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Background
The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970’s to 1980’s. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed.
Objective
To define anemia in pregna...
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Determinar las principales complicaciones que experimentan los recién nacidos hijos de madres con trastornos hipertensivos del embarazo atendidas en el Hospital Universitario de Guayaquil, Ecuador.
MATERIALES Y MÉTODOS:
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Citations
... Anemia was de ned as a hemoglobin value of less than 11 g/dL [9]. Hemoglobin responses to IFA supplementation were categorized as either adequate or inadequate [5,10]. ...
Background Iron-folate supplementation is a common recommended strategy for reducing the incidence of anemia in pregnant women. However, studies on the hemoglobin response to iron folate supplementation and factors associated with the effectiveness of the intervention in developing countries, including Ethiopia, are limited. Objective This study aimed to assess the hemoglobin response to iron folate supplementation and associated factors among pregnant women attending public hospitals in Addis Ababa, Ethiopia. Methods A prospective follow-up study was conducted in public hospitals in Addis Ababa between May 1, 2023, and March 30, 2024. A total of 410 participants were selected via systematic random sampling. The data collection methods included participant interviews, medical record reviews, laboratory tests, and anthropometric assessments. Statistical analyses were carried out via SPSS Version 27. Descriptive statistics were used to describe the profile of the study participants. A p value of less than 0.05 was considered statistically significant. Logistic regression analysis was performed, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated to identify significant associations. Results A total of 59.7% of pregnant women exhibited an inadequate hemoglobin response to iron-folate supplementation, and 17% remained anemic despite supplementation. Early ANC booking (AOR = 3.9, 95% CI: 2.4–4.2), iron-folate intake for more than two months (AOR = 2.6, 95% CI: 1.6–4.2), adequate dietary diversity (OR = 3.4, 95% CI: 2.1–5.6), and primiparity (OR = 2.4, 95% CI: 1.4–4.2) were significantly associated with an adequate hemoglobin response. Conclusion The response of hemoglobin to iron-folate supplementation is low. Promoting early antenatal care, prolonged iron-folate supplementation, and ensuring adequate dietary diversity are crucial to improve the hemoglobin response in pregnant women. Efforts to increase awareness and accessibility to these key factors can help reduce the burden of anemia during pregnancy and improve maternal and fetal health outcomes.
... Anemia was de ned as a hemoglobin value of less than 11 g/dL [10]. ...
Background Iron-folate (IFA) supplementation is a well-established strategy for reducing anemia in pregnant women. Studies on the extent to which it reduces maternal anemia, its effect on leukocytes and platelet count are limited and require further investigation. Objective This study aimed to assess effect of iron folate supplementation on maternal hematological parameters among pregnant women in public hospitals in Addis Ababa, Ethiopia. Methods An institution-based prospective follow-up study was conducted in public hospitals in Addis Ababa from May 1, 2023, to March 30, 2024, with 410 participants selected through systematic random sampling. Data collection involved interviews, medical record reviews, and laboratory tests. Statistical analysis was performed using SPSS Version 27, including Shapiro-Wilk test, descriptive statistics, paired sample t-tests, and Wilcoxon signed-rank tests. A p-value of less than 0.05 was considered significant. Results The RBC count significantly increased in both sets of respondents. In non-anemic individuals, it rose from a baseline of 4.51 ± 0.43 to 4.70 ± 0.54 million cells per microliter (P < 0.001), while in anemic respondents, it increased from 4.05 ± 0.37 to 4.23 ± 0.39 million cells per microliter (P < 0.001). Similarly, the platelet count decreased across both groups. In anemic participants, it dropped from 293.3 ± 37.01 to 285.4 ± 37.83 thousand per microliter (P < 0.01), and in non-anemic pregnant women, it declined from 274.9 ± 56.3 to 254.29 ± 59.07 thousand per microliter (P < 0.001). After supplementation, no significant change in leukocyte count was observed in both anemic and non-anemic pregnant women (p = 0.065 and p < 0.059) respectively. Conclusion Iron-folate supplementation significantly increased RBC counts in both anemic and non-anemic pregnant women, with a slight decrease in platelet counts and no change in leukocyte levels. Further research on the effect of iron folate intake on hematological indices is recommended.
... g/dL), moderate (Hb 7-9.9 g/dL) and severe (Hb <7 g/dL) (WHO, 2011). The Center of Disease Control (CDC) defined in detail that Hb level lower than 11 g/dL or Hct level lower than 33% in the first and third trimester of pregnancy and Hb level lower than 10.5 g/dL or Hct level lower than 32% in the second trimester of pregnancy us due to the physiological changes during pregnancy (CDC, 1989;Zofkie et al., 2022). ...
