Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
BMC Pregnancy Childbirth. 2024 Jan 5;24(1):39. doi: 10.1186/s12884-023-06169-1.
Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria.
In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA.
Iron deficiency was observed among 41% (95%CI: 38 - 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 - 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 - 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 - 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 - 2.82).
About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.
怀孕期间贫血会对妇女和胎儿造成不良后果，包括贫血性心力衰竭、早产和宫内生长受限。缺铁性贫血（IDA）是贫血的主要原因，怀孕期间广泛推荐口服铁补充剂。然而，人们对饮食摄入的关注较少。本研究估计了尼日利亚拉各斯和卡诺州孕妇中 IDA 的发生率，并研究了中度或重度 IDA 孕妇的相关危险因素（包括饮食因素）。
在这项横断面研究中，对 20-32 周妊娠的 11582 名妇女进行了贫血筛查。其中 872 名患有中度或重度贫血（血红蛋白浓度<10g/dL）的妇女被纳入本研究。缺铁定义为血清铁蛋白水平<30ng/mL。我们描述了样本的社会人口学和产科特征及其对常见食物消费的自我报告。我们进行了单变量和多变量逻辑回归分析，以确定与 IDA 相关的危险因素。
在中度或重度贫血的妇女中，41%（95%CI：38-45）存在缺铁，并且随着妊娠周数的增加，患病率也增加。与不食用绿叶蔬菜的孕妇相比，每 2-3 周食用一次绿叶蔬菜的孕妇发生 IDA 的几率降低，aOR：0.36（95%CI：0.13-0.98）；与不食用绿叶蔬菜的孕妇相比，每天食用绿叶蔬菜的孕妇发生 IDA 的几率降低，aOR：0.26（95%CI：0.09-0.73）。与不食用食用性高岭土的孕妇相比，每日食用食用性高岭土的孕妇发生 IDA 的几率增加，aOR：9.13（95%CI：3.27-25.48）。每周食用大豆 3-4 次与不食用大豆相比，发生 IDA 的几率更高，aOR：1.78（95%CI：1.12-2.82）。
大约 40%的妊娠中期或晚期中度或重度贫血妇女患有 IDA。本研究为绿叶蔬菜对 IDA 的保护作用提供了证据，而自我报告的食用性高岭土和大豆的摄入似乎会增加妊娠期间发生 IDA 的几率。需要加强孕妇饮食方面的健康教育，因为这可能会提高认识并改变行为，从而减少尼日利亚和其他国家中度或重度贫血孕妇的 IDA 发生率。
