Abstract:To assess the prevalence and risk factors of anaemia in pregnancy and recommend a cut-off value for antenatal women in developing countries, a cross sectional study was carried in the University of Port Harcourt Teaching Hospital, Port Harcourt, a 523 bed tertiary health care institution in Nigeria. 1371 apparently healthy asymptomatic pregnant women visiting the antenatal clinic for the first time were enrolled for the study. Another 60 age-matched non-pregnant apparently healthy women served as controls. Haemoglobin concentration, malaria, human immunodeficiency virus (HIV)S, haemoglobin electrophoretic pattern and C-reactive protein as marker of infection were investigated using standard haematological and serological procedures. Anaemia in pregnancy (Hb <11.0g/dl) and (Hb<10.0g/dl) were found to be 23.2% and 6.7% respectively. The aetiology of anaemia was found to be multifactorial; 40.2% had anaemia of infection, 20.3% had Plasmodium falciparum alone, 8.5% had HIV alone, 2.5% had HIV and malaria parasite co-infection; 8.9% undetermined infections and 0.6% had sickle cell anaemia. There is moderate prevalence of anaemia in pregnancy in this part of the world. Since the mean Hb value of the pregnant women in this study was 11.62±1.21g/dl and the pregnant women with Hb values around 10g/dl are apparently healthy, a cut-off value of 10.0g/dl may be considered ideal for defining anaemia in pregnancy in developing countries.
ObjectiveMenstrual disorders are common in young women, and heavy menstrual blood losses (MBL) are an important cause of anaemia. Menstrual morbidity normally goes untreated in developing countries where cultural barriers also serve to make the problems. We investigated the prevelance of menstrual morbidity, and measured MBL and its relationship to iron deficiency in a rural adolescent population. The rationale was to assess whether or not reducing heavy MBL could be part of a strategy to reduce iron deficiency anaemia.SettingRural village in south-east Nigeria.DesignCross-sectional survey.SubjectsThe studdy included all non-pregnant, unmarried nulliparous girls (< 20 years) who had menstruated, and who lived in K'Dere village.MethodsA field worker allocated to each girl completed a questionnaire, and supervised recovery and collection of soiled pads and ensured blood sampling. MBL was measured using the standard alkaline haematin method. Haemoglobin (HB), serum iron, transferin saturation and protoporphyrin levels (ZPP) were also measured.Results307 girls completed MBL measurements; 11.9% refused to participate. 12.1% had menorrhagia (> 80 ml);. median MBL was 33.1 ml. Menorrhagia was more frequent in girls who had menstruated for > 2 years (p = 0.048), and had longer duration of meneses (p < 0.001). Iron status as measured by haematocrit, serum iron, transferrin saturation and ZPP values was inversely related to MBL. Neither height nor body mass index for age was associated with current iron status.ConclusionsThe level of menorrhagia detected (12%) may be an ‘expected’ level for a condition which often has no underlying pathology. Heavy MBL is one of the most important factors contributing to iron deficiency anaemia. Measures are needed to alleviate menstrual disorders and improve iron status. Oral contraceptives can be part of a strategy to reduce anaemia, particularly for adolescents at high risk of unwanted pregnancies.
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