Department of Epidemiology, Columbia University, New York, USA.
Department of Nursing, University of Alberta, Edmonton, Canada.
BMC Pregnancy Childbirth. 2021 May 3;21(1):352. doi: 10.1186/s12884-021-03825-2.
Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. Although there is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a very limited understanding of factors associated with iron consumption among Pakistani pregnant women. Thus, this study aimed to investigate the predictors of iron consumption for at least ≥90 days during pregnancy in Pakistan.
We analyzed dataset from the nationally representative Pakistan Demographic Health Survey 2017-2018. The primary outcome of the current study was the consumption of iron supplementation for ≥90 days during the pregnancy of the last birth. Women who had last childbirth 5 years before the survey and who responded to the question of iron intake were included in the final analysis (n = 6370). We analyzed the data that accounted for complex sampling design by including clusters, strata, and sampling weights.
Around 30% of the women reported consumed iron tablets for ≥90 days during their last pregnancy. In the multivariable logistic regression analysis, we found that factors such as women's age (≥ 25 years) (adjusted prevalence ratio (aPR) = 1.52; 95% CI: 1.42-1.62)], wealth index (rich/richest) (aPR = 1.25; [95% CI: 1.18-1.33]), primary education (aPR = 1.33; [95% CI: 1.24-1.43), secondary education (aPR = 1.34; [95% CI: 1.26-1.43), higher education (aPR = 2.13; [95% CI: 1.97-2.30), women's say in choosing husband (aPR = 1.68; [95% CI: 1.57-1.80]), ≥ five antenatal care visits (aPR =2.65; [95% CI (2.43-2.89]), history of the last Caesarian-section (aPR = 1.29; [95% CI: 1.23-1.36]) were significantly associated with iron consumption for ≥90 days.
These findings demonstrate complex predictors of iron consumption during pregnancy in Pakistan. There is a need to increase the number of ANC visits and the government should take necessary steps to improve access to iron supplements by targeting disadvantaged and vulnerable women who are younger, less educated, poor, and living in rural areas.
在巴基斯坦,铁补充剂被认为是预防和控制妊娠期间贫血的必要策略。尽管有一些关于巴基斯坦妇女缺铁性贫血预测因素的证据,但对于巴基斯坦孕妇铁摄入相关因素的了解非常有限。因此,本研究旨在调查巴基斯坦孕妇至少≥90 天内铁摄入的预测因素。
我们分析了 2017-2018 年全国代表性的巴基斯坦人口健康调查数据集。本研究的主要结局是在最后一次妊娠期间至少≥90 天内服用铁补充剂。在调查前 5 年内最后一次分娩且对铁摄入量问题做出回答的妇女被纳入最终分析(n=6370)。我们通过纳入簇、层和抽样权重来分析考虑复杂抽样设计的数据。
约 30%的妇女报告在最后一次妊娠期间≥90 天服用了铁片剂。在多变量逻辑回归分析中,我们发现妇女年龄(≥25 岁)(调整后的患病率比(aPR)=1.52;95%CI:1.42-1.62))、财富指数(富裕/最富裕)(aPR=1.25;95%CI:1.18-1.33))、接受过小学教育(aPR=1.33;95%CI:1.24-1.43))、接受过中学教育(aPR=1.34;95%CI:1.26-1.43))、接受过高等教育(aPR=2.13;95%CI:1.97-2.30))、妇女在选择丈夫方面的发言权(aPR=1.68;95%CI:1.57-1.80))、≥5 次产前保健就诊(aPR=2.65;95%CI(2.43-2.89))、上次剖宫产史(aPR=1.29;95%CI:1.23-1.36))与≥90 天内铁摄入显著相关。
这些发现表明了巴基斯坦孕妇铁摄入的复杂预测因素。需要增加产前保健就诊次数,政府应采取必要措施,通过针对年轻、受教育程度较低、贫困和居住在农村地区的弱势和脆弱妇女,改善铁补充剂的获取。