Prevalence Of Maternal Anemia Research Articles

Prevalence and Risk Factors for Newborn Anemia in Southwestern Uganda: A Cross-Sectional Study.

The global prevalence of maternal anemia is about 42%, and in sub-Saharan Africa, the prevalence of newborn anemia ranges from 25% to 30%. Anemia in newborn babies may cause complications such as delayed brain maturation and arrested growth. However, there is limited data on the prevalence of newborn anemia and its risk factors in people living in resource-limited settings. We determined the prevalence and risk factors for newborn anemia and its correlation with maternal anemia in southwestern Uganda. This was a cross sectional study of 352 pregnant women presenting to the Mbarara Regional Referral Hospital for delivery. We collected maternal blood in labor and umbilical cord blood from the placental vein. We measured hemoglobin using a point-of-care Hemocue machine. We used summary statistics to characterize the study participants and compared demographic characteristics and outcomes using chi-square, t-test, and Wilcoxon rank sum analyses. We defined newborn anemia as umbilical cord hemoglobin <13 g/dl and measured the relationship between maternal and umbilical cord hemoglobin using linear regression analysis. The prevalence of newborn anemia was 17%. Maternal parity was significantly higher for anemic than nonanemic newborns (3 versus 2, P=0.01). The mean age in years (SD) was significantly lower for participants with umbilical cord hemoglobin <13 g/dl than those ≥13 g/dl (26 years [5.6] versus 28 [6.3], P=0.01). In multivariable linear regression analysis, a 1-point decrease in maternal hemoglobin was associated with a 0.14-point decrease in umbilical cord hemoglobin (P=0.02). Each one-unit increase in parity was associated with a 0.25-point decrease in umbilical cord hemoglobin (P=0.01). Cesarean delivery was associated with a 0.46-point lower umbilical cord hemoglobin level compared with vaginal delivery (P=0.03). We found a significant association between maternal and newborn hemoglobin, underscoring the importance of preventing and correcting maternal anemia in pregnancy. Furthermore, maternal anemia should be considered a risk factor for neonatal anemia.

Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision

Background Maternal anaemia (anaemia in pregnancy, childbirth, and the postpartum period) remains a persistent challenge, particularly in Kano State, Nigeria, which has the highest prevalence of maternal anaemia globally, at 72%. Methods We conducted a qualitative study in Murtala Muhammad Specialist Hospital in Kano State, Nigeria. We aimed to identify factors constraining uptake and provision of maternal anaemia care, exploring perspectives across different stakeholders. We carried out 10 key informant interviews with policymakers and hospital managers, 28 in-depth interviews with healthcare providers and pregnant women using antenatal services and four focus group discussions with pregnant women’s husbands and mothers-in-law. Data were analysed thematically. Results Issues with provision include a lack of provider training and guidelines specific to maternal anaemia and blood transfusion, insufficient staff to meet increasing demand, and inadequate resources. Issues with uptake include the inability to afford informal user fees, distrust in health services and the blood transfusion process, and a lack of understanding of the causes, consequences, and treatment for anaemia, resulting in poor uptake of care and adherence to treatment. Conclusions This study recommends the implementation of standardized guidelines and training sessions to better support healthcare providers in offering quality services and increasing funding allocated to supporting maternal anaemia care. Education initiatives for service users and the public are also recommended to build public trust in health services and to improve understanding of maternal anaemia.

Prevalence and correlates of childhood anemia in the MINA-Brazil birth cohort study.

