Seck Binetou C, Jackson Robert T
University of Maryland, Department of Nutrition and Food Science, 0112 Skinner Building, College Park, MD 20742, USA.
Trans R Soc Trop Med Hyg. 2009 May;103(5):485-92. doi: 10.1016/j.trstmh.2008.11.022. Epub 2009 Feb 8.
Iron (Fe) deficiency and anemia during pregnancy remain highly prevalent in Senegal because of low compliance with Fe supplementation. Improving women's access to supplements may increase compliance. Six prenatal centers in Dakar were randomly assigned to either a control group in which women received routine prenatal visits, including prescriptions to purchase iron/folic acid tablets (IFA) according to the guidelines of the current Senegalese supplementation program (n=112), or to an intervention group in which women received free IFA (n=109) in addition to routine prenatal care. Compliance was assessed 20 weeks after enrollment by pill count and interviews. Hemoglobin, erythrocyte protoporphyrin and serum ferritin were measured at baseline and follow-up. Compliance was 48% and 86% in the control and intervention groups, respectively (P<0.001). After adjustment for confounding, prevalence of anemia was 62% in the control group versus 31% in the intervention group (P<0.001); prevalence of Fe deficiency was 49% and 21% in the control and intervention groups, respectively (P<0.001). Improving access to IFA for pregnant women visiting health centers could dramatically increase their compliance, improve Fe status and decrease the incidence of anemia.
由于铁补充剂的依从性较低，塞内加尔孕期缺铁和贫血现象仍然极为普遍。改善妇女获取补充剂的途径可能会提高依从性。达喀尔的六个产前中心被随机分为两组，一组为对照组，孕妇接受常规产前检查，包括按照塞内加尔当前补充剂计划的指南开具购买铁/叶酸片（IFA）的处方（n = 112）；另一组为干预组，孕妇除接受常规产前护理外，还可获得免费的IFA（n = 109）。入组20周后，通过清点药片数量和访谈评估依从性。在基线和随访时测量血红蛋白、红细胞原卟啉和血清铁蛋白。对照组和干预组的依从性分别为48%和86%（P<0.001）。在对混杂因素进行调整后，对照组贫血患病率为62%，而干预组为31%（P<0.001）；对照组和干预组的缺铁患病率分别为49%和21%（P<0.001）。改善前往健康中心就诊的孕妇获取IFA的途径，可显著提高其依从性，改善铁状态并降低贫血发生率。
