Objectives Maternal anemia is a critical public health problem, especially in Low- and Middle-Income Countries (LMIC) like India. Anemia during pregnancy increases the risk of poor fetal outcomes, such as low birth weight. The Indian national Iron + Initiative includes iron & folic acid (IFA) supplementation for pregnant & lactating women. We sought out to assess the effectiveness of the IFA program in Nagpur, India. Methods We conducted a prospective cohort study of 200 pregnant women from four clusters in Nagpur (Eastern Maharashtra), India. Maternal hemoglobin was assessed using Hemocue and the finger prick method. Anemia was defined as hemoglobin < 110g/L. IFA receipt and consumption was assessed via questionnaire during the 1st and 3rd trimester of pregnancy. Results Hemocue/capillary assessment revealed prevalence of anemia in the third trimester of 69.52% (N = 187), as compared to 50.0% (N = 200) in the first trimester. In the first trimester, 44.5% of women reported consuming IFA the previous day, while 84.8% reported consuming it the previous day by the 3rd trimester. In the first trimester, 61% (n = 122) of women reported receiving IFA: 43% for free from a public health facility, 14% purchased it from a store/pharmacy, and 4% from other locations. By the 3rd trimester, 99.5% of women had received IFA: 75.4% for free from a facility, 11.8% from a pharmacy/store and 8.02% from other locations. Conclusions We noted a markedly high prevalence of anemia in pregnancy that increased from the first to third trimester, characteristic of physiologic amenia, despite an increase IFA coverage and consumption. Other nutritional and non-nutritional interventions to reduce anemia in pregnancy need to be explored to prevent maternal anemia in Nagpur, India and possibly other LMIC contexts. Funding Sources This study was funded by the Thrasher Research Fund grant.
Objectives Maternal anemia during pregnancy increases the risk of a myriad of negative birth outcomes, including maternal mortality, neonatal mortality, and low birth weight. In Eastern Maharashtra, India, the prevalence of anemia among pregnant women has been reported to be > 80%. While the most common cause of anemia is iron deficiency, its relative contribution is often unknown, as are rates of other key micronutrient deficiencies including B12 and folic acid. The primary objectives of this study are 1) to determine the prevalence of micronutrient deficiencies (iron, folic acid, and B12) and 2) to quantify the contribution of these micronutrient deficiencies to anemia among pregnant women in Nagpur (Eastern Maharashtra, India). Methods We conducted a cross-sectional study of 200 women from four clusters in Nagpur. In the first trimester of pregnancy, trained nurses collected venous blood samples and we used Hemocue on blood samples collected with a finger prick. Anemia was defined as hemoglobin < 110 g/L, iron deficiency as serum ferritin < 15 µg/mL (adjusted for inflammation), folic acid deficiency as serum folic acid < 3 ng/mL, and B12 deficiency as < 203 pg/mL. Results Among women in our sample, 37.5% were anemic, 40.0% were iron deficient, 30.0% were vitamin B12 deficient, and none were folic acid deficient. Hemocue assessment of capillary blood yielded a prevalence of anemia of 50.0%. Approximately half (53.0%) of women diagnosed with anemia via Hemocue were iron deficient and 31.0% were vitamin B12 deficient. We did not find any folate deficiency in this population. Conclusions We found the prevalence of anemia in Eastern Maharashtra to be lower compared to previous studies collecting capillary blood, though still unacceptably high. Furthermore, as only half of anemia cases were associated with iron deficiency, iron and folic acid (IFA) supplementation programs may only partially ameliorate the high prevalence of anemia. Funding Sources This study was funded by the Thrasher Research Fund grant.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.