pre-pregnancy BMI, partner's educational status, maternal occupation, hemoglobin levels, and alcohol consumption were key determinants of gestational weight gain. These findings highlight the need for targeted nutritional counseling and lifestyle interventions to promote optimal weight gain during pregnancy.
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Affiliation(s)
- Teka Girma Terfassa
- Department of Public Health, College of Health Sciences and References Hospital, Ambo University, Ambo, Ethiopia
- Department of Public Health Institute of Health, Wallaga University, Ethiopia
| | - Dessalegn Wirtu
- Department of Public Health Institute of Health, Wallaga University, Ethiopia
| | - Gudina Egata
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Kindschuh WF, Austin GI, Meydan Y, Park H, Urban JA, Watters E, Pollak S, Saade GR, Chung J, Mercer BM, Grobman WA, Haas DM, Silver RM, Serrano M, Buck GA, McNeil R, Nandakumar R, Reddy U, Wapner RJ, Kav AB, Uhlemann AC, Korem T. Early prediction of preeclampsia using the first trimester vaginal microbiome. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.12.01.626267. [PMID: 39677801 PMCID: PMC11642775 DOI: 10.1101/2024.12.01.626267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/17/2024]
Abstract
Preeclampsia is a severe obstetrical syndrome which contributes to 10-15% of all maternal deaths. Although the mechanisms underlying systemic damage in preeclampsia-such as impaired placentation, endothelial dysfunction, and immune dysregulation-are well studied, the initial triggers of the condition remain largely unknown. Furthermore, although the pathogenesis of preeclampsia begins early in pregnancy, there are no early diagnostics for this life-threatening syndrome, which is typically diagnosed much later, after systemic damage has already manifested. Here, we performed deep metagenomic sequencing and multiplex immunoassays of vaginal samples collected during the first trimester from 124 pregnant individuals, including 62 who developed preeclampsia with severe features. We identified multiple significant associations between vaginal immune factors, microbes, clinical factors, and the early pathogenesis of preeclampsia. These associations vary with BMI, and stratification revealed strong associations between preeclampsia and Bifidobacterium spp., Prevotella timonensis, and Sneathia vaginalis. Finally, we developed machine learning models that predict the development of preeclampsia using this first trimester data, collected ~5.7 months prior to clinical diagnosis, with an auROC of 0.78. We validated our models using data from an independent cohort (MOMS-PI), achieving an auROC of 0.80. Our findings highlight robust associations among the vaginal microbiome, local host immunity, and early pathogenic processes of preeclampsia, paving the way for early detection, prevention and intervention for this devastating condition.
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Affiliation(s)
- William F. Kindschuh
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - George I. Austin
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, USA
| | - Yoli Meydan
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - Heekuk Park
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Julia A. Urban
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - Emily Watters
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Susan Pollak
- Biomarkers Core, Irving Institute for Clinical and Translational Research, Columbia University Irving Medical Center, New York, NY, USA
| | - George R. Saade
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Judith Chung
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California Irvine, CA, USA
| | - Brian M. Mercer
- Departments of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA
| | | | - David M. Haas
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, USA
| | - Robert M. Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Myrna Serrano
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA
| | - Gregory A. Buck
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA
- Department of Computer Science, School of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Renu Nandakumar
- Biomarkers Core, Irving Institute for Clinical and Translational Research, Columbia University Irving Medical Center, New York, NY, USA
| | - Uma Reddy
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ronald J. Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Aya Brown Kav
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - Anne-Catrin Uhlemann
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Tal Korem
- Program for Mathematical Genomics, Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
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Rachmah Q, Mondal P, Phung H, Ahmed F. Association between overweight/obesity and iron deficiency anaemia among women of reproductive age: a systematic review. Public Health Nutr 2024; 27:e176. [PMID: 39324337 PMCID: PMC11504706 DOI: 10.1017/s1368980024001794] [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: 12/02/2023] [Revised: 05/08/2024] [Accepted: 06/04/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE Numerous studies have examined the relationship between overweight/obesity and iron deficiency anaemia (IDA) across diverse population groups, but a definitive link has not been clearly determined. This systematic review examined the association between overweight/obesity and IDA in women of reproductive age (WRA). DESIGN The initial search was performed in the CINAHL, Embase, MEDLINE, SCOPUS and Web of Science databases. The studies included should report at least one Fe status with/without an inflammatory marker, using the BMI to define overweight/obesity. Only baseline data were extracted for longitudinal studies. SETTING Global. PARTICIPANT Pregnant or non-pregnant women aged 18-50 years. RESULTS In total, twenty-seven papers were included (twelve addressing pregnant women and fifteen addressing non-pregnant women). Overall, most of the studies reported no association between overweight/obesity and Hb concentration. However, a positive association was reported more frequently in pregnant women. The association between overweight/obesity and serum ferritin concentrations was mixed. Most of the studies on non-pregnant women reported a positive association. Only a few studies measured hepcidin and inflammatory markers, and the majority revealed an increased level among overweight/obese WRA. Among pregnant women, overweight/obesity was positively associated with anaemia and IDA but negatively associated with iron deficiency (ID). Meanwhile, overweight/obese non-pregnant women were positively associated with anaemia, ID and IDA. CONCLUSIONS Overweight/obesity was associated with a decreased prevalence of anaemia and IDA but an increased prevalence of ID, while its association with several Fe markers was inconclusive. Further studies integrating the assessment of various Fe markers, inflammatory markers and hepcidin are needed.