This study aimed to describe the prevalence and predictors of childhood anemia in an Amazonian population-based birth cohort study. Prevalence of maternal anemia was estimated at delivery (hemoglobin [Hb] concentration < 110 g/L) in women participating in the MINA-Brazil birth cohort study and in their children, examined at ages one, two (Hb < 110 g/L), and five (Hb < 115 g/L). Moreover, ferritin, soluble transferrin receptor, and C-reactive protein concentrations were measured in mothers at delivery and in their 1- and 2-year-old children to estimate the prevalence of iron deficiency and its contribution to anemia, while adjusting for potential confounders by multiple Poisson regression analysis (adjusted relative risk [RRa]). The prevalence 95% confidence interval (CI) of maternal anemia, iron deficiency, and iron-deficiency anemia at delivery were 17.3% (14.0-21.0%), 42.6% (38.0-47.2%), and 8.7% (6.3-11.6)%, respectively (n = 462). At one year of age (n = 646), 42.2% (38.7-45.8%) of the study children were anemic, 38.4% (34.6-42.3%) were iron-deficient, and 26.3 (23.0-29.9) had iron-deficiency anemia. At two years of age (n = 761), these values decreased to 12.8% (10.6-15.2%), 18.1% (15.5-21.1%), and 4.1% (2.8-5.7%), respectively; at five years of age (n = 655), 5.2% (3.6-7.2%) were anemic. Iron deficiency (RRa = 2.19; 95%CI: 1.84-2.60) and consumption of ultra-processed foods (UPF) (RRa = 1.56; 95%CI: 1.14-2.13) were significant contributors to anemia at 1 year, after adjusting for maternal schooling. At 2 years, anemia was significantly associated with maternal anemia at delivery (RRa: 1.67; 95%CI: 1.17-2.39), malaria since birth (2.25; 1.30-3.87), and iron deficiency (2.15; 1.47-3.15), after adjusting for children's age and household wealth index. Anemia continues to be highly prevalent during pregnancy and early childhood in the Amazon. Public health policies should address iron deficiency, UPF intake, maternal anemia, and malaria to prevent and treat anemia in Amazonian children.

Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision

Background: Maternal anaemia (anaemia in pregnancy, childbirth, and the postpartum period) remains a persistent challenge, particularly in Kano State, Nigeria, which has the highest prevalence of maternal anaemia globally, at 72%. Methods: We conducted a qualitative study in Murtala Muhammad Specialist Hospital in Kano State, Nigeria. We aimed to identify factors constraining uptake and provision of maternal anaemia care, exploring perspectives across different stakeholders. We carried out 10 key informant interviews with policymakers and hospital managers, 28 in-depth interviews with healthcare providers and pregnant women using antenatal services and four focus group discussions with pregnant women’s husbands and mothers-in-law. Data were analysed thematically. Results: Issues with provision include a lack of provider training and guidelines specific to maternal anaemia and blood transfusion, insufficient staff to meet increasing demand, and inadequate resources. Issues with uptake include the inability to afford informal user fees, distrust in health services and the blood transfusion process, and a lack of understanding of the causes, consequences, and treatment for anaemia, resulting in poor uptake of care and adherence to treatment. Conclusions: This study recommends the implementation of standardized guidelines and training sessions to better support healthcare providers in offering quality services and increasing funding allocated to supporting maternal anaemia care. Education initiatives for service users and the public are also recommended to build public trust in health services and to improve understanding of maternal anaemia.

Prevalence and influencing factors of anaemia among pregnant women in rural areas of Northwestern China

ObjectivesAnaemia during pregnancy is a significant public health problem that adversely impacts both the mother and foetus. However, the factors influencing maternal anaemia in deprived areas of Northwestern China have not yet been thoroughly investigated. This study aimed to describe the prevalence and potential influencing factors of anaemia among expectant mothers in rural areas of Northwestern China. Study designThis was a cross-sectional survey. MethodsA cross-sectional survey of 586 expectant mothers was conducted to investigate the prevalence of anaemia, prenatal healthcare coverage, dietary diversity and nutrient supplementation intake. The study population was selected from the sample areas using a random sampling method. Data were collected through a questionnaire, and haemoglobin concentrations were measured by a capillary blood test. ResultsThe results show that 34.8% of the study population were anaemic, with 13% having moderate-to-severe anaemia. The results of the regression analysis showed that diet was not significantly associated with haemoglobin concentrations or the prevalence of anaemia. However, regular prenatal healthcare attendance was found to be an important influencing factor for both haemoglobin concentration (β = 3.67, P = 0.002) and the prevalence of anaemia (odds ratio = 0.59, P = 0.011). ConclusionsPregnant women receiving regular prenatal care were less likely to be anaemic; thus, it is essential to implement strategies to improve attendance at maternal public health services to reduce the prevalence of maternal anaemia.

Effect of late antenatal booking on maternal anemia and fetus birth weight on parturients in Enugu, Nigeria: An analytical cross-sectional study.

