Prevalência de anemia ferropriva em gestantes brasileiras: uma revisão dos últimos 40 anos

Abstract

A anemia ferropriva é conhecida como uma das principais deficiências nutricionais em todo o mundo e sua ocorrência pode ser observada em diversas populações. Alguns grupos populacionais ainda apresentam altas prevalências de anemia ferropriva, comprometendo diversas funções do organismo. Dentre esses grupos de risco, podem ser citadas as gestantes, que merecem especial atenção devido à sua vulnerabilidade à carência e ao aumento significativo de suas necessidades, que não são acompanhados por aumento suficiente no consumo ou na absorção de ferro. Este artigo analisa dados de artigos publicados nos últimos 40 anos nas línguas inglesa, espanhola ou portuguesa nos bancos de dados Lilacs e Medline sobre prevalência de anemia ferropriva na gestação. Em todas as pesquisas verificadas, a prevalência de anemia ferropriva na gestação apresenta valores elevados, o que caracteriza essa situação como um problema de saúde pública para o Brasil, mesmo com as políticas nacionais atuais de combate à deficiência.

Níveis de hemoglobina e prevalência de anemia em gestantes atendidas em unidades básicas de saúde, antes e após a fortificação das farinhas com ferro

“…The results confirmed the increase in the occurrence of anemia with the advance in the gestational period, as observed in several studies, where the prevalences of anemia varied from 3.6% to 23.9% in the first trimester; from 9.2% to 43.9% in the second trimester; and from 10.9% to 52.3% in the third trimester 4 .…”

“…The total prevalences of anemia found in the city of Maringá-PR both before (12.3%) and after (9.3%) flour fortification were lower than the prevalences of 30 to 40% estimated for pregnant women in Brazil 2 and the data established by a review of articles published in the last 40 years 4 . With regard to categories of epidemiological importance, they are classified as mild, a level defined by prevalences of anemia in pre-school children and pregnant women ranging between 5% and 20%, according to the classification proposed by the World Health Organization (WHO) 1 .…”

“…Thus, an alternative to assess interventions is to compare results of prevalence surveys based on baseline data, when such are present in the beginning of the program, to subsequent findings 15 . Considering the fact that studies on the prevalence of anemia among pregnant women in Brazil are restricted to specific populations, thus preventing the generalization of findings 4 , and that the city of Maringá, PR, does not have reference data, a before-and--after study was designed, including two independent groups of pregnant women.…”

“…It is estimated that 52% of pregnant women in developing countries have anemia, whereas this proportion is 23% in developed countries 1 . Although national data are not available, a review of studies that have been published in the last 40 years showed that the prevalence of anemia during pregnancy is high, despite the policies implemented to fight this disease 4 . Recent data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS -National Demographic and Health Survey of Children and Women) 5 showed a reduction in the prevalence of anemia in children aged between six and 59 months, although the same was not observed among non-pregnant women of childbearing age, who had a high rate of anemia, with a prevalence of 29.4% in Brazil and relevant regional differences.…”

Factors associated with iron deficiency in pregnant women seen at a public prenatal care service

“…The National Survey on the Demography and Health of Children and Women reported that 30% of the women of childbearing age are anemic and that there are no national studies with consistent data about the occurrence of anemia in pregnant women 4 . In a review study, Côrtes et al 5 reported that the prevalence of anemia in Brazilian women on the second trimester of pregnancy varies from 9% to 44%.…”