Anemic Mothers Research Articles

Verbal autopsy of neonatal and infant deaths from Bhavnagar rural and comparison with recent data

Background: Infant deaths from Bhavnagar rural areas were studied by using a verbal autopsy tool.Methods: Community visit based retrospective study of Bhavnagar rural by WHO verbal autopsy questionnaire.Results: Of the 92 deaths analyzed, 59 % (early), 12% (late), and 29% were during the post neonatal period. Male deaths were 55 (60%). The most common immediate causes were infection (39%), birth asphyxia (23%), and hyaline membrane disease (15%). Underlying causes were: maternal illness with feeding problem (45%), prematurity (26%), meconium aspiration syndrome (9%), and congenital/genetic anomalies (10%). Infant and neonatal deaths were seen more with illiteracy of mother, age of mother (25-29 years), third parity, anemia, and vaginal discharge; and non-breastfed, low birth weight and preterm. Birth asphyxia and hyaline membrane disease were during early, and meningitis and pneumonia were after the neonatal period. Verbal autopsy was accurate in 18/23 (78%) of the facility-based deaths where the cause of death was available. Ethics approval was obtained.Conclusions: Reproductive health education to adolescent girls and mothers, regarding the treatment of fever, vaginal discharge; and breastfeeding counselling with vitamin B12 should be used as more infant deaths are associated with anemia of mother. Health workers should be skilled in neonatal resuscitation, prematurity management, and referral, after stabilization, identification of congenital anomaly, antenatal screening by USG, and neonatal metabolic screen. Recent 2018 data obtained from Bhavnagar District Health Authority shows that over a period of eight years, institutional deliveries have increased and home deliveries, early neonatal deaths, HMD, and septicemia have decreased. Perinatal care should be check-list based, monitored, and mentored.

A Comparative Study to Assess the Knowledge and Practice Regarding Antenatal Diet among Anaemic and Non Anaemic Antenatal Mothers in Selected Antenatal Clinics at Vijayapur in a View to Prepare Guideline Sheet

A Comparative Study to Assess the Knowledge and Practice Regarding Antenatal Diet among Anaemic and Non Anaemic Antenatal Mothers in Selected Antenatal Clinics at Vijayapur in a View to Prepare Guideline Sheet

Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections.

Gestational IDA has been linked to adverse maternal and neonatal outcomes, but the impact of iron supplementation on outcome measures remains unclear. Our objective was to assess the effects of gestational IDA on pregnancy outcomes and compare outcomes in pregnancies treated with either oral or intravenous iron supplementation. We evaluated maternal and neonatal outcomes in 215 pregnancies complicated with gestational IDA (Hb<100g/L) and delivered in our tertiary unit between January 2016 and October 2018. All pregnancies from the same period served as a reference group (n=11,545). 163 anemic mothers received oral iron supplementation, and 52 mothers received intravenous iron supplementation. Gestational IDA was associated with an increased risk of preterm birth (10.2% vs. 6.1%, p=0.009) and fetal growth restriction (FGR) (1.9% vs. 0.3%, p=0.006). The gestational IDA group that received intravenous iron supplementation had a greater increase in Hb levels compared to those who received oral medication (18.0g/L vs. 10.0g/L, p<0.001), but no statistically significant differences in maternal and neonatal outcomes were detected. Compared to the reference group, prematurity, FGR, postpartum infections, and extended hospital stays were more common among mothers with gestational IDA, causing an additional burden on the families and the healthcare system.

Maternal anemia – an important determinant of low birth weight babies – An observational study from central India