The benefits of antenatal care are maximized when women book early for care. However, despite these resounding benefits, women still book late, while others do not book at all, resulting in dire feto-maternal consequences. Determine the effect of late prenatal booking on maternal anemia and birth weight in babies of women who delivered in public health facilities in Enugu and deduce the reasons for booking late. A cross-sectional study of two groups of women (235 participants in each group) who delivered in 4 randomly selected hospitals in Enugu. Descriptive statistics were obtained for continuous variables, and frequency and percentages were used for categorical variables. Degree of associations was determined using the Chi-square, the student's t-test, and 2 x 2 table. The prevalence of anemia among women that booked late and early were (69.7%; n = 147) and (50.7%; n = 107) respectively. Women who booked late were two times more likely to have anemia than those who booked early (OR = odds ratio, p = p-value, CI = confidence interval,). Those who booked late were six times more likely to deliver low birth weight babies than those who booked early (OR = 5.934, 95% CI = 1.299-27.119, P = 0.022). Late prenatal booking is associated with a high prevalence of maternal anemia in labor, low mean maternal hemoglobin, and low birth weight compared to those of women who booked early and the reasons for booking late are multifactorial.

Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision.

Maternal anaemia (anaemia in pregnancy, childbirth, and the postpartum period) remains a persistent challenge, particularly in Kano State, Nigeria, which has the highest prevalence of maternal anaemia globally, at 72%. We conducted a qualitative study in Murtala Muhammad Specialist Hospital in Kano State, Nigeria. We aimed to identify factors constraining uptake and provision of maternal anaemia care, exploring perspectives across different stakeholders. We carried out 10 key informant interviews with policymakers and hospital managers, 28 in-depth interviews with healthcare providers and pregnant women using antenatal services and four focus group discussions with pregnant women's husbands and mothers-in-law. Data were analysed thematically. Issues with provision include a lack of provider training and guidelines specific to maternal anaemia and blood transfusion, insufficient staff to meet increasing demand, and inadequate resources. Issues with uptake include the inability to afford informal user fees, distrust in health services and the blood transfusion process, and a lack of understanding of the causes, consequences, and treatment for anaemia, resulting in poor uptake of care and adherence to treatment. This study recommends the implementation of standardized guidelines and training sessions to better support healthcare providers in offering quality services and increasing funding allocated to supporting maternal anaemia care. Education initiatives for service users and the public are also recommended to build public trust in health services and to improve understanding of maternal anaemia.

Determinants and spatial patterns of anaemia and haemoglobin concentration among pregnant women in Nigeria using structured additive regression models

Anaemia which is a condition that describes low haemoglobin (Hb) levels has been recognized as a major public health problem amongst pregnant women in many sub-Saharan African countries including Nigeria. The causes of maternal anaemia which are interconnected and complex vary between countries and can vary within a country. This study aimed to investigate the spatial pattern and identify demographic and socio-economic determinants associated with anaemia amongst Nigerian pregnant women aged 15–49 years using data from the 2018 Nigeria Demographic and Health Survey (NDHS). This study utilized chi-square tests of independence and semiparametric structured additive models to describe the relationship between the presumed factors and anaemia status or Hb level while also taking spatial effects at state level into account. The Gaussian and Binomial distributions were used for Hb level and anaemia status respectively. The overall observed prevalence of anaemia in pregnant women and average Hb level in Nigeria were 64% and 10.4 (SD = 1.6) g/dL respectively while the prevalence of mild, moderate and severe anaemia were 27.2%, 34.6% and 2.2% respectively. Higher education, older age, and currently breastfeeding were associated with higher Hb level. Low education, being unemployed and recently having a sexually transmitted infection were identified as risk factors for maternal anaemia. Body mass index (BMI) and household size had a nonlinear effect on Hb level while BMI and age were nonlinearly related to odds of anaemia. Bivariate analysis indicated that living in rural area, low wealth class, using unsafe water and non-usage of internet were significantly associated with increased risk of anaemia. Maternal anaemia prevalence was highest in the South Eastern part of Nigeria with Imo state producing the highest prevalence of maternal anaemia while Cross River state yielded the lowest prevalence of maternal anaemia. The spatial effects associated with states were significant but unstructured indicating that states in close proximity do not necessarily share similar spatial effects. Hence, unobserved characteristics shared by states in close proximity do not influence maternal anaemia and Hb level. The findings from this study can undoubtedly help in the planning and designing of anaemia interventions that match local conditions taking into consideration the aetiology of anaemia in Nigeria.