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Affiliation(s)
- Qonita Rachmah
- Public Health, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Prasenjit Mondal
- Public Health, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Hai Phung
- Public Health, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Faruk Ahmed
- Public Health, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Samim S, Loukid M, Lamtali S. Risk Factors and Outcomes Associated with Maternal Obesity and Overweight: A Cross Sectional Study among Moroccan Women in Marrakech. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:846-854. [PMID: 39444465 PMCID: PMC11493576 DOI: 10.18502/ijph.v53i4.15561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/11/2023] [Indexed: 10/25/2024]
Abstract
Background Obesity is becoming a real challenge for public health among pregnant women. This study aimed to identify sociodemographic and lifestyle risk factors and outcomes linked to maternal obesity and overweight. Methods A cross-sectional study was carried out from Nov 2021 to Dec 2022 in the maternity health facility of Mohammed VI Hospital, as well as in one of the main health centers with a delivery unit in Marrakech, Morocco. Parturients were divided into four categories according to their pre pregnancy BMI: underweight, normal weight, overweight and obese. We used the chi-square test (χ2) to analyze the sociodemographic and lifestyle factors associated with maternal obesity and overweight. The same tool was utilized to explore maternal and neonatal complications. Results Overall, 400 parturient women with singleton pregnancies were included in the study. The prevalence of overweight and obesity was 29.8% and 31.5% respectively. Maternal age, type of housing, practicing sports, feelings about pregnancy were correlated with an increased risk of maternal obesity and being overweight. The risks of gestational diabetes, hypertension, anemia, cesarean delivery, and fetal macrosomia were higher among overweight and obese women compared to normal weight ones. The differences were significant (P<0.05). Conclusion Maternal overweight and obesity are strongly linked with socio-economic, lifestyle, and psychological factors which can lead to serious complications for both mother and baby. Further research is needed to develop appropriate preventive measures and interventions for maternal obesity and overweight.
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Affiliation(s)
- Sara Samim
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Cadi Ayyad University, Faculty of Sciences Semlalia, Marrakech, Morocco
| | - Mohamed Loukid
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Cadi Ayyad University, Faculty of Sciences Semlalia, Marrakech, Morocco
| | - Saloua Lamtali
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Cadi Ayyad University, Faculty of Sciences Semlalia, Marrakech, Morocco
- Higher Institute of Nursing and Health Techniques, Marrakech, Morocco
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Eltayeb R, Binsaleh NK, Alsaif G, Ali RM, Alyahyawi AR, Adam I. Hemoglobin Levels, Anemia, and Their Associations with Body Mass Index among Pregnant Women in Hail Maternity Hospital, Saudi Arabia: A Cross-Sectional Study. Nutrients 2023; 15:3508. [PMID: 37630699 PMCID: PMC10458202 DOI: 10.3390/nu15163508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
The level of association between hemoglobin level/anemia and obesity during pregnancy is not yet fully understood. A cross-sectional study was conducted in Hail Maternity Hospital in northern Saudi Arabia from March to May 2023 to assess the associations between hemoglobin levels, anemia, and obesity among pregnant women. Reproductive history was gathered through a questionnaire. Body mass index (BMI) was calculated/computed from the women's weight and height. Linear and binary regression analyses were performed. A total of 334 pregnant women were enrolled. The median (interquartile range (IQR)) age and parity were 33.2 (27.4-37.8) years and 3 (1-5), respectively. Of the 334 women, 52 (15.6%) were normal weight, while 87 (26.0%) were overweight and 195 (58.4%) were obese. In the multiple linear regression, parity (coefficient = -0.121, p = 0.001) and BMI (coefficient = 0.030, p = 0.006) were negatively associated with the hemoglobin level. Ninety-nine (26.9%) women had anemia. In the multivariate analysis, primiparity (adjusted odds ratio (AOR) = 0.54, 95% confidence interval (CI) = 0.30-0.97), increasing BMI (AOR = 0.93, 95% CI = 0.89-0.97), and obesity (AOR = 0.31, 95% CI = 0.16-0.61) were associated with decreased ORs of anemia. Increasing parity was associated with increased ORs of anemia (AOR = 1.18, 95% CI = 1.05-1.32). Being overweight was not associated with anemia (AOR = 0.56, 95% CI = 0.27-1.16). In the current study, a high hemoglobin level and lower prevalence of anemia were observed among obese pregnant women.
