Govindaraju S L Manojna, Yalamanchili Padmasri, Kandipudi Kesava Lakshmi Prasad, Vadlamani Sarada
Department of Community Medicine, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India.
Department of Community Medicine, Government Medical College, Vijayanagaram, Andhra Pradesh, India.
J Family Med Prim Care. 2024 Oct;13(10):4225-4230. doi: 10.4103/jfmpc.jfmpc_201_24. Epub 2024 Oct 18.
Anaemia in pregnancy is defined by the World Health Organisation (WHO) as a haemoglobin concentration of less than 11 g/dl in venous blood. The prevalence of anaemia among ante-natal mothers in India is 50.3%[3]. The government of India supplies ferrous sulphate for prophylaxis and treatment of anaemia among ante-natal mothers for free through the reproductive maternal neonatal and child health + adolescent (RMNCH+A) programme. However, patient compliance is poor due to gastrointestinal disturbances (of all registered pregnancies, less than 1/3 consumed a full course of ferrous sulphate). Previous studies in different settings have shown increased compliance and higher mean haemoglobin levels with ferrous ascorbate, which is more affordable than other commercially available compounds.
Hence, the current study was done to compare the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among ante-natal mothers in a rural field practice area of a medical college.
An interventional community-based study was conducted in the rural field practice area of Andhra Medical College. The study was done among 76 registered (registered at Rural Primary Health Centre Simhachalam) ante-natal mothers in gestational age 13-17 weeks with haemoglobin concentration of 7-10.9 g/dl (mild to moderate anaemia) after taking informed consent. The study was performed for two years. Ante-natal mothers who were registered but unavailable during the study period, with a medical history of haematological disorders, chronic cardiac and kidney diseases, known or suspected to have sensitivity to iron compounds, with known thyroid dysfunction or mental illness were excluded from the study.
There was a rise in haemoglobin among the entire study population, which was statistically significant ( < 0.0001). There was a higher rise in haemoglobin among the antenatal women who took ferrous ascorbate than among those who took ferrous sulphate (mean difference = 0.344 gm/dl) after 12 weeks of follow-up, which was statistically significant ( = 0.014).
The study compared the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among antenatal mothers in a medical college's rural field practice area. There was a significant rise in haemoglobin percentage among the study group, which was on ferrous ascorbate with better compliance and fewer gastrointestinal side effects.
世界卫生组织（WHO）将孕期贫血定义为静脉血血红蛋白浓度低于11g/dl。印度产前母亲贫血患病率为50.3%[3]。印度政府通过生殖、孕产妇、新生儿和儿童健康+青少年（RMNCH+A）计划免费提供硫酸亚铁，用于预防和治疗产前母亲的贫血。然而，由于胃肠道不适，患者依从性较差（在所有登记的妊娠中，不到1/3的人服用了完整疗程的硫酸亚铁）。先前在不同环境中的研究表明，服用抗坏血酸亚铁的依从性和平均血红蛋白水平有所提高，且其价格比其他市售化合物更实惠。
因此，本研究旨在比较抗坏血酸亚铁与硫酸亚铁在提高医学院农村实地实践地区产前母亲血红蛋白百分比方面的有效性。
在安得拉医学院农村实地实践地区开展了一项基于社区的干预性研究。在获得知情同意后，对76名登记在册（在辛哈查拉姆农村初级卫生中心登记）、孕周为13 - 17周、血红蛋白浓度为7 - 10.9g/dl（轻度至中度贫血）的产前母亲进行了研究。研究持续了两年。在研究期间登记但无法找到的产前母亲、有血液系统疾病病史、慢性心脏和肾脏疾病、已知或疑似对铁化合物敏感、已知甲状腺功能障碍或精神疾病的产前母亲被排除在研究之外。
整个研究人群的血红蛋白水平有所上升，具有统计学意义（<0.0001）。随访12周后，服用抗坏血酸亚铁的产前妇女血红蛋白升高幅度高于服用硫酸亚铁的妇女（平均差异 = 0.344g/dl），具有统计学意义（=0.014）。
本研究比较了抗坏血酸亚铁与硫酸亚铁在提高医学院农村实地实践地区产前母亲血红蛋白百分比方面的有效性。服用抗坏血酸亚铁的研究组血红蛋白百分比显著上升，依从性更好，胃肠道副作用更少。
