Factors associated with anemia among women of the reproductive age group in Thatta district: study protocol

Prevalence of anemia and comparison of perinatal outcomes among anemic and nonanemic mothers

BACKGROUND

The prevalence of anemia is a significant public health challenge. Approximately half of all pregnant women in India experience anemia during pregnancy. This study aims to determine the prevalence of anemia and perinatal outcomes among anemic and nonanemic pregnant mothers.

MATERIALS AND METHODS

The quantitative research approach was adopted using a descriptive comparative design. The study was conducted in the Obstetrics and Gynecology and Pediatric departments of a tertiary care hospital. Hemoglobin (Hb) was recorded using antenatal records of pregnant mothers in their III trimester. Based on their Hb level, subjects were divided into two groups, anemic and nonanemic as per World Health Organization criteria. The subjects were followed up until the first week after birth.

RESULTS

The prevalence of anemia was 48% [N = 410]; 70.6% had mild, 13.7% had moderate, and 15.7% had severe. The anemic group had a significantly higher incidence of low birthweight (30.9% vs 10.3%, P = 0.001) and preterm births (24.2% vs 3.2%, P = 0.001) compared to the nonanemic group. Additionally, there were significant differences in various quantitative perinatal parameters such as weight (P = 0.001), length (P = 0.001), head circumference (P = 0.001), chest circumference (P = 0.034), APGAR score at one minute (P = 0.022), and APGAR score at five minutes (P = 0.001) between the anemic and nonanemic.

CONCLUSION

The maternal anemia is associated with increased risk of unfavorable perinatal outcomes. Identifying and managing anemia among pregnant women is critical to minimize adverse outcomes. Adequate antenatal care can play a significant role in preventing avoidable complications associated with anemia during the third trimester.

Anaemia among lactating and non-lactating women in low-income and middle-income countries: a comparative cross-sectional study

OBJECTIVE

This study aimed to assess the prevalence and determinants of anaemia among lactating and non-lactating women in low-income and middle-income countries (LMICs).

DESIGN

Comparative cross-sectional study.

SETTING

LMICs.

PARTICIPANTS

Reproductive-age women.

PRIMARY OUTCOME

Anaemia.

METHODS

Data for the study were drawn from the recent 46 LMICs Demographic and Health Surveys (DHS). A total of 185 330 lactating and 827 501 non-lactating women (both are non-pregnant) who gave birth in the last 5 years preceding the survey were included. STATA V.16 was used to clean, code and analyse the data. Multilevel multivariable logistic regression was employed to identify factors associated with anaemia. In the adjusted model, the adjusted OR with 95% CI and a p value <0.05 was reported to indicate statistical association.

RESULT

The prevalence of anaemia among lactating and non-lactating women was found at 50.95% (95% CI 50.72, 51.17) and 49.33% (95% CI 49.23%, 49.44%), respectively. Maternal age, mother's educational status, wealth index, family size, media exposure, residence, pregnancy termination, source of drinking water and contraceptive usage were significantly associated determinants of anaemia in both lactating and non-lactating women. Additionally, the type of toilet facility, antenatal care visit, postnatal care visit, iron supplementation and place of delivery were factors significantly associated with anaemia in lactating women. Besides, smoking was significantly associated with anaemia in non-lactating women.

CONCLUSIONS AND RECOMMENDATIONS

The prevalence of anaemia was higher in lactating women compared with non-lactating. Almost half of the lactating and non-lactating women were anaemic. Both individual-level and community-level factors were significantly associated with anaemia. Governments, non-governmental organisations, healthcare professionals and other stakeholders are recommended to primarily focus on disadvantageous communities where their knowledge, purchasing power, access to healthcare facilities, access to clean drinking water and clean toilet facilities are minimal.

Impact of Anemia in Pregnant Women on the Neonatal Conditions

Background. One of the most prevalent illnesses in the world is anemia. Anemia in pregnant women has been a pressing obstetric issue for many years and is one of the most common complications of pregnancy in the world, particularly in developing countries. Aim. To study the condition of neonates born to women with anemia during pregnancy. Methods. A retrospective analysis of 230 patients' medical records in maternity and pregnancy pathology departments. The patients were divided into 2 groups: Group 1 consisted of patients suffering from iron deficiency anemia, Group 2 comprised patients without iron deficiency anemia. Results. The height-to-weight ratio in the group of neonates born to mothers with anemia statistically was significantly lower compared to the control group. The proportion of neonates with hypotrophy in the group born to mothers with anemia statistically was significantly higher. Body length and birth condition indices assessed according to the APGAR scale were virtually identical across the groups. Conclusions. Anemia during pregnancy affects the trophism of a fetus, which is largely reflected in the health of neonates. Treating maternal anemia is important to prevent or decrease the incidence of underweight in infants at birth.

Use of Smokeless Tobacco Before Conception and Its Relationship With Maternal and Fetal Outcomes of Pregnancy in Thatta, Pakistan: Findings From Women First Study

INTRODUCTION

Smokeless tobacco (SLT) consumption during pregnancy has adverse consequences for the mother and fetus. We aimed to investigate the effects of maternal pre-pregnancy SLT consumption on maternal and fetal outcomes in the district of Thatta, Pakistan.