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Affiliation(s)
- Reem Eltayeb
- Department of Medical Laboratory Science, College of Applied Medical Science, University of Ha'il, Ha'il 8227, Saudi Arabia
| | - Naif K Binsaleh
- Department of Medical Laboratory Science, College of Applied Medical Science, University of Ha'il, Ha'il 8227, Saudi Arabia
| | - Ghaida Alsaif
- Department of Medical Laboratory Science, College of Applied Medical Science, University of Ha'il, Ha'il 8227, Saudi Arabia
| | - Reem M Ali
- Department of Medical Laboratory Science, College of Applied Medical Science, University of Ha'il, Ha'il 8227, Saudi Arabia
| | - Amjad R Alyahyawi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, University of Ha'il, Ha'il 8227, Saudi Arabia
- Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford GU2 7XH, UK
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah 51911, Saudi Arabia
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Furuita N, Okabayashi S, Yamanishi A, Nakamura M, Kawamura T. The development of a prediction model for arrest of labour to be used at regular check-ups, during 36 or 37 gestational weeks, for primiparas: a retrospective cohort study. Arch Gynecol Obstet 2023; 308:453-461. [PMID: 35931901 DOI: 10.1007/s00404-022-06710-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE An emergency caesarean section (CS) has more complications than a planned CS. The arrest of labour is a major indication for an emergency CS. This study aimed to develop a prediction model for the arrest of labour to be used in regular check-ups at 36 or 37 gestational weeks for primiparas. METHODS This was a retrospective cohort study conducted at a single institution in Japan using data from January 2007 to December 2013. Primiparas attending regular check-ups during 36 or 37 gestational weeks, with live single foetuses in a cephalic presentation were included. The outcome was the incidence of labour arrest. Candidate predictors included 25 maternal and foetal findings. We developed a prediction model using logistic regression analysis with stepwise selection. A score was assigned to each predictor of the final model based on their respective β coefficients. RESULTS A total of 739 women were included in the analysis. Arrest of labour was diagnosed in 47 women (6.4%), and all of them delivered by emergency CS. The predictors in the final model were a Bishop score ≤ 1, maternal height ≤ 154 cm, foetal biparietal diameter ≥ 91 mm, pre-pregnancy weight ≥ 54 kg, maternal haemoglobin concentration ≥ 11.0 g/dl, and amniotic fluid index ≥ 13. The area under the receiver operating characteristic curve was 0.783. CONCLUSION We have developed the first model to predict arrested labour before its onset. Although this model requires validation using external samples, it will help clinicians and pregnant women to control gestational conditions and make decisions regarding planned CS.
