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Assessment of pregnant women knowledge about iron deficiency anemia at obstetrics and gynecology hospital in Holly Karbala Governorate
Abstract
Anemia which is associated with poor maternal and perinatal outcome, is the most common medical disorder and a risk factor in pregnancy causing 20-40% of maternal deaths directly or indirectly through cardiac failure, preeclampsia, antepartum hemorrhage, postpartum hemorrhage and puerperal sepsis. The study was aimed to assess knowledge of pregnant women about iron deficiency anemia at obstetrics and gynecology hospital in Karbala city and to find out the associations between Knowledge Levels and their Socio-Demographic and clinical Data. An accidental sample (N= 85) of pregnant women who attended the obstetrics and gynecology hospital in Karbala city for receiving antenatal care was included in the study. The questionnaire utilized in data collection include; socio-demographic and clinical data, obstetric and health history and knowledge assessment, to assess the Knowledge of pregnant women regarding to Iron deficiency anemia. The findings indicated that the level of knowledge was moderate among pregnant women. The majority of participants (49.4%) have a High Knowledge and minority of them (24.7%) were of Poor Knowledge and 25.9% had fair Knowledge .The study concludes that the majority of pregnant women in Karbala city have moderate knowledge regarding iron deficiency anemia.
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Background
Anaemia in pregnancy is the leading cause of maternal morbidity and mortality and poor birth outcomes in low- and middle-income countries. The most common cause of anaemia during pregnancy is acute blood loss and iron deficiency due to physiological changes and increasing demand for iron on the mother and growing foetus. Iron and folic acid supplementation is the most widely employed strategy to alleviate iron deficiency anaemia during pregnancy. The mother’s knowledge of anaemia and the benefit of iron–folic acid is crucial in reducing the magnitude of anaemia due to iron deficiency. In Woldia town, despite the efforts made to reduce iron deficiency anaemia during pregnancy, information on pregnant mother knowledge on anaemia and the benefit of iron–folic acid and its associated factors are scarce.
Methods
A facility-based cross-sectional study design was conducted, on 414 pregnant mothers attending antenatal care in Woldia town, Northern Ethiopia. Systematic random sampling methods were used to select study participants. The data were entered into Epi-data version 4.2 and analysed using SPSS version 24. Bivariable and multivariable analysis was done to see the association between the dependent variable and independent variables.
Results
This study revealed that 54.1% and 57.7% of pregnant women had good knowledge of anaemia and the benefit of iron–folic acid, respectively. Maternal education status (AOR = 2.19, 95% CI 1.32–3.64), good knowledge of iron–folic acid (AOR = 5.85, 95% CI 3.60–9.50) and residence (AOR = 5.43, 95% CI 2.36–12.51) were statistically associated with pregnant mothers knowledge on anaemia. Obtained counselling on the benefit of iron–folic acid (AOR = 2.04, 95% CI 1.11–3.75), having four or more antenatal care visit (AOR = 3.12, 95% CI 1.38–7.07) and good knowledge of anaemia (AOR = 5.88, 95% CI 3.63–9.50) was statistically associated with pregnant mothers knowledge on the benefit of iron–folic acid.
Conclusions
Promoting frequent antenatal care visits and giving counselling on the benefit of iron–folic acid and cause, prevention and treatment of anaemia were essential strategies to raise knowledge of pregnant mother on anaemia and the benefit of iron–folic acid.
BACKGROUND: In pregnancy, several physiological changes occur that lead to decrease in the level of hemoglobin. Anemia during pregnancy is a major public health concern in underdeveloped nations, with a high rate of morbidity and death among pregnant women. Inadequate prenatal care, a lack of information about the nutritional requirements of pregnant women, and general low socioeconomic circumstances all contribute to these high rates of morbidity and death. As pregnant women’s and husbands’ education levels increased, the frequency and severity of anemia decreased in the investigated community of pregnant women. AIM: This study aims to find out the level of knowledge about anemia in pregnancy among adult females attending primary health care centers (PHCCs) and to find out if there is any association between sociodemographic characteristics of adult females and knowledge about anemia in pregnancy. METHODS: A cross-sectional study with analytic component conducted in four PHCCs in Al-Adhamiya Health District during a period of 4 months from December 1, 2020, to April 1, 2021. It included 400 females aged between 18 and 45 years attending the selected PHCCs for any complaint. The data had been collected through the distribution of well-designed questionnaire including two parts: Participants’ sociodemographic characteristics and knowledge parts. RESULTS: In this study, overall knowledge score of the participants about anemia in pregnancy showed that 60% had fair knowledge. There were statistically significant associations between knowledge score and age of females, marital status, educational level, occupation, and parity. CONCLUSION: The majority of Iraqi adult females have fair and acceptable levels of knowledge about anemia in pregnancy. Younger age, being single, low educational level, unemployed, and low parity were associated with worst level of knowledge.