Introduction: A baby’s weight at birth is a strong indicator of maternal and newborn health and nutrition. Among the various factors affecting the birth weight, anemia during pregnancy still has been found to have a significant effect on weight as well as maturity of the baby.1 Objective: Present study is an attempt to find out the impact of corrected maternal anemia on the perinatal outcome, assessed in terms of birth weight and gestational age in comparison to babies born to mothers with anemia during pregnancy and at the time of delivery. Materials and Methods: Total 144 pregnant women of 20±4 weeks of gestation with singleton pregnancy attending OPD of Department of Obstetrics & Gynaecology from January 2015 to December 2015 were enrolled in our study. Antenatal mothers with hemoglobin level between 7–10 gm% constituted our study group, and were supplemented with hematinics. Perinatal outcome in terms of birth weight and gestational age was assessed in babies of mother with improved anemia and compared with babies delivered to mother with moderate anemia at the time of delivery. Results: Out of 144 registered~63.8% women had moderate anemia, which constituted our study group. On supplementation with hematinics to these antenatal mothers, improvement in mean hemoglobin was reported to be from 8.4 gm% to 11.4 gm%. On comparing Perinatal outcome of this group with babies of anaemic mother, there was statistically significant increase in low birth weight babies of 27.8% (p< 0> Conclusion: Anemic mothers are at increased risk of delivering low birth weight babies, which again is an important determinant of survival and quality of life of a child. Positive impact of improvement of maternal anemia on birth weight of babies can be considered as an effective antenatal intervention taken to improve health of our newborns and their mothers. Keywords: Maternal anemia, Perinatal outcome, Premature and low birth weight babies.

Impacts of Eating Behaviors of Pregnant and Lactating Women on the Nutritional Status of Children under 6 Months in the Lake-Chad Region

Background: Malnutrition causes real problems, especially for the survival and growth of children on the one hand and for the health of pregnant and lactating women on the other.&#x0D; Purpose: The purpose of our study is to evaluate the impact of pregnant and lactating women's eating behaviors on the nutritional status of children under 6 months in the Lake Chad Region.&#x0D; Methods: A cross-sectional, descriptive and analytical study of 380 patients including 106 pregnant women 137 lactating women and 137 children under 6 months of age identified in few hospitals and health centers in the Lake Chad Region was conducted from October 1 to November 30, 2017, using a questionnaire administered to pregnant and lactating women after their consent. The 24-hour recall and the frequency of consumption of the food groups allowed us to evaluate the food intake of the surveyed women. The nutritional status of mothers and children was assessed by anthropometric and biochemical measures. The data was analyzed using the SPSS version 20 software. The Chi-square test allowed us to establish the correlations between the different variables at a significance level set at 5%.&#x0D; Results: This study found that only 8.5% and 10.9% of pregnant and lactating women respectively had satisfactory dietary diversity scores. The exclusive breastfeeding rate was 11.7% and the immediate initiation rate for breastfeeding after delivery was 50.4%. The children had 19% wasting, 31.4% stunting, 34.3% underweight and 56.4% anemia. Respectively, 34% and 29% of pregnant and lactating women were malnourished; 17% and 10.2% were at risk of malnutrition, with 60.6 % and 50% prevalence of anemia respectively.&#x0D; Conclusion: The modifiable factors that significantly influenced the nutritional status of children were: maternal feeding behaviors such as low dietary diversity scores and daily meals lack of hygiene and sanitary follow-up, underweight and presence of children anemia in mothers.

Analysis of Transitional Milk of Post-Natal Cases in Non-Anaemic Mothers and Its Comparison With Anaemic Mothers in Rural Western Uttar Pradesh.

Aim: Present study is aimed at determining the analysis of transitional milk of post-natal non-anaemic mothers and its comparison with anaemic mothers in rural Uttar Pradesh.Methods: Totally, 132 post-natal cases were enrolled for the study. After taking ethical committee approval, breast milk samples were collected from day 4 to 11. We measured the following important parameters in breast milk (fat, density, carbohydrates, solid not fat [SNF], protein and added water). Data were analysed by using SPSS-24 software (IBM Corp., Armonk, NY). Tests used in our study were the analysis of variance (ANOVA) test, Chi-square test and independent T-test.Result: In our study, it was found that severe anaemia causes significant changes in fat, lactose and protein content of breast milk. We found that there are no significant changes in breast milk composition with age. Our study shows statistically no association between residence and breast milk content.Conclusion: As the severity of anaemia increases, protein and fat content in breast milk decreases, lactose content on the contrary follows a reverse relationship with maternal haemoglobin. Maternal anaemia not only affects the macronutrients in breast milk but also decreases the density of breast milk.