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Affiliation(s)
- Noriko Furuita
- Department of Preventive Services, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida-honmachi, Sakyo-ku, Kyoto, 606-8501, Japan
- Kyoto Min-iren Chuo Hospital, 2-1 Uzumasa Tsuchimoto-cho, Ukyo-ku, Kyoto, 616-8147, Japan
| | - Satoe Okabayashi
- Kyoto University Health Service, Yoshida-honmachi, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Ayumi Yamanishi
- Kyoto Min-iren Chuo Hospital, 2-1 Uzumasa Tsuchimoto-cho, Ukyo-ku, Kyoto, 616-8147, Japan
| | - Misako Nakamura
- Kyoto Min-iren Chuo Hospital, 2-1 Uzumasa Tsuchimoto-cho, Ukyo-ku, Kyoto, 616-8147, Japan
| | - Takashi Kawamura
- Kyoto University Health Service, Yoshida-honmachi, Sakyo-ku, Kyoto, 606-8501, Japan
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7
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Grzeszczak K, Kapczuk P, Kupnicka P, Mularczyk M, Kwiatkowski S, Chlubek D, Kosik-Bogacka D. Preliminary Study of Iron Concentration in the Human Placenta in Twin Pregnancies. Biomolecules 2023; 13:biom13050749. [PMID: 37238619 DOI: 10.3390/biom13050749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Pregnancy significantly increases the demand for iron (Fe) in the female body to facilitate maternal blood volume expansion, placental development, and fetal growth. As Fe flux in pregnancy is significantly influenced by the placenta, the aim of this study was to determine the dependencies between the Fe concentration in the placenta, the infant's morphometric parameters and the woman's morphological blood parameters in the last trimester. METHODS The study was conducted on 33 women with multiple (dichorionic-diamniotic) pregnancies from whom the placentas were drawn, and their 66 infants, including pairs of monozygotic (n = 23) and mixed-sex twins (n = 10). Fe concentrations were determined based on inductively coupled plasma atomic emission spectroscopy (ICP-OES) using ICAP 7400 Duo, Thermo Scientific. RESULTS The results of the analysis showed that lower placental Fe concentrations were associated with deteriorated morphometric parameters of infants, including weight and head circumference. Although we found no statistically significant dependencies between Fe concentration in the placenta and the women's morphological blood parameters, higher Fe concentration in the placenta of mothers supplemented with Fe correlated with better morphometric parameters in infants compared to those whose mothers received no Fe supplementation. CONCLUSIONS The research adds additional knowledge for placental iron-related processes during multiple pregnancies. However, many limitations of the study do not allow detailed conclusions to be assessed, and statistical data should be assessed conservatively.
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Affiliation(s)
- Konrad Grzeszczak
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Patrycja Kapczuk
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Patrycja Kupnicka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Maciej Mularczyk
- Chair and Department of Human and Clinical Anatomy, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Danuta Kosik-Bogacka
- Independent Laboratory of Pharmaceutical Botany, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Maternal factors associated with iron deficiency without anaemia in early pregnancy: ECLIPSES study. Ann Hematol 2023; 102:741-748. [PMID: 36790457 PMCID: PMC9998312 DOI: 10.1007/s00277-023-05123-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023]
Abstract
Several population-specific genetic, sociodemographic, and maternal lifestyle factors are related to iron status in early pregnancy, and their identification would allow preventive actions to be taken. The study aimed to identify maternal factors associated with iron deficiency (ID) in early pregnancy in non-anaemic pregnant women from a European Mediterranean country. Cross-sectional study using the initial population of the ECLIPSES study performed in non-anaemic pregnant women before gestational week 12. Serum ferritin (SF) and haemoglobin concentrations were measured to evaluate iron status, and ID was defined as SF < 15 µg/L. Several sociodemographic and lifestyle data were recorded and used as covariates in the multivariate-adjusted regression models. Out of the 791 participants, 13.9% had ID in early pregnancy. Underweight (OR 3.70, 95%CI 1.22, 15.53) and parity (1 child: OR 2.03, 95%CI 1.06, 3.88; ≥ 2 children: OR 6.96, 95%CI 3.09, 15.69) increased the odds of ID, while a high intake of total meat (≥ 108.57 g/day: OR 0.37, 95%CI 0.15, 0.87), red/processed meat (≥ 74.29 g/day: OR 0.70, 95%CI 0.35, 0.98), protein (≥ 65.05 g/day: OR 0.85, 95%CI 0.30, 0.99), and dietary iron (≥ 8.58 mg/day: OR 0.58, 95%CI 0.35, 0.94) protected against it. Smoking was also associated with a reduction in ID odds (OR 0.34, 95%CI 0.12, 0.99). Baseline BMI, parity, smoking, and diet are associated with ID in early pregnancy in non-anaemic women. Pregnancy planning policies should focus on women at higher risk of ID, such as those who are underweight, multiparous, or following vegetarian diets. This clinical trial was registered at www.clinicaltrialsregister.eu as EudraCT number 2012-005,480-28 and at www.clinicaltrials.gov with identification number NCT03196882.