The nurse has an important role caring for the patient infected with the coronavirus disease (COVID- 19). It is an infectious disease caused by the SARS-CoV-2 virus. The virus can spread from the mouth or nose of an infected person in small liquid particles when they cough, sneeze, speak, sing, or breathe. These particles range from larger respiratory droplets to smaller aerosols. It is important to practice respiratory etiquette, for example coughing into a flexed elbow, and to stay home and self-isolate until you recover if you feel unwell. Most people infected with the virus will experience mild to moderate respiratory illness and will recover without requiring special treatment. Older people and people with underlying medical conditions such as cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illnesses. The goal of the research is to propose the best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 meter away from others, wearing a well-fitting mask, and washing your hands or using an alcohol-based rub frequently.
Back ground: Anemia affects 1.62 billion people (24.8%), among which 56 million are pregnant women. It is a major public health problem particularly among poorer segments of the population in developing countries where 95% of the world anemic pregnant women are residing. Anemia is one of the most commonly encountered medical disorders during pregnancy. According to WHO estimates, up to 56% of all women living in developing countries are anemic. Objective: The objective of the study was to assess the knowledge and practice regarding Prevention of anemia among pregnant mothers attending ANC in Governmental hospitals at west shoa zone, Ethiopia.Method: Hospital based cross sectional study was employed in three public hospitals found in West Shewa Zone to find out the level of knowledge and practice regarding prevention of anemia dung pregnancy among women attending ANC. A total of 286 pregnant mothers were interviewed by using pretested structured questionnaire from three hospitals. Simple random sampling procedure was carried out to attain the required sample size. Data was entered and processed in to the computer using SPSS version 20. Results: A total of 286 pregnant women were participated on the study. Among them only 57.3% and 50% were found to have good knowledge and poor practice respectively regarding prevention of anemia during pregnancy. Crude and adjusted odds ratio done revealed that educational status, living in urban, having nuclear family type, previous history of anemia and good practice were significantly associated with knowledge, while educational status and having good knowledge also found to be significantly associated with prevention of anemia during pregnancy.Conclusions: Based on study findings, half of the study participants attending ANC at West Shoa Zone Governmental Hospitals have Poor Knowledge and poor skills regarding prevention of anemia during pregnancy. Multiple factors such as education, residency, having nuclear type of family and previous anemia history found to affect knowledge and practice regarding prevention of anemia during pregnancy significantly. Therefore, Policy makers would be better consider those factors contributed in prevention of anemia during pregnancy.
Background
Anemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which varies by age, sex, altitude, smoking, and pregnancy status. The study aim is to determine the prevalence and factors associated with anemia among pregnant women attending a hospital in southern Ethiopia using a structured interview administered questionnaire.
Methods
Facility-based cross-sectional study was conducted from March 01–April 30 2015 at Butajira General Hospital, Ethiopia. A total of 217 women responded to the questionnaire and provided blood and stool samples for analysis. Data were analyzed using Statistical packages for social sciences version 20 for windows.
Result and conclusions
The overall burden of anemia in this study was 27.6%. Residence, ANC follow up, history of excess menstrual bleeding and interpregnancy interval were statistically associated with anemia among the pregnant women. Therefore, working in the identified gaps could reduce the current burden of anemia among pregnant women in the study area.
