Antelman G, Msamanga G I, Spiegelman D, Urassa E J, Narh R, Hunter D J, Fawzi W W
Departments of Nutrition, Biostatistics and Epidemiology, Harvard School of Public Health, Boston MA, 02115, USA.
J Nutr. 2000 Aug;130(8):1950-7. doi: 10.1093/jn/130.8.1950.
The objective of this cross-sectional study was to identify risk factors for anemia among human immunodeficiency virus (HIV)-positive pregnant women in Dar es Salaam, Tanzania. Baseline data from 1064 women enrolled in a clinical trial on the effect of vitamin supplementation in HIV infection were examined to identify potential determinants of anemia. The mean hemoglobin (Hb) level was 94 g/L, and the prevalence of severe anemia (Hb < 85 g/L) was 28%; 83% of the women had Hb < 110 g/L. Iron deficiency and infectious disease appeared to be the predominant causes of anemia. Significant independent associations with severe anemia were observed for women with body mass index (BMI) < 19 kg/m(2) compared with women with BMI > 24 kg/m(2) [odds ratio (OR) 3.13, 95% confidence interval (CI): 1. 37-7.14); malaria parasite densities > 1000/mm(3) (OR 2.70, CI: 1. 58-4.61) compared with women with no parasites; eating soil during early pregnancy (OR 2.47, CI: 1.66-3.69); CD4+ cell count < 200/microL compared with CD4+ count > 500/microL (OR 2.70, CI: 1. 42-5.12); and serum retinol levels < 70 micromol/L (OR 2.45, CI: 1. 44-4.17) compared with women with retinol levels > 1.05 micromol/L. The most significant risk factors associated with severe anemia in this population are preventable. Public health recommendations include increasing the effectiveness of iron supplementation and malaria management during pregnancy, and providing health education messages that increase awareness of the potentially adverse nutritional consequences of eating soil during pregnancy.
这项横断面研究的目的是确定坦桑尼亚达累斯萨拉姆市感染人类免疫缺陷病毒（HIV）的孕妇贫血的风险因素。对1064名参与维生素补充对HIV感染影响的临床试验的女性的基线数据进行了检查，以确定贫血的潜在决定因素。平均血红蛋白（Hb）水平为94g/L，重度贫血（Hb<85g/L）患病率为28%；83%的女性Hb<110g/L。缺铁和传染病似乎是贫血的主要原因。与体重指数（BMI）>24kg/m²的女性相比，BMI<19kg/m²的女性与重度贫血存在显著独立关联[比值比（OR）3.13，95%置信区间（CI）：1.37 - 7.14]；与无疟原虫的女性相比，疟原虫密度>1000/mm³的女性（OR 2.70，CI：1.58 - 4.61）；孕早期食土的女性（OR 2.47，CI：1.66 - 3.69）；CD4⁺细胞计数<200/μL的女性与CD4⁺细胞计数>500/μL的女性相比（OR 2.70，CI：1.42 - 5.12）；血清视黄醇水平<70μmol/L的女性与视黄醇水平>1.05μmol/L的女性相比（OR 2.45，CI：1.44 - 4.17）。该人群中与重度贫血相关的最显著风险因素是可以预防的。公共卫生建议包括提高孕期铁补充和疟疾管理的有效性，以及提供健康教育信息，提高对孕期食土潜在不良营养后果的认识。
