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Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania
BACKGROUND: Anemia is a major public health problem that adversely affects pregnancy outcomes. The prevalence of anemia among pregnant women before conception is not well known in Tanzania. The aim of this study was to determine the prevalence, types, and risk factors of preconception anemia in wome...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298689/ https://www.ncbi.nlm.nih.gov/pubmed/30562390 http://dx.doi.org/10.1371/journal.pone.0208413 |
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author | Msemo, Omari A. Bygbjerg, Ib C. Møller, Sofie L. Nielsen, Birgitte B. Ødum, Lars Perslev, Kathrine Lusingu, John P. A. Kavishe, Reginald A. Minja, Daniel T. R. Schmiegelow, Christentze |
author_facet | Msemo, Omari A. Bygbjerg, Ib C. Møller, Sofie L. Nielsen, Birgitte B. Ødum, Lars Perslev, Kathrine Lusingu, John P. A. Kavishe, Reginald A. Minja, Daniel T. R. Schmiegelow, Christentze |
author_sort | Msemo, Omari A. |
collection | PubMed |
description | BACKGROUND: Anemia is a major public health problem that adversely affects pregnancy outcomes. The prevalence of anemia among pregnant women before conception is not well known in Tanzania. The aim of this study was to determine the prevalence, types, and risk factors of preconception anemia in women of reproductive age from a rural Tanzanian setting. METHODS: Trained field workers visited households to identify all female residents aged 18–40 years and invited them to the nearby health facility for screening and enrolment into this study. Baseline samples were collected to measure hemoglobin levels, serum ferritin, vitamin B(12), folate, C-reactive protein, alanine amino-transferase, the presence of malaria, HIV, and soil transmitted helminth infections. Anthropometric and socio-economic data were recorded alongside with clinical information of participants. Logistic regression analysis was used to determine the adjusted odds ratios (AOR) for the factors associated with preconception anemia. FINDINGS: Of 1248 women enrolled before conception, 36.7% (95% confidence interval (CI) 34.1–39.4) had anemia (hemoglobin <12 g/dL) and 37.6% (95% CI 34.9–40.4) had iron deficiency. For more than half of the anemic cases, iron deficiency was also diagnosed (58.8%, 95% CI 54.2–63.3). Anemia was independently associated with increased age (AOR 1.05, 95% CI 1.03–1.07), malaria infection at enrolment (AOR 2.21, 95% CI 1.37–3.58), inflammation (AOR 1.77, 95% CI 1.21–2.60) and iron deficiency (AOR 4.68, 95% CI 3.55–6.17). The odds of anemia were reduced among women with increased mid-upper arm circumference (AOR 0.90, 95% CI 0.84–0.96). CONCLUSION: Anemia among women of reproductive age before conception was prevalent in this rural setting. Increased age, iron deficiency, malaria infection and inflammation were significant risk factors associated with preconception anemia, whereas increased mid-upper arm circumference was protective against anemia. Interventions to ensure adequate iron levels as well as malaria control before conception are needed to prevent anemia before and during pregnancy and improve birth outcomes in this setting. TRIAL REGISTRATION: NCT02191683. |
format | Online Article Text |
id | pubmed-6298689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-62986892018-12-28 Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania Msemo, Omari A. Bygbjerg, Ib C. Møller, Sofie L. Nielsen, Birgitte B. Ødum, Lars Perslev, Kathrine Lusingu, John P. A. Kavishe, Reginald A. Minja, Daniel T. R. Schmiegelow, Christentze PLoS One Research Article BACKGROUND: Anemia is a major public health problem that adversely affects pregnancy outcomes. The prevalence of anemia among pregnant women before conception is not well known in Tanzania. The aim of this study was to determine the prevalence, types, and risk factors of preconception anemia in women of reproductive age from a rural Tanzanian setting. METHODS: Trained field workers visited households to identify all female residents aged 18–40 years and invited them to the nearby health facility for screening and enrolment into this study. Baseline samples were collected to measure hemoglobin levels, serum ferritin, vitamin B(12), folate, C-reactive protein, alanine amino-transferase, the presence of malaria, HIV, and soil transmitted helminth infections. Anthropometric and socio-economic data were recorded alongside with clinical information of participants. Logistic regression analysis was used to determine the adjusted odds ratios (AOR) for the factors associated with preconception anemia. FINDINGS: Of 1248 women enrolled before conception, 36.7% (95% confidence interval (CI) 34.1–39.4) had anemia (hemoglobin <12 g/dL) and 37.6% (95% CI 34.9–40.4) had iron deficiency. For more than half of the anemic cases, iron deficiency was also diagnosed (58.8%, 95% CI 54.2–63.3). Anemia was independently associated with increased age (AOR 1.05, 95% CI 1.03–1.07), malaria infection at enrolment (AOR 2.21, 95% CI 1.37–3.58), inflammation (AOR 1.77, 95% CI 1.21–2.60) and iron deficiency (AOR 4.68, 95% CI 3.55–6.17). The odds of anemia were reduced among women with increased mid-upper arm circumference (AOR 0.90, 95% CI 0.84–0.96). CONCLUSION: Anemia among women of reproductive age before conception was prevalent in this rural setting. Increased age, iron deficiency, malaria infection and inflammation were significant risk factors associated with preconception anemia, whereas increased mid-upper arm circumference was protective against anemia. Interventions to ensure adequate iron levels as well as malaria control before conception are needed to prevent anemia before and during pregnancy and improve birth outcomes in this setting. TRIAL REGISTRATION: NCT02191683. Public Library of Science 2018-12-18 /pmc/articles/PMC6298689/ /pubmed/30562390 http://dx.doi.org/10.1371/journal.pone.0208413 Text en © 2018 Msemo et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Msemo, Omari A. Bygbjerg, Ib C. Møller, Sofie L. Nielsen, Birgitte B. Ødum, Lars Perslev, Kathrine Lusingu, John P. A. Kavishe, Reginald A. Minja, Daniel T. R. Schmiegelow, Christentze Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania |
title | Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania |
title_full | Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania |
title_fullStr | Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania |
title_full_unstemmed | Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania |
title_short | Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania |
title_sort | prevalence and risk factors of preconception anemia: a community based cross sectional study of rural women of reproductive age in northeastern tanzania |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298689/ https://www.ncbi.nlm.nih.gov/pubmed/30562390 http://dx.doi.org/10.1371/journal.pone.0208413 |
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