Effect of maternal nutritional status on children nutritional status in India

• The risk of anaemia in children was 77% in 2005–06 and increased to 92% in 2015–16 among anaemic mothers. • In India, prevalence of malnutrition among children is higher among underweight mothers. • The risk of anaemia in children is higher among anaemic mothers. The focus of the United Nations Sustainable Development Goal 2 is to prevent all forms of malnutrition by 2030. In India, anaemia affects half of the pregnant women, adolescent girls and children. Anaemia puts women at higher risk of morbidity, mortality, postpartum haemorrhage, and poor birth outcomes such as preterm birth and low birth weight due to weak intrauterine growth. This study assessed the relationship between maternal nutritional status on children nutritional status in India. We used two rounds of National Family Health Survey (NFHS III & IV) data from women aged 15–49 years and their children age of 6–59 months for the study. The prevalence of anaemia in children was higher among younger, not educated, rural, poorest, currently breastfeeding and anaemic mothers compared to their counterparts in NFHS-III and IV. After controlling selected mothers' and children background characteristics, the results showed that 77% of higher odds (OR = 1.77, p < 0.001, 95% CI:1.68–1.85) and 92% (OR = 1.92, p < 0.001, 95% CI:1.88–1.95) of higher odds of anaemic children among those who were born to anaemic mothers in NFHS-III and IV respectively. Similarly, prevalence of stunted, underweight and wasted children was higher among underweight, not educated, rural and extremely poorest mothers in both the rounds of survey. After controlling for selected mothers’ and children background characteristics, underweight mothers were more likely to have stunted, underweight and wasted children of 18% (OR = 1.18, p < 0.001, 95% CI:1.12–1.23), 57% (OR = 1.57, p < 0.001,95% CI:1.50–1.65) and 57% (OR = 1.57, p < 0.001, 95% CI: 1.49–1.66) in NFHS-III and 22% (OR = 1.22, p < 0.001, 95% CI:1.19–1.25) 64% (OR = 1.64, p < 0.001, 95% CI: 1.60–1.67) and 40% (OR = 1.40, p < 0.001, 95% CI: 1.11–1.19) in NFHS-IV. For effective resource allocation and utilization, the anaemic women and children should be the focus of targeted interventions for policy makers and programmers to address nutritional deficiencies to achieve Sustainable Development Goals in India.

Socioeconomic determinants of anaemia in preschool children in Uttar Pradesh: evidence from NFHS-4 survey

Background: In India, 89 million preschool children (6-59 months) suffer from anaemia. As per NFHS-4, the prevalence of anaemia in Uttar Pradesh was 63.2%. A study was undertaken to estimate the prevalence of anaemia among preschool children and to examine rural-urban differentials and association of socioeconomic determinants with anaemia. The secondary data of the National Family Health Survey-4 conducted in the year 2015-16 was used.Methods: The prevalence of anaemia was calculated and chi-square test and binary logistic regression was carried out to identify the association between anaemia status and socioeconomic factors.Results: Results show that 78% and 77% children in 12-23 months age group were anaemic in urban and rural areas respectively. Around 72% and 65% children whose mothers had no formal education were anaemic in urban and rural areas respectively. Around 73% of children belonging to poorest wealth index in urban areas and 64% belonging to poorer wealth index in rural areas were anaemic. Around 70% children whose mothers had anaemia were anaemic in both urban and rural areas of the state.Conclusions: The association between anaemia in preschool children and different socioeconomic variables was profound. Educational status of mother and anaemia in mothers have a significant role in reduction of anaemia. The socioeconomic conditions of households, education level of mothers and their anaemia status need to be improved to reduce anaemia in preschool children in Uttar Pradesh and it requires immediate attention of planners and policy makers.

The relationship between maternal anemia and umbilical cord oxygen content at delivery

