Volume 6, Issue 2 (Spring 2021)
J Obstet Gynecol Cancer Res 2021, 6(2): 57-64 |
Back to browse issues page
Department of Obstetrics and Gynaecology, Lakshmi Madhavan Hospital, Tamilnadu, India , drmbm25@gmail.com
Abstract: (173 Views)
Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.
Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics and gynaecology department for antenatal care on their first appointment. The diagnosed participants’ knowledge, awareness and management potential about AIP was assessed.
Results: The mean age was 26.9 and 24.2 years in AIP and non-anemia in pregnancy NAIP groups, respectively. First trimester early week’s appointment was 38.3% and 37.6% of AIP and NIAP groups, respectively. AIP compared to parity (χ2 = 3.0739) and gestation age (χ2 = 0.8435) was not significant at P-value<0.05. According to WHO definition, AIP was reported in 49.2% of the study population involving 30.4% of urban and 18.8% of rural population. The knowledge and awareness of pregnant women towards anemia in pregnancy was not significant with eleven predictor’s odds ratio. However, both of the groups, 60.3% of the AIP and 46.2% of the NAIP cases were aware of the anemia-related complications during pregnancy.
Conclusions: First trimester anemia in pregnancy was a prominent health burden in spite of available resources and awareness programmes. There was a sensitization lacunae to rule out the misconception and the belief. A healthy state of mind and practice among women shall be instrumental in bringing about an improved perception of AIP and its prevention.
Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics and gynaecology department for antenatal care on their first appointment. The diagnosed participants’ knowledge, awareness and management potential about AIP was assessed.
Results: The mean age was 26.9 and 24.2 years in AIP and non-anemia in pregnancy NAIP groups, respectively. First trimester early week’s appointment was 38.3% and 37.6% of AIP and NIAP groups, respectively. AIP compared to parity (χ2 = 3.0739) and gestation age (χ2 = 0.8435) was not significant at P-value<0.05. According to WHO definition, AIP was reported in 49.2% of the study population involving 30.4% of urban and 18.8% of rural population. The knowledge and awareness of pregnant women towards anemia in pregnancy was not significant with eleven predictor’s odds ratio. However, both of the groups, 60.3% of the AIP and 46.2% of the NAIP cases were aware of the anemia-related complications during pregnancy.
Conclusions: First trimester anemia in pregnancy was a prominent health burden in spite of available resources and awareness programmes. There was a sensitization lacunae to rule out the misconception and the belief. A healthy state of mind and practice among women shall be instrumental in bringing about an improved perception of AIP and its prevention.
Keywords: |Antenatal Care|Anemia in Pregnancy|Iron deficiency Anemia|Deworm|First trimester anemia. ,
Systematic Review: Original Research |
Subject:
Obstetrics and Gynecology
Received: 2020/08/31 | Accepted: 2021/01/23 | Published: 2021/02/17
Received: 2020/08/31 | Accepted: 2021/01/23 | Published: 2021/02/17
References
1. Chellan R, Paul L. Prevalence of Iron-Deficiency Anemia in India: Results from a Large Nationwide Survey. J Popul Stud Soc Stu. 2010; 19: 1-23.
2. WHO. The Global Prevalence of Anaemia in 2011. Geneva: World Health Organization, 2015.
3. Toteja GS, Singh P, Dhillon BS. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Part 1 Report of ICMR task force study. Food Nutr Bull. 2006; 27:311-15. [DOI:10.1177/156482650602700405] [PMID]
4. WHO. Intermittent iron and folic acid supplementation during pregnancy. Feb 11, 2019. https://www.who.int/elena/titles/intermittent_iron_pregnancy/en/ (accessed Jan 07, 2021).
5. World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System, Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.1) 2011.
6. Puchalski Ritchie LM, Khan S, Moore JE, Timmings C, van Lettow M, Vogel JP, et al. Low- and middle-income countries face many common barriers to implementation of maternal health evidence products. J Clin Epidemiol. 2016; 76:229-37. [DOI:10.1016/j.jclinepi.2016.02.017] [PMID]
7. Benoist Bd, McLean E, Egll I, Cogswell M. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia: World Health Organization; 2008.
8. Petry N, Olofin I, Hurrell R, Boy E, Wirth J, Moursi M, et al. The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries: A systematic analysis of national surveys. Nutrients. 2016; 8 pii: E693. [DOI:10.3390/nu8110693] [PMID] [PMCID]
9. International Institute for Population Sciences. National Family Health Survey (NFHS-4) Mumbai: IIPS; 2016.
10. Ramachandran P, Kalaivani K. Time trends in prevalence of anemia in pregnancy. Indian J Med Res. 2018; 147:268. [DOI:10.4103/ijmr.IJMR_1730_16] [PMID] [PMCID]
11. Strategies to prevent anaemia: recommendations from an Expert Group Consultation, New Delhi, India, 5-6 December 2016. New Delhi: World Health Organization Regional Office for South-East Asia; 2016 (https: //apps. who.int/iris/handle/10665/312109, accessed 07 January 2021).
