The Burden of Anemia in Pregnancy Among Women Attending the Antenatal Clinics in Mkuranga District, Tanzania

Burden and Predictors of Anemia Among Pregnant and Lactating Females in a Rural Area in India With a High Tribal Population

Introduction Nutritional anemia is a silent emergency particularly rampant in developing countries, especially among women of reproductive age group. This study was done with the objective to determine the prevalence and predictors of anemia among pregnant and lactating females in the Ormanjhi block of Ranchi district, Jharkhand. Methodology A community-based cross-sectional study was done on 388 pregnant and lactating females from July 2022 to June 2024 using a multi-stage cluster sampling technique. A pre-designed, pre-tested, semi-structured, interviewer-administered questionnaire containing different sections namely socio-demographic details, dietary history, menstrual history, obstetric history, antenatal history, medical history, behavioral history, and personal history was used. House-to-house visits were done for the collection of data. To estimate the prevalence, hemoglobin levels were analyzed using a digital hemoglobinometer. Results The overall prevalence of anemia among pregnant and lactating females was found to be 361 (93%) among 388 participants. Prevalence among pregnant females was 295 (92.76%) out of 318, and among lactating females, it was 66(94.28%) out of 70. The prevalence of anemia in the first trimester was 80 (80.45%) out of 87, 112 (94.91%) in the second trimester among 118, and 103 (91.15%) among 113 females in the third trimester. Conclusion There are concerns about stagnancy in the prevalence of anemia in pregnancy despite strong political commitments. A baseline data is generated from this study giving a clear picture of the exact prevalence and the predictors of anemia among pregnant and lactating females. This would help the policymakers to make warranted modifications imperative to improve the nutritional status of pregnant and lactating women and hence the children.

Dietary diversity and associated factors among women attending antenatal clinics in the coast region of Tanzania

BACKGROUND

Antenatal care (ANC) is crucial for reducing maternal morbidity and mortality, especially in low-resource settings. During antenatal care, women are provided with resources for enhancing their dietary diversity, like nutrition education and counseling. Improved nutrition knowledge influences positive nutritional behavior change, like women's improved dietary diversity, which may increase the likelihood of a healthier pregnancy and delivery experience.

OBJECTIVE

This study aim was to assess dietary diversity and associated factors among pregnant women attending antenatal care in the Coast region of Tanzania.

METHODS

The descriptive cross-sectional study design was used to assess dietary diversity and associated factors among 338 pregnant women. A semi-structured questionnaire collected information from pregnant women on social demographic characteristics, nutrition knowledge and dietary diversity. Women were classified as having a varied diet if they had consumed at least five of the ten food groups over the previous twenty-four hours. Multivariable logistic regression analyses were used to identify predictors of dietary diversity in pregnant women.

RESULTS

Only 28% (95% CI: 23.5-33.1) (n = 95) of pregnant women met the minimum dietary diversity, and 18% (95% CI: 13.8-21.9) (n = 59) were considered to have a high level of nutrition knowledge. Living near a health facility (AOR = 1.77, CI 1.02, 3.06), having high nutrition knowledge (AOR = 2.58, 95% CI: 1.36, 4.89), and being pregnant for the first time (AOR = 2.44, 95% CI: 1.09, 5.44) were associated with adequate dietary diversity.

CONCLUSION

Pregnant women in the study were found to have low knowledge about nutrition and inadequate dietary diversity intake. The findings underscore the need to improve nutrition knowledge provision in antenatal clinics by emphasizing the importance of a diversified and high-quality diet. Healthcare providers in antenatal care clinics should consistently provide nutrition education and counseling to pregnant women and promote their diversified food consumption. Such knowledge may eventually promote healthier pregnancy and child development by curbing the nutritional deficiencies experienced during pregnancy.

