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参加产前保健的孕妇贫血相关因素:一项基于医疗机构的横断面研究。

Factors associated with anemia among pregnant women attended antenatal care: a health facility-based cross-sectional study.

作者信息

Balcha Wondu F, Eteffa Tola, Tesfu Azimeraw A, Alemayehu Bezawit A, Chekole Fentahun A, Ayenew Asteray A, Gessesse Nigusu A, Getu Alemwork A, Kassahun Eden A, Gezahegn Tigist W, Adugna Kebede F, Nega Amanuel T

机构信息

Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar.

Department of Midwifery, Pawi Health Science College, Pawi.

出版信息

Ann Med Surg (Lond). 2023 Apr 11;85(5):1712-1721. doi: 10.1097/MS9.0000000000000608. eCollection 2023 May.

Abstract

UNLABELLED

Anemia is characterized by a decline in the number or size of red blood cells and Hb concentration, which results in impairment capacity to transport oxygen. It is a major cause of indirect maternal mortality. Anemia is largely preventable and easily treatable, if detected in time; however, it remains one of the leading causes of maternal morbidity and mortality, especially in developing countries. This study aimed to assess factors associated with anemia among pregnant women who attended antenatal care.

METHODS

A health facility-based cross-sectional study was conducted from 1 February 2020 to 2 March 2020 among 420 pregnant women. The data were collected by systematic random sampling technique, entered into a computer using EpiData 3.5, and analyzed using the Statistical Package of Social Sciences 23.0 version. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and a -value of less than 0.05 considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables.

RESULTS

The overall prevalence of anemia was 32.9% (95% CI: 28.6-37.4), and it was higher in rural than urban pregnant women (45 vs. 23%), respectively. In multivariable analysis women who are found in the age group of greater than or equal to 30 years (AOR=3.45, 95% CI=1.22-9.78), rural residency (AOR=3.51, 95% CI=1.92-6.42), low family income (AOR=3.10, 95% CI=1.19-8.08), multiparty (AOR=2.91, 95% CI=1.33-6.38), a short interpregnancy gap (AOR 3.32, 95% CI=1.69-6.53), not taking iron and folate (AOR=4.83, 95% CI=2.62-9.90), third trimester of pregnancy (AOR=3.21, 95% CI=1.25-8.25), poor minimum dietary diversity score (AOR=3.54, 95% CI=1.58-7.95), undernourished (AOR=4.9, 95% CI=2.19-7.64), poor knowledge of anemia (AOR=3.19, 95% CI=1.72-5.93), consumption of coffee always after meal per day (AOR=3.24, 95% CI=1.42-7.42), having a history of irregular menstruation, and antepartum hemorrhage were significantly associated with anemia in pregnant women.

CONCLUSION

This study showed that the prevalence of anemia in pregnant women in this study area was a moderate public health problem. The author suggest emphasizing the education and counseling of women on the advantage of taking the supplemented iron and folic acid. Health care providers should have to advise women to stay for at least 2 years before the next pregnancy to reduce the risk of adverse maternal and infant outcomes. Awareness creation in the community on the utilization of insecticide-treated bed nets is also needed.

摘要

未标注

贫血的特征是红细胞数量或大小以及血红蛋白浓度下降,这会导致氧气运输能力受损。它是孕产妇间接死亡的主要原因。贫血在很大程度上是可预防且易于治疗的,前提是能及时发现;然而,它仍然是孕产妇发病和死亡的主要原因之一,尤其是在发展中国家。本研究旨在评估参加产前检查的孕妇中与贫血相关的因素。

方法

于2020年2月1日至2020年3月2日在420名孕妇中开展了一项基于医疗机构的横断面研究。通过系统随机抽样技术收集数据,使用EpiData 3.5录入计算机,并使用社会科学统计软件包23.0版进行分析。进行双变量和多变量逻辑回归分析,以估计粗比值比和调整后的比值比,95%置信区间以及P值小于0.05被认为具有统计学意义。使用频率表、图表和描述性摘要来描述研究变量。

结果

贫血的总体患病率为32.9%(95%置信区间:28.6 - 37.4),农村孕妇的患病率高于城市孕妇(分别为45%和23%)。在多变量分析中,年龄大于或等于30岁的女性(比值比 = 3.45,95%置信区间 = 1.22 - 9.78)、农村居住(比值比 = 3.51,95%置信区间 = 1.92 - 6.42)、家庭收入低(比值比 = 3.10,95%置信区间 = 1.19 - 8.08)、多胎妊娠(比值比 = 2.91,95%置信区间 = 1.33 - 6.38)、妊娠间隔短(比值比3.32,95%置信区间 = 1.69 - 6.53)、未服用铁剂和叶酸(比值比 = 4.83,95%置信区间 = 2.62 - 9.90)、妊娠晚期(比值比 = 3.21,95%置信区间 = 1.25 - 8.25)、最低饮食多样性得分低(比值比 = 3.54,95%置信区间 = 1.58 - 7.95)、营养不良(比值比 = 4.9,95%置信区间 = 2.19 - 7.64)、对贫血知识了解不足(比值比 = 3.19,95%置信区间 = 1.72 - 5.93)、每天饭后总是喝咖啡(比值比 = 3.24,95%置信区间 = 1.42 - 7.42)、有月经不规律病史以及产前出血与孕妇贫血显著相关。

结论

本研究表明,该研究地区孕妇贫血的患病率是一个中度的公共卫生问题。作者建议强调对女性进行关于补充铁剂和叶酸益处的教育和咨询。医疗保健提供者应建议女性在下一次怀孕前至少间隔2年,以降低母婴不良结局的风险。还需要在社区开展关于使用经杀虫剂处理的蚊帐的宣传活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7969/10205215/ba39346ec3ab/ms9-85-1712-g001.jpg

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