12. Rai RK, Fawzi WW, Barik A, Chowdhury A. The burden of iron-deficiency anaemia among women in India: how have iron and folic acid interventions fared?. WHO South-East Asia J Public Health 2018; 7: 18-23. [DOI:10.4103/2224-3151.228423] [PMID]
13. Rajaratnam J, Abel R, Ganesan C, Jayaseelan SA. Maternal anaemia: a persistent problem in rural Tamil Nadu. Natl Med J India. 2000; 13(5):242-5.
14. Welch VA, Ghogomu E, Hossain A et al. Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis. The Lancet Global Health. 2017; 5(1): e40-e50. [DOI:10.1016/S2214-109X(16)30242-X]
15. Al-Farsi YM, Brooks DR, Werler MM, Cabral HJ, Al-Shafei MA, Wallenburg HC. Effect of high parity on occurrence of anemia in pregnancy: a cohort study. BMC Pregnancy Childbirth. 2011; 11:7. [DOI:10.1186/1471-2393-11-7] [PMID] [PMCID]
16. Lazovic N, Pocekovac P. The importance of time intervals between childbirth and anemia in pregnancy. Srp Arh Celok Lek. 1996; 124: 307-10.
17. Balarajan Y, Ramakrishnan U, Ozaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. Lancet. 2011; 378 (9809):2123-35. [DOI:10.1016/S0140-6736(10)62304-5]
18. Kapil U, Pathak P, Tandon M, Singh C, Pradhanb R, Dwivedi SN. Micronutrient deficiency disorders amongst pregnant women in three urban slum communities of Delhi. Indian Pediat. 1999; 36(10): 983-89.
19. Sedlander E, Long MW, Mohanty S, et al. Moving beyond individual barriers and identifying multi-level strategies to reduce anemia in Odisha India. BMC Public Health. 2020; 20(1):457. [DOI:10.1186/s12889-020-08574-z] [PMID] [PMCID]
20. Placek CD, Hagen EH. Fetal Protection: The Roles of Social Learning and Innate Food Aversions in South India. Hum Nat. 2015; 26(3):255-76. [DOI:10.1007/s12110-015-9239-2] [PMID]
21. Chatterjee N, Fernandes G. 'This is normal during pregnancy': a qualitative study of anaemia-related perceptions and practices among pregnant women in Mumbai, India. Midwifery. 2014; 30(3):e56-63. [DOI:10.1016/j.midw.2013.10.012] [PMID]
22. Krupp K, Placek CD, Wilcox M, Ravi K, Srinivas V, Arun A, Madhivanan P. Financial decision making power is associated with moderate to severe anemia: A prospective cohort study among pregnant women in rural South India. Midwifery. 2018; 61:15-21. [DOI:10.1016/j.midw.2018.02.014] [PMID] [PMCID]
23. Bentley ME, Griffiths PL. The burden of anemia among women in India. Eur J Clin Nutr. 2003; 57(1):52-60. [DOI:10.1038/sj.ejcn.1601504] [PMID]
24. Randall DA, Patterson JA, Gallimore F, Morris JM, McGee TM, Ford JB; Obstetric Transfusion Steering Group. The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. PLoS One. 2019; 14(11):e0225123. [DOI:10.1371/journal.pone.0225123] [PMID] [PMCID]
25. Vemulapalli B, Rao K. Prevalence of anaemia among pregnant women of rural community in Vizianagaram, North Coastal Andhra Pradesh, India. Asian J Med Sci. 2013; 5:21-25. [DOI:10.3126/ajms.v5i2.5295]
26. Bisoi S, Haldar D, Majumdar TK, et al. Correlates of anemia among pregnant women in rural area of West Bengal. J Fam Welf. 2011; 57:72-78.
27. Shastri L, Pammal RS, Mani I, Thomas T, Kurpad AV. Oxidative stress during early pregnancy and birth outcomes. Public Health Nutr. 2016; 19(17):3210-15. [DOI:10.1017/S1368980016001191] [PMID]
28. Fouelifack FY, Sama JD, Sone CE. Assessment of adherence to iron supplementation among pregnant women in the Yaounde gynaeco-obstetric and paediatric hospital. Pan Afr Med J. 2019; 34:211. [DOI:10.11604/pamj.2019.34.211.16446] [PMID] [PMCID]
29. Daru J, Zamora J, Ferna'ndez-Fe' lix BM, et al. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. Lancet Global Health 2018; 6:e548-e554. [DOI:10.1016/S2214-109X(18)30078-0]