Krupp Karl, Placek Caitlyn D, Wilcox Meredith, Ravi Kavitha, Srinivas Vijaya, Arun Anjali, Madhivanan Purnima
Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA; Public Health Research Institute of India, Mysore, India.
Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA; Ball State University, Muncie, IN, USA.
Midwifery. 2018 Jun;61:15-21. doi: 10.1016/j.midw.2018.02.014. Epub 2018 Feb 20.
According to the World Health Organization, about half of all pregnant women in India suffer from some form of anemia. While poor nutrition is the most common cause, social factors, such as gender and religion, also impact anemia status. This study investigates the relationship between anemia and socioeconomic and health-related factors among pregnant women in Mysore, India.
Prospective cohort study conducted between January 2009 and 2012 SETTING: 144 rural villages ten or more kilometers outside of Mysore City received integrated antenatal care and HIV testing services provided by mobile medical clinic in their communities.
1675 pregnant women from the villages were screened. All women and their infants were then followed up for up to a year after childbirth.
women who provided informed consent underwent an interviewer-administered questionnaire, physical examination by a doctor, and antenatal laboratory investigations including blood test for anemia. Women were followed through pregnancy and 12 months after childbirth to assess mother-infant health outcomes. Anemia was categorised as normal, mild, moderate, and severe, with moderate/severe anemia defined as a hemoglobin concentration of less than 100 g/l.
two out of three pregnant women were anemic at baseline (1107/1654; 66.9%). Of those women, 32.7% (362) had mild anemia, 64.0% (708) had moderate anemia, and 3.3% (37) had severe anemia. Anemia was associated with lower education among spouses (p = 0.021) and lower household income (p = 0.022). Women living in a household where others had control over household decision-making had lower odds of moderate/severe anemia (Adjusted Odds Ratio: 0.602; 95% Confidence Interval: 0.37-0.97) as compared to women who shared decision-making power with others in the household.
Interventions to reduce anemia should focus on education among men and other household decision makers on the importance of nutrition during pregnancy in India.
To our knowledge, this research is one of the first to examine how control of household resources is related to risk for anemia among pregnant women in India. Our data suggests that interventions aimed at reducing anemia may need to address economic factors beyond nutrition and iron status to reduce the burden of anemia among women in developing countries.
根据世界卫生组织的数据，印度约有一半的孕妇患有某种形式的贫血。虽然营养不良是最常见的原因，但社会因素，如性别和宗教，也会影响贫血状况。本研究调查了印度迈索尔孕妇贫血与社会经济及健康相关因素之间的关系。
2009年1月至2012年期间进行的前瞻性队列研究
迈索尔市以外十公里或更远的144个乡村接受了社区流动医疗诊所提供的综合产前护理和艾滋病毒检测服务。
对来自这些村庄的1675名孕妇进行了筛查。然后对所有妇女及其婴儿在分娩后进行了长达一年的随访。
提供知情同意的妇女接受了由访谈员实施的问卷调查、医生的体格检查以及包括贫血血液检测在内的产前实验室检查。对妇女在孕期及分娩后12个月进行随访，以评估母婴健康结局。贫血分为正常、轻度、中度和重度，中度/重度贫血定义为血红蛋白浓度低于100g/l。
三分之二的孕妇在基线时贫血（1107/1654；66.9%）。在这些妇女中，32.7%（362人）患有轻度贫血，64.0%（708人）患有中度贫血，3.3%（37人）患有重度贫血。贫血与配偶教育程度较低（p = 0.021）和家庭收入较低（p = 0.022）有关。与在家庭中与他人共享决策权的妇女相比，生活在他人控制家庭决策的家庭中的妇女患中度/重度贫血的几率较低（调整后的优势比：0.602；95%置信区间：0.37 - 0.97）。
在印度，减少贫血的干预措施应侧重于对男性和其他家庭决策者进行关于孕期营养重要性的教育。
据我们所知，本研究是首批研究家庭资源控制权如何与印度孕妇贫血风险相关的研究之一。我们的数据表明，旨在减少贫血的干预措施可能需要解决营养和铁状况之外的经济因素，以减轻发展中国家妇女的贫血负担。