Background The aim of this study was to determine the relationship between maternal anemia during pregnancy and pregnancy outcomes. Materials and Methods This systematic review was conducted in domestic (Sid, Iran.doc, Iran medex and Magiran) and international (PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer, Embase, Google scholar) databases from January 1, 1990 to April 10, 2016 with using standard key words "Pregnancy", "Pregnant women", "Hemoglobin/ haemoglobin", "Anemia/ anaemia", and "Pregnancy outcome". Relative risks (RR) and confidence intervals were extracted from each study. Results Overall 30 studies with a total sample size of 1,194,746 were entered into the final meta-analysis. Maternal anemia in the first trimester showed a significant relationship with low birth weight (RR: 1.28, 95% CI, 1.10 - 1.50, P0.05) and pre-term birth (RR: 1.55, 95% CI, 0.83 - 2.88, P>0.05). Conclusion Maternal anemia during pregnancy in the first trimester in particular can be considered as a risk factor for pregnancy outcomes and must be treated as an advance.
According to the World Health Organization (WHO), anemia is the most common disease, affecting > 1.5 billion people worldwide. Furthermore, iron deficiency anemia (IDA) accounts for 50% of cases of anemia. IDA is common during pregnancy and the postpartum period, and can lead to serious maternal and fetal complications. The aim of this report was to present the experiences of a multidisciplinary expert group, and to establish reference guidelines for the optimal diagnosis and treatment of IDA during pregnancy and the postpartum period. Studies and guidelines on the diagnosis and treatment of IDA published in Turkish and international journals were reviewed. Conclusive recommendations were made by an expert panel aiming for a scientific consensus. Measurement of serum ferritin has the highest sensitivity and specificity for diagnosis of IDA unless there is a concurrent inflammatory condition. The lower threshold value for hemoglobin (Hb) in pregnant women is <11 g/dL during the 1st and 3rd trimesters, and <10.5 g/dL during the 2nd trimester. In postpartum period a Hb concentration <10 g/dL indicates clinically significant anemia. Oral iron therapy is given as the first-line treatment for IDA. Although current data are limited, intravenous (IV) iron therapy is an alternative therapeutic option in patients who do not respond to oral iron therapy, have adverse reactions, do not comply with oral iron treatment, have a very low Hb concentration, and require rapid iron repletion. IV iron preparations can be safely used for the treatment of IDA during pregnancy and the postpartum period, and are more beneficial than oral iron preparations in specific indications. © 2015, Turkish Society of Obstetrics and Gynecology. All rights reserved.
Iron requirements are greater in pregnancy than in the nonpregnant state. Although iron requirements are reduced in the first trimester because of the absence of menstruation, they rise steadily thereafter; the total requirement of a 55-kg woman is ≈1000 mg. Translated into daily needs, the requirement is ≈0.8 mg Fe in the first trimester, between 4 and 5 mg in the second trimester, and >6 mg in the third trimester. Absorptive behavior changes accordingly: a reduction in iron absorption in the first trimester is followed by a progressive rise in absorption throughout the remainder of pregnancy. The amounts that can be absorbed from even an optimal diet, however, are less than the iron requirements in later pregnancy and a woman must enter pregnancy with iron stores of ≥300 mg if she is to meet her requirements fully. This is more than most women possess, especially in developing countries. Results of controlled studies indicate that the deficit can be met by supplementation, but inadequacies in health care delivery systems have limited the effectiveness of larger-scale interventions. Attempts to improve compliance include the use of a supplement of ferrous sulfate in a hydrocolloid matrix (gastric delivery system, or GDS) and the use of intermittent supplementation. Another approach is intermittent, preventive supplementation aimed at improving the iron status of all women of childbearing age. Like all supplementation strategies, however, this approach has the drawback of depending on delivery systems and good compliance. On a long-term basis, iron fortification offers the most cost-effective option for the future.
Anaemia is the most common haematological disorder seen in pregnancy. Early recognition and effective management will help to reduce adverse maternal and fetal outcomes.
Purpose:
Iron supplementation is associated with side effects and overload risk. We compared different regimens of iron supplementation on maternal hematological status and pregnancy outcome in a cohort of healthy pregnant women.
