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Bhushan A, Sagar V, Kujur A. Burden and Predictors of Anemia Among Pregnant and Lactating Females in a Rural Area in India With a High Tribal Population. Cureus 2024; 16:e67868. [PMID: 39328677 PMCID: PMC11424750 DOI: 10.7759/cureus.67868] [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] [Accepted: 08/26/2024] [Indexed: 09/28/2024] Open
Abstract
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.
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Affiliation(s)
- Aishwarya Bhushan
- Community Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Vidya Sagar
- Preventive Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Anit Kujur
- Community Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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Sharma N, Kharkongor D, Sundaram SP, Karnatak R, Basu R, Mishra S, Sharma A, Singh SA, Charaimuriya B, Gowda N. Ferric carboxymaltose: A game changer in the management of iron deficiency anaemia in pregnancy. J Family Med Prim Care 2024; 13:2379-2384. [PMID: 39027861 PMCID: PMC11254033 DOI: 10.4103/jfmpc.jfmpc_1258_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/05/2023] [Accepted: 01/02/2024] [Indexed: 07/20/2024] Open
Abstract
Anaemia is a well-known global health concern in the South Asian countries, and it is estimated that India has the utmost prevalence of anaemia and maternal deaths due to iron deficiency anaemia. This study aims to assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) in antenatal women with anaemia in the second and third trimesters of pregnancy. Methods A single-arm prospective cohort (before-after) study among 60 antenatal women with moderate to severe anaemia in the second and third trimesters was conducted from December 2020 to December 2022, and the eligible women were given 1000 mg of intravenous FCM injection. Efficacy was assessed by rate of improvement in haemoglobin and ferritin at 2 weeks post infusion. Safety analysis was done by assessing adverse drug reactions and foetal heart monitoring during the infusion. Results A total 60 antenatal women with a median gestational age of 32.5 weeks at presentation received 1000 mg of intravenous FCM. There was a rise in mean haemoglobin from 8.05 gm% pre-infusion to 10.93 gm% 2 weeks post infusion, showing a mean rise of 2.88 gm%. Similar improvement was noted in mean serum ferritin levels from 25.92 pre-infusion to 253.96 post FCM infusion. There were no reports of drug-related major adverse effects in the mother or the foetus. Conclusions FCM is found to be safe and effective treatment with rapid replenishment of haemoglobin and ferritin levels in a single dose, which makes it suitable and compels consideration as the first choice for treatment of iron-deficiency anaemia.
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Affiliation(s)
- Nalini Sharma
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shilong, Meghalaya, India
| | - Dimple Kharkongor
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shilong, Meghalaya, India
| | - Shanthosh P. Sundaram
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India
| | - Ruchi Karnatak
- Department of Obstetrics and Gynaecology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Ritisha Basu
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shilong, Meghalaya, India
| | - Shweta Mishra
- Department of Obstetrics and Gynaecology, Rama Medical College Hospital and Research Center, Hapur, Uttar Pradesh, India
| | - Aryan Sharma
- MBBS Student, Rama Medical College Hospital and Research Center, Hapur, Uttar Pradesh, India
| | - Santa A. Singh
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shilong, Meghalaya, India
| | - Birangana Charaimuriya
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shilong, Meghalaya, India
| | - Namita Gowda
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shilong, Meghalaya, India
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Johnson A, Vaithilingan S, Ragunathan L. Quantifying the Occurrence of High-Risk Pregnancy: A Comprehensive Survey. Cureus 2024; 16:e59040. [PMID: 38800298 PMCID: PMC11128061 DOI: 10.7759/cureus.59040] [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: 04/08/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Background High-risk pregnancies are characterized by various factors that pose potential risks to maternal and newborn health outcomes. Early detection of these high-risk pregnancies serves as a crucial initial step in preventing maternal mortality and morbidity, thereby promoting the overall health of both mother and baby. This study sought to assess the occurrence of high-risk pregnancy and investigate the factors associated with it among pregnant women. Methods A descriptive survey was undertaken at the Obstetrics and Gynaecology outpatient department of a District Government Hospital in Tamil Nadu, involving 1889 pregnant women in their second and third trimesters. A structured questionnaire, constructed following the Indian standard criteria outlined by the National Health Portal of India, served as the data collection tool. The survey was conducted in February and March 2022, during which pregnant women were interviewed. Subsequently, the collected data underwent descriptive and inferential statistical analysis. Results Among the 1889 pregnant women surveyed, 29% (n=530) were classified as high-risk pregnancies. Within this group, 34.3% (n=182) were diagnosed with hypothyroidism, while 23.2% (n=123) experienced pregnancy-induced hypertension. Significant associations with high-risk pregnancy were observed for factors such as age, education status, occupation, family income, socioeconomic status, and gravida among the pregnant women. Conclusion Policymakers must urgently implement evidence-based interventions aimed at early detection and treatment of high-risk pregnancies. This proactive approach is essential in preventing maternal mortality and morbidity.