Anemia is one of the most commonly diagnosed comorbidities in pregnancy and is known to increase the risk of obstetrical complications. However, little is known about the effect of anemia on placental oxygen transfer and fetal oxygenation. This study examined the relationship between maternal anemia and fetal oxygenation status at delivery as measured by umbilical cord partial pressure of oxygen. This is a secondary analysis of a prospective cohort study of singleton term deliveries with universal admission complete blood count and umbilical cord gases between 2010 and 2014. Maternal anemia was defined as hemoglobin of ≤10 g/dL on admission. The primary outcomes were umbilical artery and vein partial pressure of oxygen; the secondary outcomes were acidemia (umbilical artery pH of <7.1), hypoxemia (umbilical artery or umbilical vein partial pressure of oxygen at the <5th percentile), and hyperoxemia (umbilical artery/umbilical vein partial pressure of oxygen at the >90th percentile). Outcomes were compared between patients with and without anemia. Maternal anemia was associated with a significantly higher umbilical artery partial pressure of oxygen (median [interquartile range], 20 [16-24] vs 19 [15-24] mm Hg; P=.01) and umbilical vein partial pressure of oxygen (median [interquartile range], 30 [25-36] vs 29 [23-34] mm Hg; P<.01). Neonates born to anemic mothers were more likely to have umbilical vein hyperoxemia (15.7% vs 10.9%; adjusted odds ratio, 1.51; 95% confidence interval, 1.26-1.81) with no difference in umbilical artery hyperoxemia. There was no difference in the rates of umbilical artery or umbilical vein hypoxemia. Although maternal anemia was associated with a significant difference in umbilical artery pH (7.28±0.060 vs 7.27±0.065; P<.01), there was no difference in the rate of neonatal acidemia between groups (1.6% vs 1.9%; adjusted odds ratio, 0.93; 95% confidence interval, 0.55-1.55). Umbilical cord oxygen content is higher in anemic mothers. Maternal anemia may lead to adaptations in maternal, placental, and fetal physiology, allowing for easier unloading ofoxygen to the placenta and increased oxygen transfer to the fetus.

Prevalence and risk factors of childhood anemia in Nepal: A multilevel analysis.

IntroductionAnemia is a common problem in children particularly in developing countries and taking steps to tackle it is one of the major public health challenges for Nepal. The objective of this study is to investigate the prevalence of individual, household and community level determinants of childhood anemia in Nepal.MethodsData was taken from a nationally representative sample of 1,942 Nepalese children aged from 6–59 months. The Chi-square test was used to determine the bivariate relationship between the selected variables and childhood anemia and a multilevel logistic regression model with a random intercept at household and community level was used to identify important determinants of this kind of anemia.ResultsThe results showed that 52.6% (95% CI: 49.8%-55.4%) of the children were anemic while 26.6% (95% CI: 24.0%-29.3%) of them were moderate to severe. The prevalence of overall anemia was higher among children aged less than 11 months as well as in underweight children, children of underweight, anemic and uneducated mothers and those in the terrain ecological regions. Multivariable analysis showed that children aged less than 11 months, who were underweight and had anemic mothers were more likely to have moderate or severe anemia. Children in the hilly ecological region were less likely to have it compared to mountain and terrain ecological regions. Children in middle-class families and children of mothers who completed secondary education were more likely to have anemia.ConclusionNepal is facing a serious public health problem due to the high prevalence of childhood anemia. This adverse situation occurs due to socio-demographic and geographical factors such as age, malnutrition status, mother’s anemia status, socio-economic status and regional variations. Prevention of childhood anemia should be given top priority in Nepal and should be considered as a major public health intervention.

Assessment of Cord Blood Hemoglobin and Serum Ferritin Levels in Newborns of Anemic and Non Anemic Mothers in Children and Maternity Minia University Hospital

Assessment of Cord Blood Hemoglobin and Serum Ferritin Levels in Newborns of Anemic and Non Anemic Mothers in Children and Maternity Minia University Hospital

Tele-follow up of anemic ANC Mother; subjective and objective correlation of anemia and potential improvement: Case report study

Tele-follow up of anemic ANC Mother; subjective and objective correlation of anemia and potential improvement: Case report study