Heat Stress-Induced Fetal Intrauterine Growth Restriction Is Associated with Elevated LPS Levels Along the Maternal Intestine-Placenta-Fetus Axis in Pregnant Mice

The exacerbation of the greenhouse effect has made heat stress (HS) an important risk factor for the occurrence of intrauterine growth restriction (IUGR). The experiment aims to uncover the effects of maternal HS on IUGR and its mechanisms. The results showed that HS leads to decreased maternal and fetal birth weights, accompanied by increased serum oxidative stress and cortisol levels. Moreover, HS inflicted significant damage to both the intestinal and placental barriers, altering maternal gut microbiota and increasing intestinal LPS levels. As a result, LPS levels increased in maternal serum, placenta, and fetus. Furthermore, HS damaged the intestinal structure, intensifying inflammation and disrupting the redox balance. The placenta exposed to HS exhibited changes in the placental structure along with disrupted angiogenesis and decreased levels of nutritional transporters. Additionally, the leakage of LPS triggered placental JNK and ERK phosphorylation, ultimately inducing severe placental inflammation and oxidative stress. This study suggests that LPS translocation from the maternal intestine to the fetus, due to a disrupted gut microbiota balance and compromised intestinal and placental barrier integrity, may be the primary cause of HS-induced IUGR. Furthermore, increased LPS leakage leads to placental inflammation, redox imbalance, and impaired nutrient transport, further restricting fetal growth.

History of Pica, Obesity, and Their Associations with Anemia in Pregnancy: A Community-Based Cross-Sectional Study

Anemia in pregnancy represents a major global health problem, and progress is insufficient to meet the World Health Assembly's global nutrition target of halving anemia prevalence by 2030. We assessed the prevalence and factors associated with anemia among pregnant women in northern Sudan. This community-based cross-sectional study was conducted at Almatamah, River Nile State, Sudan. Sociodemographic and obstetric data were collected using a questionnaire. Hemoglobin (Hb) was measured using an automated hematology analyzer. Multivariate and simple linear regression analyses were performed. A total of 586 pregnant women were enrolled. Their median (interquartile range, IQR) age was 25 (21-30) years. The median (IQR) of body mass index (BMI) was 26.67 (24.34-30.04) kg/m2. The median (IQR) for Hb was 11.0 (10.0-11.9) g/dL. Of the 586 women, 271 (46.2%) had anemia (Hb: <11 gm/dL). In multivariate analysis, increasing BMI and obesity were significantly associated with decreased odds ratios (ORs) of anemia, while pica was associated with increased ORs of anemia. In conclusion, anemia in pregnant women is a major public health problem, as approximately half of pregnant women in northern Sudan have anemia. Increasing BMI and obesity were associated with a lower risk for anemia. More efforts are needed to improve the maternal nutritional status for good pregnancy outcomes.

Tackling Anemia in Pregnant Women in India: Reviewing the Obstacles and Charting a Path Forward

This study examined the obstacles and factors influencing the prevention and treatment of anemia among pregnant women in India. Maintaining antenatal care is essential, leading to favorable birth outcomes and healthier offspring. However, inadequate consumption of essential nutrients is widespread among pregnant women, particularly in lower and middle-income economies such as India, contributing to high maternal and infant mortality rates. The factors influencing anemia prevention and treatment are categorized into individual, socioeconomic, interpersonal, and organizational levels. This study discussed the prevalence of anemia among pregnant women in different states of India. It highlights the interventions and initiatives the government and World Health Organization (WHO) have implemented to address the issue while also emphasizing the need for comprehensive approaches that effectively address the multiple levels of influence needed to prevent and treat anemia. It calls for increased awareness, improved education, and better healthcare services to ensure proper nutrition and iron supplementation. Strengthening healthcare systems and involving family members and healthcare providers in supporting pregnant women are crucial for successful anemia prevention and treatment programs.

Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta-analysis

Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta-analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random-effects meta-analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta-analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66-2.65), while that for low birth weight was 2.04 (95% CI, 1.46-2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68-17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95-3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19-4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29-2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food-based dietary guidelines, should be strengthened.

Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis

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.