Baig-Ansari Naila, Badruddin Salma Halai, Karmaliani Rozina, Harris Hillary, Jehan Imtiaz, Pasha Omrana, Moss Nancy, McClure Elizabeth M, Goldenberg Robert L
Program in International and Community Nutrition, Room 3252, Myer Hall, One Shields Ave., University of California, Davis, CA 95616, USA.
Food Nutr Bull. 2008 Jun;29(2):132-9. doi: 10.1177/156482650802900207.
Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal morbidity and mortality and to low birthweight.
To determine the prevalence of anemia and the dietary and socioeconomic factors associated with anemia in pregnant women living in an urban community setting in Hyderabad, Pakistan.
This was a prospective, observational study of 1,369 pregnant women enrolled at 20 to 26 weeks of gestation and followed to 6 weeks postpartum. A blood sample was obtained at enrollment to determine hemoglobin levels. Information on nutritional knowledge, attitudes, and practice and dietary history regarding usual food intake before and during pregnancy were obtained by trained interviewers within 1 week of enrollment.
The prevalence of anemia (defined by the World Health Organization as hemoglobin < 11.0 g/dL) in these subjects was 90.5%; of these, 75.0% had mild anemia (hemoglobin from 9.0 to 10.9 g/dL) and 14.8% had moderate anemia (hemoglobin from 7.0 to 8.9 g/dL). Only 0.7% were severely anemic (hemoglobin < 7.0 g/ dL). Nonanemic women were significantly taller, weighed more, and had a higher body mass index. Multivariate analysis after adjustment for education, pregnancy history, iron supplementation, and height showed that drinking more than three cups of tea per day before pregnancy (adjusted prevalence odds ratio [aPOR], 3.2; 95% confidence interval [CI], 1.3 to 8.0), consumption of clay or dirt during pregnancy (aPOR, 3.7; 95% CI, 1.1 to 12.3), and never consuming eggs or consuming eggs less than twice a week during pregnancy (aPOR, 1.7; 95% CI, 1.1 to 2.5) were significantly associated with anemia. Consumption of red meat less than twice a week prior to pregnancy was marginally associated with anemia (aPOR, 1.2; 95% CI, 0.8 to 1.8) but was significantly associated with lower mean hemoglobin concentrations (9.9 vs. 10.0 g/dL, p = .05) during the study period. A subanalysis excluding women with mild anemia found similar associations to those of the main model, albeit even stronger.
A high percentage of women at 20 to 26 weeks of pregnancy had mild to moderate anemia. Pica, tea consumption, and low intake of eggs and red meat were associated with anemia. Women of childbearing age should be provided nutritional education regarding food sources of iron, especially prior to becoming pregnant, and taught how food choices can either enhance or interfere with iron absorption.
在发展中国家，贫血影响着近三分之二的孕妇，会导致孕产妇发病和死亡以及低体重出生。
确定巴基斯坦海得拉巴市一个城市社区环境中孕妇贫血的患病率以及与贫血相关的饮食和社会经济因素。
这是一项对1369名孕妇进行的前瞻性观察性研究，这些孕妇在妊娠20至26周时登记入组，并随访至产后6周。在登记时采集血样以测定血红蛋白水平。训练有素的访谈人员在登记后1周内获取有关营养知识、态度、做法以及孕前和孕期通常食物摄入量的饮食史信息。
这些受试者中贫血（世界卫生组织定义为血红蛋白<11.0 g/dL）的患病率为90.5%；其中，75.0%为轻度贫血（血红蛋白9.0至10.9 g/dL），14.8%为中度贫血（血红蛋白7.0至8.9 g/dL）。只有0.7%为重度贫血（血红蛋白<7.0 g/dL）。非贫血女性明显更高、更重，且体重指数更高。在对教育、妊娠史、铁补充剂和身高进行调整后的多变量分析显示，孕前每天饮用超过三杯茶（调整后的患病率比值比[aPOR]，3.2；95%置信区间[CI]，1.3至8.0）、孕期食用泥土（aPOR，3.7；95%CI，1.1至12.3）以及孕期从不食用鸡蛋或每周食用鸡蛋少于两次（aPOR，1.7；95%CI，1.1至2.5）与贫血显著相关。孕前每周食用红肉少于两次与贫血有微弱关联（aPOR，1.2；95%CI，0.8至1.8），但在研究期间与较低的平均血红蛋白浓度显著相关（9.9对10.0 g/dL，p = 0.05）。一项排除轻度贫血女性的亚分析发现与主要模型有类似关联，尽管关联更强。
妊娠20至26周的女性中很大比例患有轻度至中度贫血。异食癖、饮茶以及鸡蛋和红肉摄入量低与贫血有关。应向育龄妇女提供关于铁的食物来源的营养教育，尤其是在怀孕前，并教导她们食物选择如何增强或干扰铁的吸收。
