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德拉地区孕妇贫血的严重程度及相关因素:埃塞俄比亚西北部的一项横断面研究

Magnitude and associated factors of anemia among pregnant women in Dera District: a cross-sectional study in northwest Ethiopia.

作者信息

Derso Terefe, Abera Zelalem, Tariku Amare

机构信息

Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O.Box:196, Gondar, Ethiopia.

John Snow Integrated Family Health Program, Ethiopia, P.O.Box:1841, Bahirdar, Ethiopia.

出版信息

BMC Res Notes. 2017 Aug 1;10(1):359. doi: 10.1186/s13104-017-2690-x.

Abstract

BACKGROUND

Anemia is associated with adverse health and socio-economic consequences among pregnant women. Particularly, severe anemia increases the risk of maternal mortality by 20%. However, literatures are scarce in the northwest Ethiopia. Therefore, this study aimed to determine the magnitude and associated factors of anemia among pregnant women attending antenatal care in Dera District, South Gondar Zone, northwest Ethiopia.

METHODS

A facility-based cross-sectional study was conducted in Dera District health centers from June 27 to September 2, 2015. Capillary blood samples were taken from 348 pregnant women. The raw measured values of hemoglobin were obtained using the portable Hb301 instrument and adjusted for altitude. Besides, nutritional status of the women was assessed by the mid upper arm circumference (MUAC) taken on non-dominant upper limb, mostly of the left hand. Socio-demographic factors, obstetric history, environmental related factors and dietary intake were collected by interviewing the pregnant women. A multivariate logistic regression analysis was employed to identify factors associated with anemia. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was computed to show the strength of association. In multivariable analysis, a P value of <0.05 was used to declare statistical significance.

RESULTS

The overall prevalence of anemia among pregnant women was 30.5% [95% CI 21.0, 40.0]. The result of multivariable analysis revealed that the likelihood of anemia was higher among pregnant women living in rural areas [AOR = 3.03, 95% CI 1.17, 7.82], had no latrine [AOR = 4.75, 95% CI 1.15, 16.60], low monthly income: <Eth. Birr 1200 (US dollar 52.22) [AOR = 2.56, 95% CI 1.17, 5.60], five or above parity [AOR = 4.17; 95% CI 1.62, 10.69], MUAC < 23 cm [AOR = 4.97; 95% CI 2.61, 9.43] and did not prenatal take iron supplementation [AOR = 5.63; 95% 2.21, 14.32].

CONCLUSION

So far in the district, the magnitude of anemia existed as a moderate public health concern. Thus, improved socio-economic status, latrine and maternal iron supplementation coverage are essential to mitigate the high burden of anemia. In addition, nutritional counseling and education on the consumption of extra meals and iron-rich foods should be intensified.

摘要

背景

贫血与孕妇不良健康状况及社会经济后果相关。特别是,严重贫血会使孕产妇死亡风险增加20%。然而,在埃塞俄比亚西北部,相关文献匮乏。因此,本研究旨在确定埃塞俄比亚西北部南贡德尔区德拉县接受产前护理的孕妇中贫血的严重程度及相关因素。

方法

2015年6月27日至9月2日,在德拉县卫生中心开展了一项基于机构的横断面研究。采集了348名孕妇的毛细血管血样。使用便携式Hb301仪器获取血红蛋白的原始测量值,并根据海拔高度进行调整。此外,通过测量非优势上肢(大多为左手)的上臂中段周长(MUAC)来评估这些女性的营养状况。通过访谈孕妇收集社会人口学因素、产科病史、环境相关因素和饮食摄入情况。采用多因素logistic回归分析来确定与贫血相关的因素。计算调整后的优势比(AOR)及相应的95%置信区间(CI)以显示关联强度。在多变量分析中,P值<0.05被用于判定具有统计学意义。

结果

孕妇贫血的总体患病率为30.5%[95%CI 21.0, 40.0]。多变量分析结果显示,居住在农村地区的孕妇贫血可能性更高[AOR = 3.03, 95%CI 1.17, 7.82],没有厕所[AOR = 4.75, 95%CI 1.15, 16.60],月收入低:<埃塞俄比亚比尔1200(52.22美元)[AOR = 2.56, 95%CI 1.17, 5.60],生育次数达到或超过5次[AOR = 4.17; 95%CI 1.62, 10.69],MUAC<23 cm[AOR = 4.97; 95%CI 2.61, 9.43]以及未在孕期补充铁剂[AOR = 5.63; 95% 2.21, 14.32]。

结论

到目前为止,在该地区,贫血严重程度已成为一个中度的公共卫生问题。因此,改善社会经济状况、提供厕所和提高孕产妇铁剂补充覆盖率对于减轻贫血的高负担至关重要。此外,应加强关于加餐和富含铁食物消费的营养咨询与教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66da/5540297/92ccdc4d9a7c/13104_2017_2690_Fig1_HTML.jpg

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