Chronic inflammation was a major predictor and determinant factor of anemia in lactating women in Sidama zone southern Ethiopia: A cross-sectional study

Abstract

Anemia in women of reproductive age is highly prevalent globally and remains a public health problem. In Ethiopia, despite efforts to minimize the burden of anemia, it is still a moderate public health problem. Anemia has various etiologies including nutritional deficiency, parasitic infection, and inflammation. The aim of this study was to examine contributing factors to anemia in lactating women. Following ethical approval, and six months after delivery, all lactating women (n = 150) were recruited to participate in this study from eight randomly selected rural villages. Anthropometric and socioeconomic factors were assessed. From each, a blood sample was collected for measuring hemoglobin, iron biomarkers, zinc, selenium, and inflammation markers. The median (IQR) hemoglobin (Hb) was 132 (123, 139) g/ L. Of the women, 19% were anemic and 7% had iron deficiency anemia; 31% were iron deficient and 2% had iron overload. Also, 8% had functional iron deficit, 6% had acute inflammation, 13% had chronic inflammation, and 16% had tissue iron deficiency. The majority (78%) of the women had low plasma zinc out of which more than 16% were anemic. Hb was positively associated with plasma iron and plasma zinc and negatively associated with transferrin receptor (TfR) and α-1-acid glycoprotein (AGP). Plasma iron, AGP, TfR, hepcidin and plasma zinc were significant predictors of maternal anemia. Additionally MUAC and level of education were associated positively with maternal hemoglobin. This study showed that maternal anemia was associated with multiple factors including nutritional deficiencies, inflammation and limited education.

Multiple Indicators of Undernutrition, Infection, and Inflammation in Lactating Women Are Associated with Maternal Iron Status and Infant Anthropometry in Panama: The MINDI Cohort

“…It is the consequence of iron restriction due to inflammation that is mediated by the hepatic release of hepcidin, which blocks intestinal iron absorption and favors retention of iron in macrophages [11]. This increase in serum hepcidin has been used to distinguish anemia of iron deficiency from anemia of inflammation in children [12] and during pregnancy [13], but we are aware of only one other study from Ethiopia on the impact of inflammation on anemia in lactating women [14].…”

The Serological Basis of the Correlation between Iron Deficiency Anemia and Thyroid Disorders in Women: A Community Based Study

“…), and several inflammatory disorders [6]. Among these factors, iron deficiency (ID) has been reported in nearly 50% of all anemia reported worldwide [7]. Tough iron is available in nature, ID is the most common micronutrient deficiency and the leading cause of anemia [8].…”

The impacts of okra consumption on the nutritional status of pregnant women, west Ethiopia

“…This indicated that, as hemoglobin concentration increased, the size of maternal MUAC increased as well (Saaka et al, 2017a ). There is also evidence that indicated that maternal MUAC was positively associated with maternal hemoglobin as well (Gebreegziabher et al, 2020 ). Furthermore, different evidence indicated that high bioavailability of iron was found in different parts of okra (Habtamu et al, 2018 ).…”