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Affiliation(s)
- Alby Johnson
- Obstetrics and Gynaecology, Vinayaka Mission's Research Foundation, Salem, IND
| | - Sasi Vaithilingan
- Child Health Nursing, Vinayaka Mission's College of Nursing, Puducherry, Vinayaka Mission's Research Foundation, Puducherry, IND
| | - Latha Ragunathan
- Microbiology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation, Puducherry, IND
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Babah OA, Akinajo OR, Beňová L, Hanson C, Abioye AI, Adaramoye VO, Adeyemo TA, Balogun MR, Banke-Thomas A, Galadanci HS, Sam-Agudu NA, Afolabi BB, Larsson EC. Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:39. [PMID: 38182997 PMCID: PMC10768359 DOI: 10.1186/s12884-023-06169-1] [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: 04/29/2023] [Accepted: 12/03/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria. METHODS In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA. RESULTS Iron deficiency was observed among 41% (95%CI: 38 - 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 - 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 - 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 - 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 - 2.82). CONCLUSION About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.
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Affiliation(s)
- Ochuwa Adiketu Babah
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Opeyemi Rebecca Akinajo
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ajibola Ibraheem Abioye
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Victoria Olawunmi Adaramoye
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Titilope A Adeyemo
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Mobolanle Rasheedat Balogun
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Aduragbemi Banke-Thomas
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Global Maternal and Newborn Health Hub, Institute of Lifecourse Development, University of Greenwich, London, UK
| | - Hadiza S Galadanci
- African Center of Excellence for Population Health and Policy, Bayero University, Kano, Nigeria
- Department of Obstetrics and Gynaecology, College of Health Sciences Bayero University Kano/ Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Bosede Bukola Afolabi
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Elin C Larsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Kuppusamy P, Prusty RK, Khan SA. Assessing the prevalence and predictors of anemia among pregnant women in India: findings from the India National Family Health Survey 2019-2021. Curr Med Res Opin 2024; 40:51-58. [PMID: 37888841 DOI: 10.1080/03007995.2023.2276851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/25/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Anemia is more prevalent in low- and middle-income countries including India. Anemia in pregnancy is associated with increased risk of maternal health problems and adverse birth outcomes. This study estimates the prevalence and associated risk factors of anemia among pregnant women in India. METHODS This cross-sectional study is based on secondary data from the India National Family Health Survey-V (NFHS-5) conducted during 2019-2021. We extracted data of 27,317 currently pregnant women to estimate the prevalence and contributory factors associated with anemia using descriptive statistics and logistic regression analysis. RESULTS The prevalence of anemia among pregnant women in India was 52.2%. Anemia was higher among adolescent women (61.5%), those with no education (59.2%), those belonging to poorest wealth index (61.9%), scheduled tribes (59.3%), and those from the eastern region of India (62.1%). Further, it was more prevalent among women with a habit of smoking, tobacco, or alcohol (63.0%), and women with shorter birth intervals (59.7%). Among Indian states, anemia prevalence was higher in the state of Bihar (63.1%) and the union territory of Ladakh (71.4%). Logistic regression models show that women with no education (aOR = 1.41, 95% CI = 1.27-1.57), belonging to a poorest wealth quintile (aOR = 1.69, 95% CI = 1.51-1.90), and those with a habit of smoking, tobacco, or alcohol (aOR = 1.39, 95% CI = 1.18-1.63) were more anemic than their counterparts. Additionally, women with no education showed a four-times higher risk of severe anemia (aOR = 4.79, 95% CI = 2.75-8.36) than their highly educated counterparts. CONCLUSION Anemia affects half of all pregnant women in India. Anemia prevalence is higher among adolescents, illiterate, poor, and tribal communities. Social norm-based interventions and strengthening the community health facilitators should be implemented to reduce the high burden of anemia in India.