Background: Iron deficiency anemia in pregnant women is a crucial global health problem. Iron deficiency anemia is impacted on health during antenatal, labor and postpartum period. Although the national policy provides the preventive and solving the maternal anemia, the statistics of maternal anemia are still high. Purpose: The aim of the study is to develop a health promotion program that is suitable for maternal anemia. Methods: Qualitative research was used to develop the health promotion program on maternal anemia through in-depth interviews. Ten pregnant women who had hematocrit less than 33 volume percentages or hemoglobin less than 11 g/dl and five healthcare professionals were selected by purposive sampling. A total of fifteen participants were interviewed based on the semi-structured questionnaire for 30-45 minutes per case at the antenatal care clinic, Watbot hospital, Phitsanulok, Thailand. The period of the study was six months from the first of August 2022 until the end of January 2023. Results: Thematic analysis was used to analyze the data and identified three main themes: 1) encouragement the attitude of self-care during pregnancy; 2) accessibility of the program ; and 3) practical use of the program and integrating the program based on the context of pregnant women and healthcare professionals. Conclusion: The health promotion program was developed suitable for maternal anemia. The tailored program should be tested in terms of feasibility, accessibility, and practical use. It will support pregnant women with anemia, develop a key performance index of maternal and child health, decrease risks and complications, and promote maternal and child health based on the various contexts.
... Based on Riskesdas data in 2013, the prevalence of anemia in young women was 23% and it had increased in 2018 by 32%, meaning that 3-4 out of 10 adolescents suffer from anemia. The government's program to administer Blood Supplement Tablets (TTD) to young women aims to reduce the prevalence of anemia which is still high in young women (Zhu et al., 2020;Zofkie et al., 2022). This activity is in the form of giving blood-supplemented tablets for 4 months to young women which must be consumed according to the rules so that young women do not experience iron nutritional anemia. ...
Anemia is a nutritional problem in young women that needs to be prevented and addressed because it will impact the First 1000 Days of Life (HPK) period. Creating functional food products in the form of contemporary drinks that are nutritious and liked by teenagers is very important as an alternative to preventing anemia. Delays in early treatment of anemia have an impact on women experiencing pregnancy, which can cause bleeding complications during childbirth, giving birth to babies with low body weight and stunting. This condition must be treated as early as possible, because anemia in young women can indirectly affect the quality of human resources in the future. The purpose of this study was to find out how the Formulation and Analysis of the Nutritional Content of Millenia (Anti-Anemia Jelly Drink) to Increase Hemoglobin Levels in Young Girls. This type of research is experimental research, using a completely randomized study design consisting of three factors, in this case the researchers used three treatments, namely red guava juice with the addition of moringa leaf jelly and beet jelly using the symbols A1, A2 and A3. In treatment A1, red guava fruit juice, honey, moringa leaf jelly, and beetroot jelly were added at the respective doses of 200 ml, 20 gr, 10 gr, 20 gr. This drink is expected to be a drink that is rich in iron and other nutrients that can increase hemoglobin levels in the blood and is liked by teenagers because it is made like a contemporary drink that is currently a trend
... 1,2,19,20 Consequently, practices to assess anemia often focus on the prevention of severe shorter-term outcomes, such as risks associated with hemorrhage in childbirth, severe maternal morbidity, and mortality. 21 Because iron deficiency is a leading, but not the only, cause of anemia, 4,19 iron deficiency, iron deficiency anemia, and anemia are frequently conflated, which is problematic. Furthermore, the criteria to diagnose iron deficiency, iron deficiency anemia, and anemia varies ( ...
Iron deficiency and the more severe sequela, iron deficiency anemia, are public health problems associated with morbidity and mortality, particularly among pregnant women and younger children. The 1998 Centers for Disease Control and Prevention recommendations for prevention and control of iron deficiency in the United States is old and does not reflect recent evidence but is a foundational reference for many federal, clinical, and program guidelines.
Surveillance data for iron deficiency are sparse at all levels, with critical gaps for pregnant women and younger children. Anemia, iron deficiency, and iron deficiency anemia are often conflated but should not be. Clinical guidelines for anemia, iron deficiency, and iron deficiency anemia give inconsistent recommendations, causing nonsystematic assessment of iron deficiency. Screening for iron deficiency typically relies on identifying anemia, despite anemia’s low sensitivity for iron deficiency. In the National Health and Nutrition Examination Survey, more than 70% of iron deficiency is missed among pregnant women and children by relying on hemoglobin for iron deficiency screening.