AIMS AND METHODS

We conducted a secondary data analysis of an individual randomized controlled trial of preconception maternal nutrition. Study participants were women of reproductive age (WRA) residing in the district of Thatta, Pakistan. Participants were asked questions regarding the usage of commonly consumed SLT known as gutka (exposure variable). Study outcomes included maternal anemia, miscarriage, preterm births, stillbirths, and low birth weight. We performed a cox-regression analysis by controlling for confounders such as maternal age, education, parity, working status, body mass index, and geographic clusters.

RESULTS

The study revealed that 71.5% of the women reported using gutka, with a higher proportion residing in rural areas as compared with urban areas in the district of Thatta, Pakistan. In the multivariable analysis, we did not find a statistically significant association between gutka usage and anemia [(relative risk, RR: 1.04, 95% confidence interval, CI (0.92 to 1.16)], miscarriage [(RR: 1.08, 95% CI (0.75 to 1.54)], preterm birth [(RR: 1.37, 95% CI (0.64 to 2.93)], stillbirth [(RR: 1.02, 95% CI (0.39 to 2.61)], and low birth weight [(RR: 0.96, 95% CI (0.72 to 1.28)].

CONCLUSIONS

The study did not find an association between gutka usage before pregnancy and adverse maternal and fetal outcomes. In the future, robust epidemiological studies are required to detect true differences with a dose-response relationship between gutka usage both before and during pregnancy and adverse fetomaternal outcomes.

IMPLICATIONS

While most epidemiological studies conducted in Pakistan have focused on smoking and its adverse outcomes among males, none of the studies have measured the burden of SLT among WRA and its associated adverse outcomes. In addition, previously conducted studies have primarily assessed the effect of SLT usage during pregnancy rather than before pregnancy on adverse fetal and maternal outcomes. The current study is unique because it provides an insight into the usage of SLT among WRA before pregnancy and investigates the association between pre-pregnancy SLT usage and its adverse fetomaternal outcomes in rural Pakistan.

Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study

BACKGROUND

In Pakistan, there is a dearth of literature on the perceptions of anemia among women of reproductive age (WRA). This study was undertaken to explore the perceptions of women, their husbands, and healthcare providers about anemia, its possible causes, and how anemia impacts maternal and child health in Thatta, Pakistan.

METHODS

A qualitative study was conducted in Thatta, Pakistan from September to December 2018. Using a pre-tested semi-structured interview (SSI), we collected data to understand their definitions of anemia through ten focus group discussions (FGDs) with women and their partners and ten primary informant interviews (KIIs) with healthcare providers. We identified six major themes: (I) Knowledge and awareness of anemia, (II) Causes and consequences of Anemia, (III) Dietary practices, (IV) Knowledge and practices regarding the use of iron-folic acid supplements, (V) Factors influencing prevention and control of anemia and (VI) Women's health behavior. We analyzed the data through thematic analysis using NVivo 10 software.

RESULTS

Most community members were not aware of the term anemia but described anemia as a condition characterized by 'blood deficiency' in the body. All study participants perceived anemia as an important health problem tending to cause adverse outcomes among WRA and their children. Study participants perceived gutka (chewable tobacco) consumption as an important cause of anemia. Healthcare providers identified short inter-pregnancy intervals, lack of family planning, poor health-seeking behavior, and consumption of unhealthy food as causes of anemia in the district. Consumption of unhealthy food might not be related to related to a poorer knowledge of iron-deficient foods, but economic constraints. This was further endorsed by the healthcare providers who mentioned that most women were too poor to afford iron-rich foods. All men and women were generally well versed with the sources of good nutrition to be consumed by WRA to prevent anemia.

CONCLUSION

The findings suggest that the government should plan to develop strategies for poverty-stricken and vulnerable rural women and plan health awareness programs to improve dietary practices, compliance with supplements, and health-seeking behavior among women of reproductive age. There is a need to develop effective counseling strategies and context-specific health education sessions to improve the health-seeking behavior of women and men in the Thatta district of Pakistan. Besides, there is need to address social determinants of health such as poverty that pushes women of poorer socioeconomic strata to eat less nutritious foods and have more anaemia. Therefore, a comprehensive and robust strategic plan need to be adopted by government that focuses not only on the awareness programs, but also aim to reduce inequities that lead to pregnant women eat iron-poor foods, which, in turn, forces them to become anemic.

Anemia and Dietary Behaviors among Young Adults in Riyadh, Saudi Arabia

Objective

The study sought to assess the prevalence and the risk factors associated with anemia among male and female young adults in (Riyadh city, Saudi Arabia).

Methods

A cross-sectional study was conducted at King Saud University and Alfaisal University in September 2016 among young adults aged 18 to 28 years old. Data were collected using an interview questionnaire. Additionally, the respondents were evaluated clinically and via laboratory testing for anemia.

Results

Our study population showed a higher percentage of men as compared to women participants. About half of our study sample had a lightly active lifestyle, and more than one-third of the study participants were overweight (34.7%). The average age of the respondents was 22.08 ± 1.98 years. The only factor significantly associated with anemia was gender, in that female gender showed a positive association with anemia.

Conclusion

The most explicit risk factor for anemia among Saudi individuals of college and young professional ages was the female gender. Dietary lifestyle, heavy menstruation, pregnancy, and intake of non-steroidal anti-inflammatory drugs were additional important risk factors among these individuals, but they were statistically not significant.