Is maternal anemia among tribal women being neglected? A study from Southern Rajasthan.

Poor birth outcomes have been linked to maternal anemia. Tribal women are at higher risk of malnutrition and disease due to sociocultural barriers and poor educational status. The data on the prevalence of maternal anemia and its associated factors among pregnant tribal women are limited. A community-based cross-sectional study was conducted among 429 pregnant tribal women for maternal anemia from August 2021 to June 2022. A structured questionnaire was employed to collect sociodemographic data. The prevalence of anemia was 85.7%, with a mean hemoglobin level of 9.21 ± 1.3 g/dL. On applying WHO 2011 anemia criteria for pregnant women, 25.0% had mild anemia, 73.4% had moderate anemia, and 1.6% had severe anemia. The significant factors associated with anemic condition were household condition, monthly income, and husband's occupation. The higher prevalence of anemia among pregnant tribal women is alarming that necessitates a rethinking of health infrastructure and outreach in tribal dominant areas.

Predictors of Anemia Among Pregnant Women Attending Public Healthcare Facilities in Bengaluru, South India

Background and Aims Anemia in pregnancy leads to poor outcomes. The Indian government has reduced anemia only at a marginal level from 58 in the National Family Health Survey NFHS-3 to 50.4 in the NFHS-4 survey. This study aims to determine the predictors of anemia among pregnant women in the maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin MAASTHI cohort of Bengaluru. This will help provide valuable information to design the appropriate intervention to lower the prevalence of anemia.Method The study was nested in the MAASTHI cohort study in public health facilities in Bengaluru. The present study was a multi-center prospective cohort study. Pregnant women attending health facilities for antenatal care were included in the study after obtaining their written consent. Socio-demographic information obstetric details smoking status and alcohol consumption among participant and their spouse were noted. Social support psychosocial stress and detailed anthropometry were recorded. All eligible pregnant women were asked to undergo a blood hemoglobin and oral glucose tolerance test after the completion of 26 weeks of gestation.Results A total of 2447 study participants with a mean age of 24.28 plusmn 4.07 years were included in the study. The overall prevalence of maternal anemia was 44.4 N 1375. Among them 24 had mild Hb 10ndash10.9 gmdl 15.8 had moderate Hb 7-9.9gmdl and 0.4 had severe anemia Hb lt7gmdl. Multivariate analysis showed that obstetric factors such as parity had a significant association with anemia. In contrast nutrition-related factors such as not consuming iron and folic acid IFA supplements and being underweight were positively associated with anemia.Conclusion Our study found a higher prevalence of maternal anemia during pregnancy in urban Bengaluru. The government should take proactive health promotion initiatives such as effective campaigns and nutrition-specific interventions especially iron supplementation. Integrated dietary interventions such as food fortification with iron and folate and IFA supplementation targeting from childhood to adolescence and reproductive age rather than targeting pregnant women may help to reduce the burden of anemia.

Association of Maternal and Child Anemia With Brain Structure in Early Life in South Africa

