Motlagh Mohammad Esmaeil, Nasrollahpour Shirvani Seiyed Davoud, Torkestani Farahnaz, Hassanzadeh-Rostami Zahra, Rabiee Seyed-Mozaffar, Ashrafian Amiri Hassan, Radpooyan Laleh
Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Iran J Public Health. 2019 Feb;48(2):338-344.
Anemia is a common nutritional disorder that is more prevalent in pregnant women than other population groups. This study aimed to assess the frequency of anemia and its association with health care determinants among Iranian pregnant women from provinces with different Maternal Mortality Rate (MMR).
This cross-sectional survey was carried out on 2737 pregnant women referred to public health centers in Iran, 2015. The participants were randomly selected by multistage sampling from six provinces with low, moderate or high MMR. The level of hemoglobin lower than 11 g/dl were defined as anemia in first and third trimester of pregnancy.
The rate of anemia in first and third trimester were respectively 8.2 and 26.7%. The most determinants of anemia among women in both first and third trimester of pregnancy were geographical classes with high MMR, no care before pregnancy, and type of house. Moreover, lower number of previous pregnancies (OR, 0.48; 95% CI, 0.27 to 0.85) and adequate care during pregnancy (OR, 0.66; 95% CI, 0.47 to 0.92) were protected women from anemia and high number of children (OR, 2.07; 95% CI, 1.13 to 3.80) enhanced risk of anemia in first trimester of pregnancy. Moreover, higher body mass index had lower odds of anemia in third trimester.
The rate of anemia is differed in various parts of Iran, and this disorder gets worse in third trimester of pregnancy than first. Strengthening health care programs may be a useful strategies to prevent and control anemia.
贫血是一种常见的营养失调症，在孕妇中比在其他人群中更为普遍。本研究旨在评估伊朗不同孕产妇死亡率（MMR）省份的孕妇贫血发生率及其与医疗保健决定因素的关联。
2015年，对转诊至伊朗公共卫生中心的2737名孕妇进行了这项横断面调查。通过多阶段抽样从六个MMR低、中或高的省份随机选取参与者。妊娠第一和第三阶段血红蛋白水平低于11 g/dl被定义为贫血。
妊娠第一和第三阶段的贫血率分别为8.2%和26.7%。妊娠第一和第三阶段女性贫血的最主要决定因素是MMR高的地理区域、孕前未接受护理以及房屋类型。此外，既往妊娠次数较少（比值比[OR]，0.48；95%置信区间[CI]，0.27至0.85）和孕期接受充分护理（OR，0.66；95% CI，0.47至0.92）可使女性免受贫血影响，而子女数量较多（OR，2.07；95% CI，1.13至3.80）会增加妊娠第一阶段贫血的风险。此外，较高的体重指数在妊娠第三阶段患贫血的几率较低。
伊朗不同地区的贫血率存在差异，这种疾病在妊娠第三阶段比第一阶段更为严重。加强医疗保健项目可能是预防和控制贫血的有效策略。
