Mishra Archana, Marwah Sheeba, Divedi Pragati, Dewan Rupali, Ahluwalia Himani
Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Department of Obstetrics and Gynecology, Rama Medical College and Hospital, Hapur, IND.
Cureus. 2021 Jan 20;13(1):e12802. doi: 10.7759/cureus.12802.
Introduction Anemia in pregnancy is a significant health challenge in India and other developing countries. Various health programs aiming anemia prevention are existing in India for many decades. Despite that, anemia affects more than half of pregnant women. Our objective for performing this study was to evaluate the barriers in the prevention of anemia and to evaluate the perceptions and practices of anemic women towards their condition. Methods A cross-sectional questionnaire-based study, including 210 anemic women, was conducted in a tertiary care center in Delhi, India. In-depth interviews were conducted with 50 participants. Results Our important observations were that anemia was more prevalent in multigravida, and 43.80% of anemic patients were not taking iron supplements at the time of diagnosis. Chronic diseases were associated with 28.2% (n=59) of anemic women. Only 19% (n=40) of women sought antenatal care in the first and second trimester; the rest all booked themselves in the third trimester only. Twenty-two percent (n=48) of women reached our hospital after 36 weeks. Ignorance to anemia symptoms and the importance of consistent intake of the oral iron supplements was seen in 35.2% (n=74). One hundred and sixty-five (74.8%) women accepted that healthcare provider had informed them about iron-rich and high protein diet, but only 47.1% (n=98) actually made dietary modifications. Only 9.5% (n=20) of women were consistent in iron intake. Side effects of iron were reported by 30% (n=64) of women, and 15% (n=32) were intolerant to oral iron. Non-availability, change of residence, and forgetfulness were the main reasons behind non-compliance to oral iron. Conclusion We emphasize motivation for early registration, regular antenatal care, adequate iron supplement supply, and persistent counseling to ensure compliance to iron supplements by the antenatal care provider. Behavior-changing communication is needed at a societal level for antenatal mothers and their families aiming to prevent anemia in pregnancy instead of focussing on treatment.
引言
孕期贫血是印度和其他发展中国家面临的一项重大健康挑战。印度存在各种旨在预防贫血的健康项目已有数十年。尽管如此，贫血仍影响着超过一半的孕妇。我们开展这项研究的目的是评估预防贫血的障碍，并评估贫血女性对自身状况的认知和做法。
方法
在印度德里的一家三级护理中心进行了一项基于问卷调查的横断面研究，纳入了210名贫血女性。对50名参与者进行了深入访谈。
结果
我们的重要观察结果是，贫血在经产妇中更为普遍，43.80%的贫血患者在诊断时未服用铁补充剂。28.2%（n = 59）的贫血女性患有慢性病。只有19%（n = 40）的女性在孕早期和孕中期接受了产前检查；其余的都只在孕晚期才进行登记。22%（n = 48）的女性在36周后才到我院就诊。35.2%（n = 74）的女性对贫血症状以及持续服用口服铁补充剂的重要性一无所知。165名（74.8%）女性表示医护人员已告知她们富含铁和高蛋白的饮食，但只有47.1%（n = 98）的女性实际进行了饮食调整。只有9.5%（n = 20）的女性持续摄入铁。30%（n = 64）的女性报告了铁的副作用，15%（n = 32）的女性对口服铁不耐受。无法获取、居住地变更和遗忘是不遵医嘱服用口服铁的主要原因。
结论
我们强调要激励早期登记、定期产前检查、充足供应铁补充剂，并持续进行咨询，以确保产前护理人员能让孕妇遵医嘱服用铁补充剂。对于产前母亲及其家庭，需要在社会层面进行改变行为的沟通，以预防孕期贫血，而不是只关注治疗。