Anemia affects millions of pregnant women and their children worldwide, particularly in low- and middle-income countries. Although anemia in pregnancy is a well-described risk factor for cognitive development, the association with child brain structure is poorly understood. To explore the association of anemia during pregnancy and postnatal child anemia with brain structure in early life. This neuroimaging nested cohort study was embedded within the Drakenstein Child Health Study (DCHS), a population-based birth cohort in South Africa. Pregnant individuals were enrolled into the DCHS between 2012 and 2015 from 2 clinics in a periurban setting. Mother-child pairs were assessed prospectively; follow-up is ongoing. A subgroup of children had brain magnetic resonance imaging (MRI) at age 2 to 3 years from 2015 to 2018. This study focused on the 147 pairs with structural neuroimaging and available hemoglobin data. Data analyses were conducted in 2021 and 2022. Mothers had hemoglobin measurements during pregnancy, and a subgroup of children had hemoglobin measurements during early life. Anemia was classified as hemoglobin levels less than 11 g/dL based on World Health Organization guidelines; children younger than 6 months were classified using local guidelines. Child brain volumes of global, subcortical, and corpus callosum structures were quantified using T1-weighted MRI. Linear regression models were used to analyze the associations between maternal and child anemia with child brain volumes, accounting for potential confounders. Of 147 children (mean [SD] age at MRI, 34 [2] months; 83 [56.5%] male) with high-resolution MRI scans, prevalence of maternal anemia in pregnancy was 31.3% (46 of 147; median [IQR] gestation of measurement: 13 [9-20] weeks). Maternal anemia during pregnancy was significantly associated with smaller volumes of the child caudate bilaterally (adjusted percentage difference, -5.30% [95% CI, -7.01 to -3.59]), putamen (left hemisphere: -4.33% [95% CI, -5.74 to -2.92]), and corpus callosum (-7.75% [95% CI, -11.24 to -4.26]). Furthermore, antenatal maternal hemoglobin levels were also associated with brain volumes in the caudate (left hemisphere: standardized β = 0.15 [95% CI, 0.02 to 0.28]; right hemisphere: β = 0.15 [95% CI, 0.02 to 0.27]), putamen left hemisphere (β = 0.21 [95% CI, 0.07 to 0.35]), and corpus callosum (β = 0.24 [95% CI, 0.09 to 0.39]). Prevalence of child anemia was 52.5% (42 of 80; median [IQR] age of measurement: 8.0 [2.7 to 14.8] months). Child anemia was not associated with brain volumes, nor did it mediate the association of maternal anemia during pregnancy with brain volumes. In this cohort study, anemia in pregnancy was associated with altered child brain structural development. Given the high prevalence of antenatal maternal anemia worldwide, these findings suggest that optimizing interventions during pregnancy may improve child brain outcomes.

Konseling Gizi Media Booklet Terhadap Perilaku Pencegahan Anemia Pada Ibu Hamil

Background : Anemia in pregnant women has a bad impact on both mother and fetus, resulting in a long labor process and bleeding, premature fetuses, low weight birth babies, disability and even infant death. Based on the results of Riskesdas in 2018, there was a significant increase in the prevalence of anemia in pregnant women, namely 48.9%, still below the target of achieving indicators in the 2020-2025 Community Nutrition Directorate Activity Action plan to reduce the prevalence of maternal anemia in pregnant women to 42%.Purpose : to determine the influence of providing nutritional counseling on knowledge, attitudes, and efforts to prevent anemia in pregnant women.Methods: quasi experiment with pretest and post-test research designs. The study was conducted in March- April 2021. Data analysis using independent t test.Results: In the Independent t test conducted in both groups on knowledge and attitudes, a p-value value lt; 0.05 was obtained, while for actions, a p-value value of 0.05 was obtained.Conclusion: There are differences in increasing knowledge and attitudes, where the treatment group uses booklet media in an effort to prevent anemia in pregnant women compared to providing just nutritional counseling.

Malaria in pregnancy control and pregnancy outcomes: a decade’s overview using Ghana’s DHIMS II data

BackgroundMalaria in pregnancy control interventions have been implemented through antenatal care services for more than 2 decades in Ghana. The uptake of these interventions has seen steady improvement over the years. This has occurred within the context of decreasing global trends of malaria infection confirmed by decreasing malaria in pregnancy prevalence in Ghana. However, not much is known about how these improvements in interventions uptake and reduction in malaria infection prevalence have impacted pregnancy outcomes in the country. This study aimed at describing trends of maternal anaemia and low birth weight prevalence and uptake of malaria in pregnancy control interventions over the last decade using data from Ghana’s District Health Information Management System (DHIMS II).MethodsData from Ghana’s DHIMS II on variables of interest covering the period 2012 to 2021 was analysed descriptively using Microsoft Excel 365. Results were computed as averages and percentages and presented in tables and graphs.ResultsThe prevalence of maternal anaemia at booking and at term and low birth weight increased marginally from 31.0%, 25.5% and 8.5% in 2012 to 36.6%, 31.9% and 9.5% in 2021 respectively. Severe anaemia prevalence at booking and at term remained under 2% over the study period. Women making at least 4 ANC visits, receiving at least 3 doses of intermittent preventive treatment of malaria and an insecticide-treated net increased from 77.0%, 41.4% and 4.1% in 2012 to 82%, 55.0% and 93.3% in 2021, respectively. Malaria test positivity rate reduced from 54.0% to 34.3% between 2014 and 2021 while women receiving iron and folate supplementation for 3 and 6 months rose from 43.0% and 25.5% to 89.7% and 61.8%, respectively between 2017 and 2021.ConclusionMaternal anaemia and low birth weight prevalence showed marginal upward trends over the last decade despite reduced malaria infection rate and improved uptake of malaria in pregnancy control interventions. There is room for improvement in current intervention implementation levels but the complex and multi-factorial aetiologies of maternal anaemia and low birth weight need urgent investigation and quantification to inform policy and practice.

