马里孕妇贫血的决定因素。

Determinants of anemia among pregnant women in Mali.

作者信息

Ayoya Mohamed Ag, Spiekermann-Brouwer Gerburg Maria, Traoré Abdel Kader, Stoltzfus Rebecca Joyce, Garza Cutberto

机构信息

Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.

出版信息

Food Nutr Bull. 2006 Mar;27(1):3-11. doi: 10.1177/156482650602700101.

DOI:10.1177/156482650602700101

PMID:16572713

Abstract

BACKGROUND

Anemia in pregnancy remains a major problem in nearly all developing and many industrialized countries. In Mali, the subpopulation prevalence and etiology of anemia during pregnancy are largely unknown.

OBJECTIVE

To examine the prevalence and likely etiologies of anemia in pregnancy in a poor urban population in Bamako, Mali.

METHODS

Pregnant women (n = 190) were selected randomly. Hemoglobin, serum iron, and total iron-binding capacity were measured; blood smears were examined for Plasmodium falciparum malaria; and single stool and urine samples were examined for Schistosoma haematobium and hookworm. Gynecologic examinations were performed and interviews conducted to qualitatively assess food consumption and other socioeconomic characteristics. Associations among mild, moderate, and severe anemia; iron and parasite status; erythrocyte sedimentation rates; and the presence of abnormal vaginal discharge were evaluated. Differences in hemoglobin and serum iron concentrations, total iron-binding capacity, and anemia were compared according to trimester of pregnancy and between infected and noninfected women. The relative and attributable risks of anemia were calculated, and adjusted odds ratios for anemia and low serum iron were estimated by multivariate logistic regression.

RESULTS

Of the 131 women for whom complete data were available, 47% had hemoglobin concentrations below 110 g/L; 13% had serum iron concentrations below 12 micromol/L; none had transferrin saturation values below 16%; 11%, 23%, and 8% harbored P. falciparum, S. haematobium, and hookworm, respectively; and 82% had an abnormal vaginal discharge. Food restrictions were reported by 45% of the women. Abnormal vaginal discharge correlated significantly with anemia (Pearson chi2 = 62.4; p < .01). Univariate and multivariate analyses found that infections were strongly associated with and predictive of anemia.

CONCLUSIONS

Our data suggest that infections and food accessibility contribute to the high rates of anemia during pregnancy in Mali.

摘要

背景

在几乎所有发展中国家和许多工业化国家，孕期贫血仍然是一个主要问题。在马里，孕期贫血的亚人群患病率及病因在很大程度上尚不明确。

目的

研究马里巴马科贫困城市人群孕期贫血的患病率及可能病因。

方法

随机选取190名孕妇。测量血红蛋白、血清铁和总铁结合力；检查血涂片以查找恶性疟原虫；检查单次粪便和尿液样本以查找埃及血吸虫和钩虫。进行妇科检查并开展访谈以定性评估食物摄入情况及其他社会经济特征。评估轻度、中度和重度贫血、铁及寄生虫状况、红细胞沉降率与异常白带之间的关联。根据孕期及感染与未感染女性比较血红蛋白和血清铁浓度、总铁结合力及贫血情况的差异。计算贫血的相对风险和归因风险，并通过多因素逻辑回归估计贫血和低血清铁的调整比值比。

结果

在可获取完整数据的131名女性中，47%的血红蛋白浓度低于110 g/L；13%的血清铁浓度低于12 μmol/L；无人转铁蛋白饱和度值低于16%；分别有11%、23%和8%的人感染恶性疟原虫、埃及血吸虫和钩虫；82%有异常白带。45%的女性报告有食物限制。异常白带与贫血显著相关（Pearson卡方检验=62.4；p<0.01）。单因素和多因素分析发现，感染与贫血密切相关且可预测贫血。