To improve assessment and diagnosis and strengthen surveillance, better and more complete data and updated foundational guidance on iron deficiency and anemia are needed that consider new evidence for measuring and interpreting laboratory results. (Am J Public Health. 2022;112(S8):S826–S835. https://doi.org/10.2105/AJPH.2022.306998 )
Importance
Postpartum transfusion is the most common indicator of severe maternal morbidity in the US. Higher rates of anemia are associated with a higher blood transfusion rate.
Objective
To determine if providing, rather than recommending, supplements with iron at prenatal visits in a medically underserved community is associated with improved hematologic indices and reduced blood transfusion.
Design, Setting, and Participants
In this quality improvement study, patients who delivered between May 13 and December 13, 2020, and thus were provided a prenatal supplement with iron throughout pregnancy were compared with those who delivered between January 1 and August 1, 2019, before supplements were dispensed. The study was conducted at Parkland Health, a safety net hospital in Dallas, Texas, with a 95% Medicaid-funded or self-pay population and included all patients who delivered at our institution during the study period with available hematologic data.
Exposures
In the earlier cohort, all patients were recommended to obtain and take iron supplements. In the later cohort, prenatal supplements with iron were dispensed via clinic pharmacy to all patients during prenatal visits.
Main Outcomes and Measures
Maternal hematocrit levels (28-32 weeks, delivery admission, and discharge), rates of anemia (hematocrit <30%), and postpartum transfusion for acute blood loss anemia were compared using χ ² and analysis of variance methods with P < .05 considered significant. The analysis took place in July of 2022.
Results
Overall, 13 910 patients (98%) met inclusion criteria (mean age [SD], 27.9 [6.5] and 27.6 [6.5] years, mean [SD] body mass index at first visit, 29.2 [6.6] and 29.3 [6.6]). Mosty of the patients in both cohorts were of Hispanic ethnicity (76%). Providing iron-containing prenatal supplements was associated with higher average hematocrit levels at all time points including a mean difference of 1.27% (95% CI, 1.13%-1.42%) on admission for delivery, when compared with those who were not directly dispensed iron. Among patients prior to providing supplements, 18% had anemia on admission compared with 11% with iron-containing supplements dispensed (risk ratio [RR], 0.61; 95% CI, 0.56-0.66). Postpartum transfusion for acute blood loss anemia was reduced by one-third in patients after program implementation from 10 per 1000 to 6.6 per 1000 (RR, 0.62; 95% CI, 0.43-0.91).
Conclusions and Relevance
In this quality improvement study, providing supplements with iron to patients at prenatal visits was associated with improved hematocrit levels, rates of anemia, and reduced transfusions unrelated to obstetric catastrophes among a predominantly Medicaid population.
Background:
Few normative longitudinal hemoglobin data are available to estimate the prevalence and risk factors for anemia among a multiethnic United States pregnant population.
Objectives:
The aim of this study was to characterize hemoglobin distributions and prevalence of anemia in a pregnant population receiving care at a large urban medical center.
Methods:
A retrospective medical chart review was undertaken in 41,226 uncomplicated pregnancies of 30,603 pregnant individuals who received prenatal care between 2011 and 2020. Mean hemoglobin concentrations and anemia prevalence in each trimester and incidence of anemia during pregnancy in a subset of 4821 women with data in each trimester were evaluated in relation to self-reported race and ethnicity and other possible risk factors. Risk ratios (RRs) of anemia were determined using generalized linear mixed-effects models. Smoothed curves describing changes in hemoglobin across pregnancy were created using generalized additive models.
Results:
The overall prevalence of anemia was 26.7%. The observed fifth percentiles of the hemoglobin distributions were significantly lower than the United States CDC anemia cutoffs in the second and third trimesters (T3). The RR (95% CI) of anemia were 3.23 (3.03, 3.45), 6.18 (5.09, 7.52), and 2.59 (2.48, 2.70) times higher in Black women than that in White women in each trimester, respectively. Asian women recorded the lowest risk of anemia compared with other racial groups in T3 (compared with White womenRR: 0.84; 95% CI: 0.74, 0.96). Hispanic women presented a higher risk of anemia in T3 than non-Hispanic women (RR: 1.36; 95% CI: 1.28, 1.45). In addition, adolescents, individuals with higher parity, and those carrying multiple fetuses experienced a higher risk of developing anemia in late gestation.
Conclusions:
Anemia was evident in more than one-quarter of a multiethnic United States pregnant population despite current universal prenatal iron supplementation recommendations. Prevalence of anemia was higher among Black women and lowest among Asian and White women.