Intravenous versus oral iron for iron deficiency anaemia in pregnant Nigerian women (IVON): study protocol for a randomised hybrid effectiveness-implementation trial

BackgroundAnaemia in pregnancy is highly prevalent in African countries. High-dose oral iron is the current recommended treatment for pregnancy-related iron deficiency anaemia (IDA) in Nigeria and other African countries. This oral regimen is often poorly tolerated and has several side effects. Parenteral iron preparations are now available for the treatment of IDA in pregnancy but not widely used in Africa.The IVON trial is investigating the comparative effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate standard-of-care for pregnancy-related IDA in Nigeria. We will also measure the implementation outcomes of acceptability, feasibility, fidelity, and cost-effectiveness for intravenous ferric carboxymaltose.MethodsThis is an open-label randomised controlled trial with a hybrid type 1 effectiveness-implementation design, conducted at 10 health facilities in Kano (Northern) and Lagos (Southern) states in Nigeria. A total of 1056 pregnant women at 20–32 weeks’ gestational age with moderate or severe anaemia (Hb < 10g/dl) will be randomised 1:1 into two groups. The interventional treatment is one 1000-mg dose of intravenous ferric carboxymaltose at enrolment; the control treatment is thrice daily oral ferrous sulphate (195 mg elemental iron daily), from enrolment till 6 weeks postpartum.Primary outcome measures are (1) the prevalence of maternal anaemia at 36 weeks and (2) infant preterm birth (<37 weeks’ gestation) and will be analysed by intention-to-treat. Maternal full blood count and iron panel will be assayed at 4 weeks post-enrolment, 36 weeks’ gestation, delivery, and 6 weeks postpartum. Implementation outcomes of acceptability, feasibility, fidelity, and cost will be assessed with structured questionnaires, key informant interviews, and focus group discussions.DiscussionThe IVON trial could provide both effectiveness and implementation evidence to guide policy for integration and uptake of intravenous iron for treating anaemia in pregnancy in Nigeria and similar resource-limited, high-burden settings. If found effective, further studies exploring different intravenous iron doses are planned.Trial registration ISRCTN registry ISRCTN63484804. Registered on 10 December 2020Clinicaltrials.govNCT04976179. Registered on 26 July 2021The current protocol version is version 2.1 (080/080/2021).

Prophylaxis With Iron and Folate Supplementation in Pregnancy; A Health Facility-Based Assessment of Its Role for Prevention of Anaemia at Delivery

Objective: Presumptive Iron and folate supplementation, (IFS), for both healthy and irondeficient pregnant women in developing countries, is aimed to ameliorate the high prevalence of maternal anaemia.1 This may be valuable only in selected women.13 Its role for averting maternal anaemia at delivery is therefore analysed.Methodology: The hospital-based cross-sectional study enrolled 413 ANC attendant parturients, exposed to IFS prior to delivery. Anaemia in pregnancy was classified by specifications of the Indian Council of Medical Research (ICMR) using maternal pre-deliveryhaemoglobin concentrations. Maternal haemoglobin concentrations and differential patterns of exposure to IFS were analysed across various maternal and environmental variables with epi info 3.5.4.Results: Parturients were mostly aged 25-34 years and largely exposed to IFS for ≥ 6 months during pregnancy. Anaemic parturients, (typically defined by lower maternal age), initiated ANC attendance later than non-anaemic parturients. Patterns of maternal anaemia varied insignificantly despite differential patterns of duration of IFS and subjectively assessed degree of compliance. Self-reported full compliance with IFS weakly correlated with higher maternal Hgb concentrations. Mean maternal Hgb concentrations remained consistent with mild anaemia irrespective of duration of IFS.Conclusion: Despite weak correlates between maternal anaemia and degree of compliance, the capacity of IFS to prevent mild, moderate or severe maternal anaemia remains unclear.Recommendation: Indiscriminate IFS for all pregnant women, regardless of their Hgb concentrations, should be reviewed while investigation of factors that may underlie maternal non-response to routine IFS should be prioritized.