Correlation of Maternal Anemia with Sonographic Placental Thickness

Anemia is a condition in which hemoglobin (Hb) concentration and/or red blood cell (RBC) numbers are lower than normal and insufficient to meet an individual’s physiological needs, it affects roughly one-third of the world’s population. Objective: To correlate the maternal anemia with placental thickness ultrasonographically . Methodology: Toshiba Nemio17 with Convex array transducer 3-5 MHz frequency was used. Patient were in spine position. Measurements of placental thickness were performed in the mid portion of the placenta, perpendicular to its long axis. The study was conducted at Gillani Ultrasound Centre and Mansoorah Teaching Hospital Lahore. Data of 110 patients was collected through cross-sectional, analytical study. Convenient Sampling Technique was used to analyze data. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Results: Out of 110 patients 44.5% patients were in 2 nd trimester and 55.5% patients were in their 3 rd trimester. In our study 26.4% patients had normal hemoglobin, 43.6% patients were diagnosed with moderate anemia and 30% patients were diagnosed with mild anemia. Hemoglobin rates varied between 7 g/dL to 15.40 g/dL. Placental thickness varied between 10.50mm and to 56.50mm. 9 patients had normal placental thickness, 89 had thick placenta and 12 had thin placenta. In 2 nd trimester minimum placental thickness was noted 15.7 mm and maximum placental thickness was 47.2 mm. In 3 rd trimester minimum placental thickness was noted as 10.5 mm and maximum thickness 56.5 mm. In normal placental thickness minimum hemoglobin was noted as 7 g/dL and maximum was 15.5 g/dL. In thick placenta minimum hemoglobin noted was; 7.8 g/dL and maximum hemoglobin was 15.4 g/dL. In thin placental thickness minimum hemoglobin was 8.9 g/dL and maximum was 11.2 g/dl. Majority patients came with hemoglobin rates between 8 to 11 (g/dL) and less than 5 patients came with hemoglobin 7 g/dL. In patients with mild anemia mean placental thickness was 30.57 mm. In patients with moderate anemia had mean placental thickness of 33.72 mm and in patients with normal anemia had mean placental thickness of 30.39 mm. Out of 110 patients, 29 had no anemia and from these 3 patients were found with normal placental thickness 4 with thick placenta and 2 were with thin. 81 patients who were diagnosed with anemia had normal placental thickness in 6 patients, 65 had thick placenta and 10 patients were found with thick placenta. Conclusion: We concluded that, maternal anemia has adverse effects on placental thickness and gestational age. In the present study we found that morphological and histological changes in placenta of anemic mother is undertaken, to study the effects of anemia on morphology of placenta and fetal outcomes. Keywords: Ultrasound (US), anemia, placenta, placental thickness DOI: 10.7176/JHMN/81-02 Publication date: October 31 st 2020

A correlative study between maternal hemoglobin concentration during third trimester and fetal birth weight of babies born at Kathmandu Medical College and Teaching Hospital

Background: Anemia is one of the commonest health problems faced by pregnant women in both developing and developed countries. Maternal anemia is a potential risk factor for fatal outcomes like low birth weight and preterm delivery. This study intended at comparing the birth weight of the babies who were born to mothers with and without anemia during the third trimesters.&#x0D; Materials and methods: This study is a descriptive, cross-sectional study conducted at Kathmandu Medical College, Teaching Hospital from July 2019 to June 2020. The third-trimester hemoglobin of mothers was recorded along with the birth weight of their respective babies. Mothers with regular antenatal care visits at this hospital were included and the known causes for anemia like renal disorders, twin pregnancies, and others were excluded from the study. The third-trimester hemoglobin level of all pregnant females was correlated with the birth weight of the babies.&#x0D; Results: Out of a total of 2417 pregnant women, 317 (13%) had anemia. The overall prevalence of low birth weight was 12%. Out of 317 anemic mothers, 99 (31%) delivered low birth weight babies. Among those 99 low birth weight babies, 30 (30%) were preterm and 69 (70%) were term babies with the prevalence of low birth weight in anemic mothers being 31%. The correlation between maternal hemoglobin and birth weight was found to be statistically significant.&#x0D; Conclusions: Despite regular antenatal care, maternal anemia still prevails, affecting neonatal birth weight. There was a statistically significant correlation between maternal hemoglobin and birth weight (p-value &lt;0.0001).

Anaemia and its determinants among young children aged 6-23 months in Ethiopia (2005-2016).

Anaemia in children remains a significant public health threat. Recent numbers from Ethiopia showed that more than two‐thirds of children under the age of 2 years were anaemic. This study aimed to investigate the determinants of anaemia throughout Ethiopia over 11 years, making use of the Ethiopian Demographic and Health Survey (EDHS) rounds 2005, 2011 and 2016. The EDHS made it possible to use data on blood tests and detailed questionnaires among infants and young children. Multivariable logistic regression was applied to assess the association of anaemia and different immediate and underlying determinants. A total of 7,324 children aged 6–23 months were included in the analysis, with prevalences of anaemia being 71% in 2005, 61% in 2011 and 72% in 2016. The following determinants were significantly associated with childhood anaemia throughout the entire period: children younger than 1 year, anaemic mothers and those growing up in pastoralist regions. Risk factors such as diet and infections were consistently not significantly associated with anaemia. Given the tremendous adverse health effects of anaemia in young children, urgent action is needed. Hence, this study recommends nationwide multisectoral interventions targeting pastoralist regions, maternal and child health, screening and treatment of risk groups that could reduce the prevalence of anaemia.