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Affiliation(s)
- Periyasamy Kuppusamy
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Ranjan K Prusty
- Department of Biostatistics, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Shagufta A Khan
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
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Trivedi P, Chitra S, Natarajan S, Amin V, Sud S, Vyas P, Singla M, Rodge A, Swami OC. Ferric Carboxymaltose in the Management of Iron Deficiency Anemia in Pregnancy: A Subgroup Analysis of a Multicenter Real-World Study Involving 1191 Pregnant Women. Obstet Gynecol Int 2022; 2022:5759740. [PMID: 36479303 PMCID: PMC9722303 DOI: 10.1155/2022/5759740] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/02/2022] [Accepted: 10/18/2022] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Real-world evidence of the efficacy and safety of ferric carboxymaltose (FCM) infusion in Indian pregnant women with iron deficiency anemia (IDA) is lacking. OBJECTIVE To assess the efficacy and safety of intravenous (IV) FCM in Indian pregnant women with IDA in 4 weeks in a real-life scenario. METHODS This is a subgroup analysis of our previously conducted retrospective, multicenter, observational, real-world PROMISE study. Data on demographic and hematological parameters, patient-reported adverse events, and physicians' clinical impressions of efficacy and safety were analysed at 4 ± 1 week. RESULTS This subgroup analysis included 1191 pregnant women in whom IV FCM resulted in a significant increase in hemoglobin (Hb) by 2.8 g/dL and serum ferritin by 30.03 μg/L at 4 weeks (P < 0.001 for both). In 103 pregnant women with severe IDA, there was a significant increase in Hb by 3.6 g/dL (P < 0.001), and serum ferritin by 16.96 μg/L (P=0.12). In 978 pregnant women with moderate IDA, significant improvement in Hb by 2.74 g/dL and serum ferritin by 33 μg/L (P < 0.001 for both) was noted. Similarly, there was a significant increase in red blood cell count, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin (P < 0.001 for all). In pregnant women with mild IDA (n = 26), Hb increased significantly by 1.99 g/dL (P < 0.001). Adverse effects were reported in 8.6% of pregnant women. No new safety signals or serious adverse effects were observed. Based on physicians' global assessment, good to very good efficacy and safety of IV FCM was noted in 99.2% and 98.6% of pregnant women, respectively. CONCLUSIONS IV FCM rapidly corrected anemia in a short period of 4 weeks with favorable safety in the second and third trimester of pregnancy with all severities of IDA (severe, moderate, and mild). The physicians' favorable global assessment of FCM's efficacy and safety in pregnant women with IDA supports its use in daily clinical practice. This trial is registered with CTRI/2021/12/039065.
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Affiliation(s)
- Prakash Trivedi
- Dr. Trivedi's Total Women Health Care Hospital, Mumbai, Maharashtra, India
| | - S. Chitra
- Lalitha Nursing Home, Tiruchirappalli, Tamil Nadu, India
| | - Suma Natarajan
- Ganga Medical Centre & Hospitals, Coimbatore, Tamil Nadu, India
| | - Vandana Amin
- Lady Care Women's Hospital & Child Care, Ahmedabad, Gujarat, India
| | - Shilpi Sud
- Safal Hospital, Nagpur, Maharashtra, India
| | - Priti Vyas
- Sangita Maternity Surgical and Diagnostic Centre, Mumbai, Maharashtra, India
| | | | - Ajinkya Rodge
- Emcure Pharmaceuticals Ltd, Pune, Maharashtra, India
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