Practices of Pica among Pregnant Females and Associated Outcomes in Newborn and Pregnant Women

Aim: To find out the females practicing pica and its effects in newborns. Study Design: Cross-sectional descriptive study Place and Duration of Study: Department of Community Medicine, Kabir Medical College Peshawar from 1st May 2021 to 31st December 2021. Methodology: Three hundred and eighty six pregnant women from 15 to 49 years were enrolled. The WHO standards for new born weight were used to measure normal and underweight babies and associated factors causing anemia and pica practicing among females. A semi-structured questionnaire was used to collect data on socioeconomic conditions, family size, maternal education, parity, gravidity and complication during and after delivery. Results: The prevalence of maternal anemia 73.3% in mothers of aged 15 to 49 years. Antenatal visits, medications used during pregnancy, and intake of non-food (pica) items showed significant results with p&lt;0.05 and showed strong association between maternal factors and newborn weight. Age, ethnicity, socioeconomic status, parity, gravidity, body mass index, history of genetic disorder factors showed non-significant results. Conclusions: The practicing pica and other factors causing anemia cause low birth weight in new born while location or place of living did not affect the weight of the new born. Keywords: Practices, Pica, Pregnant females, Outcome

Prevalence of Maternal Anemia Among Pregnant Women in Golestan Province of Iran in 2020

Background Anemia is one of the most important disorders in the world mostly affecting children and pregnant women. Objective This study aims to assess the prevalence of maternal anemia and its related factors among pregnant women in Golestan Province of Iran. Methods This cross-sectional analytical study was conducted on 1000 pregnant women referred to a comprehensive health center affiliated to Golestan University of Medical Sciences, Golestan, Iran in 2020. Chi-square (x2) and multiple logistic regression analysis were used to find demographic/obstetric factors related to maternal anemia. Results The prevalence of anemia was 18.4%; 19.27% ​​had severe anemia, 63.03% had moderate anemia and 17.7% were with mild anemia. The interpregnancy interval, parity, age of first pregnancy, age of marriage, pregnancy month, history of urinary tract infection, number of medical care, and education had a significant relationship with maternal anemia (P&lt;0.05), but the place of residence and the place to get medical care had no significant relationship with the maternal anemia. Conclusion With increase in the pregnancy month, history of urinary tract infection, low age of marriage, low number of received medical care, and low educational level, the risk of maternal anemia increases. It is important to identify women at risk of anemia and ensure adequate and timely care for them.

Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG).

This overview analyzes the data on the controversial therapy of iron substitution during pregnancy, the diagnosis of iron deficiency anemia and the indication-related therapy, and is the first recommendation issued by the OEGGG on the appropriate therapy. The effects of anemia during pregnancy on postnatal outcomes have been intensively investigated with heterogeneous results. A final scientific conclusion with regards to the “optimal” maternal hemoglobin level is limited by the heterogeneous results of various studies, many of which were conducted in emerging nations (with different dietary habits and structural differences in the respective healthcare systems). The current literature even suggests that there may be a connection between both decreased and increased maternal serum hemoglobin concentrations and unfavorable short-term and long-term neonatal outcomes. In Austria, 67 percent of pregnant women take pharmacological supplements or use a variety of dietary supplements. Clinically, the prevalence of maternal anemia is often overestimated, leading to overtreatment of pregnant women (iron substitution without a medical indication). To obtain a differential diagnosis, a workup of the indications for treatment should be carried out prior to initiating any form of iron substitution during pregnancy. If treatment is medically indicated, oral iron substitution is usually sufficient. Because of the restricted approval and potential side effects, medical indications for intravenous iron substitution should be limited. Intravenous iron substitution without a prior detailed diagnostic workup is an off-label use and should only be used in very limited cases, and women should be advised accordingly.