Effect of Anemia on Pregnancy Outcome in Labour Ward: Study in a Tertiary Level Public Hospital

Objectives: To determine the pregnancy outcome among anemic women admitted in labour ward of a tertiary level hospital.&#x0D; Methodology: This is a descriptive type of cross-sectional study. All women who were admitted at labour room for delivery with anemia and gestational age more than 28 weeks were included with purposive sampling under the GU-3 of Shaheed Suhrawardy Medical College &amp; Hospital. Respondents were recruited on the basis of clinical findings correlating with lab investigation. Blood samples were collected during the time of admission and hemoglobin (Hb) level were tested by automated machine in the laboratory of ShSMCH. Outcome of pregnancy was observed against the anemic state defined by Hb% done in laboratory. The mother who delivered, intra-partum &amp; post-partum observation up to 7 days were made for pregnancy outcome.Results: This study conducted in a tertiary level public hospital, included 100 pregnant anemic mothers admitted at labor ward. Prevalence of anemia was 30.12% among the pregnant women at delivery. It revealed that women went into labor having mild anemia in 77% and moderate anemia in 23% cases. Importantly it was observed that moderate anemia was found more in younger age group. Additionally, it was also more pronounced (&gt;50%) among the illiterate and primary education group. There was significant inverse relationship between educational status (p =.003) and anemia. Regarding family history, about two thirds anemic mother came from nuclear family and they also lives with small members. Most of the multigravida women presented with moderate anemia. Among the moderately anemic mothers’ interval of pregnancy were less than two years. It has been observed that 60.9% moderate anemic mother was not on regular antenatal checkup and total 11% respondents had no antenatal checkup. Regarding maternal outcome preterm labour (PTL), premature rupture of membrane (PROM), wound infection were more among moderately anemic group. There was significant relationship between degree of anemia with birth weight (p=.014). Adverse fetal outcome like prematurity, NICU admission, IUD were found more among moderately anemic mothers.&#x0D; J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 155-160

Prevalence of anaemia and associated factors in pregnant women admitted in a tertiary care health institute of Jaipur, Rajasthan

Introduction: Anaemia is a global health related major public health problem among pregnant women, specially affecting developing countries like India. In pregnant women it is a major contributing factor of maternal mortality and perinatal mortality. Objectives: 1. To find out prevalence of Anaemia in pregnant women of Jaipur. 2. To find out prevalence of Low Birth Weight newborns, Still births and Cesarian Section. 3. To find out various socio-demographic factors and their association with anaemia of pregnancy. Materials and Methods: All pregnant women, who were admitted for delivery in Jaipur National University, Institute for Medical Sciences and Research Centre, Jaipur, Rajasthan during the study period of 1st January 2018 to 31 December 2018. Sampling Method and Sample Size: Study sample was calculated by complete enumeration technique and, 1227 admitted cases of delivery were selected for study. Results: Total 64.72% of pregnant women were suffering from anaemia. Mild anaemia was 29.50%, Moderate anaemia in 34.55%, and Severe anaemia was observed in 0.65% of pregnant women. Total 67.67% Hindu pregnant women were anaemic while only 60.40% Muslim pregnant women were found to be anaemic. Among the anaemic mothers, 21.92% had newborn birth weight less than 2 kg, 24.05% had birth weight 2-2.5 kg and 54.03% had birth weight more than 2.5 kg weight. 50.88% delivered normally and 47.60% underwent LSCS. 1.52% had stillbirth among anaemic pregnant women. Conclusion: Improved dietary practices, consumption of locally available iron rich foods and a balanced diet, and effective national programme will go a long way in preventing iron deficiency in pregnant women. Keywords: Anaemia, LSCS, Still birth, Pregnant women.

Maternal Anaemia in Pregnancy: A Significantly Greater Risk Factor for Anaemia in Australian Aboriginal Children than Low Birth Weight or Prematurity.