Materials and methods:
Eighty non-anemic women with a normal singleton pregnancy were recruited at 11-13 weeks and randomized into controls (C; n = 20) and groups supplemented with ferrous iron 30 mg (FI; n = 20), liposomal iron 14 mg (Sideral® Pharmanutra, Pisa PI, Italy) (LI14; n = 20) and liposomal iron 28 mg/daily (LI28; n = 20) up to 6 weeks post-partum. Longitudinal maternal blood samples for iron markers were collected. Data on birth outcome were recorded. The treatment effect was evaluated using a mixed-effect regression model.
Results:
Both LI28 and LI14 groups showed significantly higher hemoglobin and ferritin concentrations compared with controls. Birth weight showed a trend to increase with supplementation, resulting in higher birth weight in the LI28 group compared with controls (3499 ± 464.1 g and 3092 ± 469.5 g, respectively, p < 0.01).
Conclusions:
Our data show the effectiveness of 28 mg and 14 mg LI on maternal anemia prevention, as previously reported with FI 40 mg. LI has similar effects of higher doses of ferrous iron on maternal hematological parameters, thus allowing to reduce iron doses and side effects.
Anaemia affects roughly a third of the world's population; half the cases are due to iron deficiency. It is a major and global public health problem that affects maternal and child mortality, physical performance, and referral to health-care professionals. Children aged 0-5 years, women of childbearing age, and pregnant women are particularly at risk. Several chronic diseases are frequently associated with iron deficiency anaemia-notably chronic kidney disease, chronic heart failure, cancer, and inflammatory bowel disease. Measurement of serum ferritin, transferrin saturation, serum soluble transferrin receptors, and the serum soluble transferrin receptors-ferritin index are more accurate than classic red cell indices in the diagnosis of iron deficiency anaemia. In addition to the search for and treatment of the cause of iron deficiency, treatment strategies encompass prevention, including food fortification and iron supplementation. Oral iron is usually recommended as first-line therapy, but the most recent intravenous iron formulations, which have been available for nearly a decade, seem to replenish iron stores safely and effectively. Hepcidin has a key role in iron homoeostasis and could be a future diagnostic and therapeutic target. In this Seminar, we discuss the clinical presentation, epidemiology, pathophysiology, diagnosis, and acute management of iron deficiency anaemia, and outstanding research questions for treatment.
Copyright © 2015 Elsevier Ltd. All rights reserved.
Anemia is a common problem in obstetrics and perinatal care. Any hemoglobin (Hb) below 10.5 g/dl can be regarded as true anemia regardless of gestational age. Main cause of anemia in obstetrics is iron deficiency, which has a worldwide prevalence between estimated 20 and 80% of especially female population. Stages of iron deficiency are depletion of iron stores, iron-deficient erythropoiesis without anemia and iron-deficiency anemia, the most pronounced form of iron deficiency. Pregnancy anemia can be aggravated by various conditions such as uterine or placental bleedings, gastrointestinal bleedings and peripartum blood loss. Beside the general consequences of anemia, there are specific risks during pregnancy for the mother and the fetus such as intrauterine growth retardation, prematurity, feto-placental miss-ratio and higher risk for peripartum blood transfusion. Beside the importance of prophylaxis of iron deficiency, main therapy options for the treatment of pregnancy anemia are oral iron and intravenous iron preparations.
Micronutrient status during pregnancy influences maternal and fetal health, birth outcomes, and the risk of chronic disease in offspring. Research reporting dietary intake during pregnancy in nationally representative population samples, however, is limited. This review summarizes the micronutrient intakes of pregnant women from developed countries and compares them with relevant national recommendations. A systematic search without date limits was conducted. All studies reporting the micronutrient intakes of pregnant women were considered, irrespective of design. Two authors independently identified studies for inclusion and assessed methodological quality. Nutritional adequacy was summarized, with confounding factors considered. Meta-analysis data are reported for developed countries collectively, by geographical region, and by dietary methodology. Pregnant women in developed countries are at risk of suboptimal micronutrient intakes. Folate, iron, and vitamin D intakes were consistently below nutrient recommendations in each geographical region, and calcium intakes in Japan were below the Japanese recommendations and the average intake levels in other developed countries. Research examining the implications of potential nutrient insufficiency on maternal and offspring health outcomes is needed along with improvements in the quality of dietary intake reporting.
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