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He G, Yang H, Chen M, Liu X. Factors influencing folic acid, multivitamin, and calcium supplementation among pregnant women in China based on a national cross-sectional survey. Chin Med J (Engl) 2023; 136:473-475. [PMID: 36752785 PMCID: PMC10106253 DOI: 10.1097/cm9.0000000000002202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Indexed: 02/09/2023] Open
Affiliation(s)
- Guolin He
- Laboratory of the Key Perinatal Diseases, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hongmei Yang
- Laboratory of the Key Perinatal Diseases, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Meng Chen
- Laboratory of the Key Perinatal Diseases, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xinghui Liu
- Laboratory of the Key Perinatal Diseases, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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In Underweight Women, Insufficient Gestational Weight Gain Is Associated with Adverse Obstetric Outcomes. Nutrients 2022; 15:nu15010057. [PMID: 36615715 PMCID: PMC9824014 DOI: 10.3390/nu15010057] [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: 11/10/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
The pre-pregnancy BMI and the gestational weight gain are two important determinants of pregnancy outcomes. The aim of this study was to determine obstetric outcomes associated with insufficient gestational weight gain in women with a pre-pregnancy BMI < 18.5 kg/m2. This study was based on observational routinely collected data from University Hospital Maternity. The participants were allocated to the group sufficient or insufficient gestational weight gain: ≥12.5 kg and <12.5 kg respectively. Primary outcomes were the adjusted birth weight in percentiles (%) and the proportion of SGA newborns. Secondary outcomes were obstetric and perinatal outcomes. A total of 132 participants with a median age of 28 ± 8 years were included. The adjusted birth weight in percentiles was significantly lower in the insufficient gestational weight gain group (27.3 ± 45.0 vs. 46.3 ± 46.2%; p < 0.001). Moreover, the insufficient gestational weight gain is associated with a higher risk of SGA (27.0% vs. 11.6%; p = 0.03). Our study also showed increased risks of premature rupture of membranes, anaemia, and intrauterine growth restriction in women with an insufficient weight gain. Future studies should explore the risk factors associated with insufficient weight gain, in order to develop specific care for underweight pregnant women.
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Zhang J, Li Q, Song Y, Fang L, Huang L, Sun Y. Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis. Front Public Health 2022; 10:1041136. [PMID: 36311562 PMCID: PMC9615144 DOI: 10.3389/fpubh.2022.1041136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/26/2022] [Indexed: 01/29/2023] Open
Abstract
Background Anemia in pregnancy is a serious threat to maternal and child health and is a major public health problem. However, the risk factors associated with its incidence are unclear and controversial. Methods PubMed, Ovid Embase, Web of Science, and Cochrane databases were systematically searched (inception to June 27, 2022). The screening of search results, extraction of relevant data, and evaluation of study quality were performed independently by two reviewers. Results A total of 51 studies of high quality (NOS score ≥ 7) were included, including 42 cross-sectional studies, six case-control studies, and three cohort studies. Meta-analysis showed that infected parasite, history of malarial attack, tea/coffee after meals, meal frequency ≤ 2 times per day, frequency of eating meat ≤ 1 time per week, frequency of eating vegetables ≤ 3 times per week, multiple pregnancies, multiparous, low household income, no antenatal care, rural residence, diet diversity score ≤ 3, have more than 3 children, history of menorrhagia, underweight, family size ≥ 5, middle upper arm circumference < 23, second trimester, third trimester, birth interval ≤ 2 year were all risk factors for anemia in pregnancy. Conclusions Prevention of anemia in pregnancy is essential to promote maternal and child health. Sufficient attention should be paid to the above risk factors from the social level and pregnant women's own aspects to reduce the occurrence of anemia in pregnancy. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022344937.
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Affiliation(s)
- Jing Zhang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Quanhong Li
- Kunming Children's Hospital, Kunming, China
- Department of Pharmacy, Children's Hospital of Kunming Medical University, Kunming, China
| | - Ying Song
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Liping Fang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Lei Huang
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
| | - Yu Sun
- Department of Obstetrics, Kunming City Maternal and Child Health Hospital, Kunming, China
- Kunming Municipal Service Center for Maternal and Child Health, Kunming, China
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12
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Hautier S, Capmas P, Houllier M. Evaluation of the impact of body mass index < 18,5 kg/m2 in early pregnancy on obstetric and neonatal outcomes. J Gynecol Obstet Hum Reprod 2022; 51:102438. [DOI: 10.1016/j.jogoh.2022.102438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
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Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life. Nutrients 2022; 14:3777. [PMID: 36145153 PMCID: PMC9503484 DOI: 10.3390/nu14183777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 12/24/2022] Open
Abstract
Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.