Effectiveness of antenatal intermittent preventive treatment for malaria with sulphadoxine-pyrimethamine on peripartum outcomes.

Background:Following the World Health Organization (WHO) recommendations for 4-weekly antenatal intermittent preventive treatment of malaria in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP), there is a need to evaluate the drug performance in order to determine their effectiveness as tools in malaria control policy.Objectives:To determine prevalence of cord blood malaria, compliance gap and adverse pregnancy outcomes (anaemia, preterm delivery, spontaneous abortion, intra-uterine foetal death and low birth weight) among antenatal IPTp-SP users compared with non-users.Methods:A cross-sectional analytical study was conducted among consenting 390 participants who were administered a questionnaire, and paired blood samples were collected from the venous blood of participants and neonatal cord immediately after delivery. The participants were categorised as IPTp-SP users and non-users. Adverse pregnancy outcomes were assessed. Neonatal birth weights were also measured within 1 h after delivery. Malaria parasitaemia and anaemia were analysed using standard parasitological and haematological methods of examination. Data were analysed using SPSS version 25 for Windows and p-value of < 0.05 considered significant.Results:Of 390 women, 336 (86.2%) were IPTp-SP users, while 54 (13.8%) were non-users. The compliance gap was 13.8%. Malaria parasitemia in pregnant women (21.7% versus 53.7%; p < 0.001) and their babies (12.2% versus 25.4%; p = 0.002) were observed for IPTp-SP users and non-users, respectively. The prevalence of maternal anaemia was 27(8.0%) in IPTp-SP users and 5 (9.3%) in non-users (p = 0.789). Mean parasite density was reduced in IPTp-SP users than in non-users (p < 0.001). Correlation of birth weight according to their sex showed a weak correlation [correlation coefficient (r) = 0.027; p = 0.736]. Pregnant women with preterm delivery, spontaneous abortion, intra-uterine foetal death, and low birth weight were significantly lower (p < 0.001, for all) in IPTp-SP users compared with non-users.Conclusion:Although the compliance gap was low, IPTp-SP users had significantly better pregnancy and foetal outcomes compared with non-users. Efforts should be intensified towards achieving total compliance in IPTp-SP usage by pregnant women.

IMPACT OF LIPID-BASED NUTRITIONAL SUPPLEMENTATION IN PRIMI-GRAVIDAS AND ITS EFFECT ON MATERNAL, BIRTH AND INFANT OUTCOMES: A RANDOMIZED CONTROLLED TRIAL

OBJECTIVE: To find out the effect of Lipid based nutritional supplement (LNS) on body composition, hematological findings, maternal, birth and infant outcomes in underweight primi-gravidas. METHODS: This single-blinded randomized controlled clinical trial was executed in the tertiary care hospitals of Khyber Pakhtunkhwa province, Pakistan from April 2018 to August 2019. Forty primi-gravidas recruited in the study were randomized into LNS and placebo groups. LNS group received 75 gms of high energy nutritional supplement, named “MAAMTA”, on daily basis from their first antenatal visit till delivery in addition to their conventional antenatal treatment. Fasting blood samples were taken and body composition was measured at baseline visit, 16th week of gestation and post-natally. For the measurement of hematological parameters neonates cord blood was obtained. Data of 36 participants (LNS group n=19; placebo group n=17) were available for final analysis. RESULTS: Majority (n=33/36; 91.7%) had normal vaginal deliveries (n=18/19 in LNS group &amp; n=15/17 in placebo group). Frequency of Cesarean section was 1/19 (5.3%) in LNS group and 2/17 (11.8%) in placebo group. No case of abortion was reported. Mean crown heel length (CHL) was 47.11±2.747 cm in LNS group and 44.24±2.359 cm in placebo group (p=0.002). Mean fronto-occipital circumference was 35.11±1.663 cm and 32.41±7.859 cm in the LNS and placebo groups respectively (p=0.153). No difference was observed between the groups in maternal gestational weight gain per visit, prevalence of maternal anemia, maternal mortality &amp; neonatal birth weight. CONCLUSION: The prenatal use of LNS increases the CHL of the neonates of underweight primi-gravidas.