To identify maternal and perinatal risk factors associated with childhood anaemia. A retrospective cohort studywas conducted in three remote Katherine East Aboriginal communities in Northern Territory, Australia. Children born 2004-2014 in Community A and 2010-2014 in Community B and C, and their respective motherswere recruited into the study.Maternal and child datawere linked to providea longitudinal view of each child for the first 1000 days from conception to 2-years of age. Descriptive analyses were used to calculate mean maternal age, and proportions were used to describe other antenatal and perinatal characteristics of the mother/child dyads. The main outcome was theprevalence of maternal anaemia in pregnancy and risk factors associated with childhood anaemia at age 6months. Prevalence of maternal anaemia in pregnancy was higher in the third trimester (62%) compared to the first (46%) and second trimesters (48%). There was a strong positive linear association (R2 = 0.46, p < 0.001) between maternal haemoglobin (Hb) in third trimester pregnancy and child Hb at age 6months. Maternal anaemia in pregnancy (OR 4.42 95% CI 2.08-9.36) and low birth weight (LBW, OR 2.62, 95% CI 1.21-5.70) were associated with an increased risk of childhood anaemia at 6months of age. This is the first study to identify the association of maternal anaemia with childhood anaemia in the Australian Aboriginal population. A review of current policies and practices for anaemia screening, prevention and treatment during pregnancy and early childhood would be beneficial to both mother and child. Our findings indicate that administering prophylactic iron supplementation only to children who are born LBW or premature would be of greater benefit if expanded to include children born to anaemic mothers.

Determinants of infant mortality in Sierra Leone: applying Cox proportional hazards model

PurposeThe aim of this paper is to examine biological, maternal and socioeconomic determinants of infant mortality in Sierra Leone.Design/methodology/approachIt uses an analytical framework and Cox proportional hazards regression to break down the effects of factors determining infant mortality. Factors utilized in the empirical investigation include sex of the child, birth size, birth spacing, mother's working status, age of mother, antenatal care, postnatal care, mother's anemia level, religion, mother's education and wealth status.FindingsResults suggest that birth spacing of three years and above associated with a reduced risk of infant mortality contrasted with short birth intervals. Children born to nonanemic mothers have a lower hazard (22%) of infant mortality compared to those born to anemic mothers (HR = 0.78; 95% CI: 0.64–0.96). At least one antenatal care visit by mothers lowers infant mortality rate by 41% compared to no antenatal visits at all ( HR = 0.59; 95% CI: 0.36–0.96). Similarly, infants whose mothers have received postnatal care are at lower risk (31%) of dying than those whose mothers have not received (HR = 0.69; 95% CI: 0.52, 0.93). Infant mortality is likely to decrease with the increase in the birth order.Practical implicationsThe family health and planning programs should aim at educating men and women about the usefulness of birth spacing methods.Originality/valueThis paper might be the first attempt to analyze the determinants of infant mortality by utilizing a methodological framework and Cox regression.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2019-0478.

Gross morphological changes of placenta associated with maternal anemia

Introduction: – Placenta is a feto-maternal organ composed of maternal component, decidua basalis, and a fetal component, chorion frondosum. The intra-uterine survival of the fetus is dependent on this vital organ. Aim: – The main aim of this study is to compare the macro architectural changes of placenta associated with maternal anemia in Dessie Referral Hospital, Northeast Ethiopia. Methods: A comparative cross sectional method was conducted from May-June, 2018 at Dessie Referral Hospital. A total of 96 placentas (48 anemic and 48 non-anemic) was collected after delivery at labor room. EPI data version 4.2.0 was used to enter the data and analyzed by SPSS version 24. One way ANOVA and independent sample t- test was used to compare the mean differences of the groups. Results: In pregnancies with maternal anemia, mean placental weight was 544±98 g and in non- anemic mother’s it was 502±93 g (p=0.03). The mean birth weight in anemic group was 2502±360 g and in non-anemic group 3035±305 g (p&lt;0.001). The mean number of cotyledons, was 13.5±1.8 and 17.6±1.1, (p&lt;0.001) in anemic and non-anemic groups, respectively. There was a significant difference in mean placental diameter of anemic 18±1.5 cm and 17±1.5 cm in non-anemic mothers (p&lt;0.001). Conclusions: Placenta was larger in anemic mothers than non-anemic mothers with amplify in mean placental weight, thickness and diameter. It was larger in weight, diameter and thickness in mild and moderate anemic but smaller in severe anemic mothers than non-anemic mothers. Maternal anemia was associated with decrease in number of cotyledons and birth weight of fetus