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Affiliation(s)
- Puspa Sari
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Dewi Marhaeni Diah Herawati
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Meita Dhamayanti
- Department of Child Health, Hasan Sadikin Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Dany Hilmanto
- Department of Child Health, Hasan Sadikin Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
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Nainggolan O, Hapsari D, Titaley CR, Indrawati L, Dharmayanti I, Kristanto AY. The relationship of body mass index and mid-upper arm circumference with anemia in non-pregnant women aged 19-49 years in Indonesia: Analysis of 2018 Basic Health Research data. PLoS One 2022; 17:e0264685. [PMID: 35239719 PMCID: PMC8893704 DOI: 10.1371/journal.pone.0264685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objectives Anemia remains a major public health problem worldwide. This study examined the relationship between anemia and the nutritional status of non-pregnant women aged 19–49 years in Indonesia. Methods and study design The data were derived from the 2018 Basic Health Research Data of Indonesia. We used information from 11,471 non-pregnant women aged 19–49 years. The dependent variable was anemia (hemoglobin level <12 g/dL). The independent variable was women’s nutritional status, a combined indicator of body mass index (BMI) and mid-upper arm circumference (MUAC). Our analysis controlled for women’s age, education, physical activity, fruit and vegetable consumption, and the presence of communicable or non-communicable diseases. We performed logistic regression analyses. Results The prevalence of anemia in non-pregnant women aged 19–49 years was 22.3% (95% confidence interval [CI]: 21.4–23.3). Women with overweight and obesity were less likely to develop anemia than those with a normal BMI, regardless of their MUAC score. The highest odds for developing anemia were observed in underweight women with low MUAC scores (adjusted odds ratio [aOR] = 2.83, 95%CI: 2.19–3.68). Higher odds ratios were also observed in women with insufficient physical activity, despite their sufficient consumption of fruits or vegetables (aOR = 1.87, 95%CI: 1.06–3.28). However, women who had been diagnosed with a non-communicable disease had a reduced likelihood of developing anemia (aOR = 0.75, 95%CI: 0.67–0.83). Conclusions Strengthening health promotion activities to improve nutritional status and healthy behaviors, particularly a healthy diet, remains important for women in Indonesia to reduce the prevalence of anemia and improve their overall health status.
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Affiliation(s)
- Olwin Nainggolan
- Centre for Research and Development of Public Health Efforts, National Institute Health Research and Development, Ministry of Health Republic of Indonesia, DKI Jakarta, Indonesia
| | - Dwi Hapsari
- Centre for Research and Development of Public Health Efforts, National Institute Health Research and Development, Ministry of Health Republic of Indonesia, DKI Jakarta, Indonesia
| | | | - Lely Indrawati
- Centre for Research and Development of Public Health Efforts, National Institute Health Research and Development, Ministry of Health Republic of Indonesia, DKI Jakarta, Indonesia
| | - Ika Dharmayanti
- Centre for Research and Development of Public Health Efforts, National Institute Health Research and Development, Ministry of Health Republic of Indonesia, DKI Jakarta, Indonesia
| | - Antonius Yudi Kristanto
- Centre for Research and Development of Public Health Efforts, National Institute Health Research and Development, Ministry of Health Republic of Indonesia, DKI Jakarta, Indonesia
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15
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Launbo N, Davidsen E, Granich-Armenta A, Bygbjerg IC, Sánchez M, Ramirez-Silva I, Avila-Jimenez L, Christensen DL, Rivera-Dommarco JA, Cantoral A, Nielsen KK, Grunnet LG. Overlooked paradox of the coexistence of overweight/obesity and anaemia during pregnancy. Nutrition 2022; 99-100:111650. [DOI: 10.1016/j.nut.2022.111650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
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16
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Mayasari NR, Hu TY, Chao JCJ, Bai CH, Chen YC, Huang YL, Chang CC, Wang FF, Hadi H, Nurwanti E, Chang JS. Associations of the pre-pregnancy weight status with anaemia and the erythropoiesis-related micronutrient status. Public Health Nutr 2021; 24:6247-6257. [PMID: 34120669 PMCID: PMC11148615 DOI: 10.1017/s1368980021002627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The coexistence of underweight (UW) and overweight (OW)/obese (OB) at the population level is known to affect iron deficiency (ID) anaemia (IDA), but how the weight status affects erythropoiesis during pregnancy is less clear at a population scale. This study investigated associations between the pre-pregnancy BMI (pBMI) and erythropoiesis-related nutritional deficiencies. DESIGN Anthropometry, blood biochemistry and 24-h dietary recall data were collected during prenatal care visits. The weight status was defined based on the pBMI. Mild nutrition deficiency-related erythropoiesis was defined if individuals had an ID, folate depletion or a vitamin B12 deficiency. SETTING The Nationwide Nutrition and Health Survey in Taiwan (Pregnant NAHSIT 2017-2019). PARTICIPANTS We included 1456 women aged 20 to 45 years with singleton pregnancies. RESULTS Among these pregnant women, 9·6 % were UW, and 29·2 % were either OW (15·8 %) or OB (13·4 %). A U-shaped association between the pBMI and IDA was observed, with decreased odds (OR; 95 % CI) for OW subjects (0·6; 95 % CI (0·4, 0·9)) but increased odds for UW (1·2; 95 % CI (0·8, 2·0)) and OB subjects (1·2; 95 % CI (0·8, 1·8)). The pBMI was positively correlated with the prevalence of a mild nutritional deficiency. Compared to normal weight, OB pregnant women had 3·4-fold (3·4; 95 % CI (1·4, 8·1)) higher odds for multiple mild nutritional deficiencies, while UW individuals had lowest odds (0·3; 95 % CI (0·1, 1·2)). A dietary analysis showed negative relationships of pBMI with energy, carbohydrates, protein, Fe and folate intakes, but positive relationship with fat intakes. CONCLUSION The pre-pregnancy weight status can possibly serve as a good nutritional screening tool for preventing IDA during pregnancy.
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Affiliation(s)
- Noor Rohmah Mayasari
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Tzu-Yu Hu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi Chun Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Ya Li Huang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fan-Fen Wang
- Department of Internal Medicine, Yangming Branch, Taipei City Hospital, Taipei, Taiwan
| | - Hamam Hadi
- Alma Ata Graduate School of Public Health, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Esti Nurwanti
- Department of Nutrition, Faculty of Health Sciences, University of Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei, Taiwan
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Tairo SR, Munyogwa MJ. Maternal anaemia during postpartum: Preliminary findings from a cross-sectional study in Dodoma City, Tanzania. Nurs Open 2021; 9:458-466. [PMID: 34595838 PMCID: PMC8685846 DOI: 10.1002/nop2.1085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 01/27/2023] Open
Abstract
AIM The aim of this study was to determine the prevalence and correlates of anaemia among postnatal women. DESIGN A cross-sectional survey was conducted from April-July, 2020, at a healthcare facility in Dodoma City. METHODS Haemoglobin concentration was measured by using HemoCue Hb 201+ analyser machine. Anaemia was defined as haemoglobin concentration of <11 g/dl. Chi-square test and logistic regression analysis were conducted to identify the correlates of anaemia. RESULTS The overall prevalence of postpartum anaemia was found to be 21.6% (83). Correlates of anaemia were found to be multiple birth (AOR = 4.97), consumption of pulses (AOR = 2.07), normal BMI (AOR = 2.28) and perception of insufficient milk supply (AOR = 3.05). CONCLUSION The prevalence of postpartum anaemia found in this study is high. Iron and folic acid supplementation, promotion of dietary diversification practices and screening women higher risk for anaemia may be feasible interventions.
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Affiliation(s)
- Sophia Rogasian Tairo
- Department of Nursing and Midwifery, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania
| | - Mariam John Munyogwa
- Department of Community Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
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18
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Tan J, He G, Qi Y, Yang H, Xiong Y, Liu C, Wang W, Zou K, Lee AH, Sun X, Liu X. Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey. BMC Pregnancy Childbirth 2020; 20:670. [PMID: 33160312 PMCID: PMC7648278 DOI: 10.1186/s12884-020-03359-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/27/2020] [Indexed: 02/08/2023] Open
Abstract
Background The current evidence about anemia and iron deficiency anemia (IDA) during pregnancy remains elusive in China. The purpose of this study is to investigate the prevalence of anemia and IDA and their risk factors in Chinese pregnant women. Methods A nationwide cross-sectional survey of pregnant women was conducted during their antenatal visits. Using a multi-stage sampling method, 24 hospitals from 16 provinces across China were selected. Structured questionnaires were administered to collect information from participants and to extract clinical data from electronic medical records. Mixed-effects logistic regression models were performed to determine the risk factors associated with anemia and IDA. Results In total, 12,403 pregnant women were enrolled, including 1018 (8.2%) at the first trimester, 3487 (28.1%) at the second, and 7898 (63.7%) at the third. Overall, 19.8% of women were diagnosed with anemia and 13.9% were diagnosed with IDA. The prevalence of anemia and IDA varied among regions and increased by gestational month, peaking at the eighth gestational month (24.0% for anemia and 17.8% for IDA). Pregnant women at advanced stage of gestation, non-local residents, multiple gestations, multiparity, pre-pregnancy underweight, and those experiencing severe nausea or vomiting during pregnancy, were associated with higher risks of anemia and IDA. Conclusions The prevalence of anemia and IDA during pregnancy are similar to those from developed countries and vary across regions in China.
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Affiliation(s)
- Jing Tan
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Guolin He
- Department of Obstetrics and Gynecology, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; West China Second University Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Yana Qi
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Hongmei Yang
- Department of Obstetrics and Gynecology, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; West China Second University Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Yiquan Xiong
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Chunrong Liu
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Wen Wang
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Kang Zou
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Xin Sun
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China
| | - Xinghui Liu
- Department of Obstetrics and Gynecology, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; West China Second University Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.
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Association of gestational weight gain rate with infant anaemia in China: a birth cohort study. Br J Nutr 2020; 124:1285-1292. [PMID: 32594922 DOI: 10.1017/s0007114520002354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Excessive gestational weight gain (GWG) increases the risk of maternal anaemia during pregnancy, but whether it is associated with offspring anaemia has not been investigated. We aimed to prospectively investigate the association of GWG rate in the second/third trimester with infant Hb concentration and anaemia risk. The present study comprised 13 765 infants born during 2006-2009 to mothers who participated in a trial on prenatal micronutrient supplementation. The GWG was calculated by subtracting the maternal weight at enrolment from that at end-pregnancy. The GWG rate was calculated as dividing the GWG by number of weeks between the two measurements and classified into quintiles within each category of maternal BMI. Infant Hb concentrations were measured at 6 and 12 months of age, and anaemia was defined as an Hb concentration <110 g/l. Of the 13 765 infants, 949 (6·9 %) were anaemic at 6 months and 728 (5·3 %) at 12 months. The GWG rate was inversely and linearly associated with the infant Hb concentrations at both 6 and 12 months (P < 0·001 for linearity). Compared with the middle quintile of GWG rate, the highest quintile was associated with an increased risk of anaemia at 6 months (adjusted OR 1·30, 95 % CI 1·07, 1·59) and 12 months (adjusted OR 1·74, 95 % CI 1·40, 2·17). The associations were consistently mediated by maternal anaemia during pregnancy (P < 0·001). In conclusion, excessive GWG rate appears to be associated with an increased risk of infant anaemia, partly independent of maternal anaemia during pregnancy that mediates the association.
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Seu MMV, Mose JC, Panigoro R, Sahiratmadja E. Anemia Prevalence after Iron Supplementation among Pregnant Women in Midwifes Practice of Primary Health Care Facilities in Eastern Indonesia. Anemia 2019; 2019:1413906. [PMID: 31772773 PMCID: PMC6854238 DOI: 10.1155/2019/1413906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/17/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) in pregnant women is common, and iron supplementation is given during pregnancy to reduce birth complication. This study aimed to explore the prevalence of anemia and type of anemia after iron supplementation among pregnant women in the eastern part of Indonesia. METHODS A cross-sectional study design was conducted between January and March 2019 in three Primary Health Care (PHC) facilities at Kupang, West Timor. After consent, pregnant women who had taken their iron supplementation for at least 3 months were asked for iron pills intake by using a self-designed questionnaire and by counting the pills leftover. Complete blood count examination was performed, and the type of anemia was assessed using Shine and Lal index (SLI; MCV ∗ MCV ∗ MCH/100) to determine whether anemia was due to iron deficiency or β-thalassemia trait (β-TT). In a subset of iron tablets distributed in the PHCs, Fe-concentration was measured. RESULTS Of 102 pregnant women included, only 25.5% had taken the pills with a pill count of >80%. Interestingly, Fe-concentration in the pills from three different PHC facilities varied between 75% and 100%. After iron supplementation, however, anemia was detected in 34.3%, and based on SLI, 14.7% was suspected because of iron deficiency and 19.6% was suspective of β-TT. Of note, nonanemic pregnant women (17.6%) had also low SLI, suggesting β-TT or other hemoglobinopathies. CONCLUSION Assessment of Shine and Lal index as the first step to screen the type of anemia in pregnant women from a limited area is of potential value, especially because Indonesia is located in the thalassemia belt area. An integrative approach and counseling among pregnant women with β-TT and their partners will increase thalassemia awareness and optimal birth management.
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Affiliation(s)
- Merry M. V. Seu
- Program Study of Midwifery, Division of Maternal and Child Health, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- RSUD Prof. Dr. W. Z. Johannes General Hospital, Kupang, Eastern Nusa Tenggara, Indonesia
| | - Johanes C. Mose
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Ramdan Panigoro
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Research Center of Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Edhyana Sahiratmadja
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Research Center of Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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