The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India

OBJECTIVES: Maternal anemia is a critical public health problem, especially in Low- and Middle-Income Countries (LMIC) like India. Anemia during pregnancy increases the risk of poor fetal outcomes, such as low birth weight. The Indian national Iron + Initiative includes iron & folic acid (IFA) s...

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Autores principales: Shah, Miloni, Bhaise, Shilpa, Gugel, Abigail, Lauer, Jacqueline M, Patel, Archana, Hibberd, Patricia L, Locks, Lindsey M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194428/
http://dx.doi.org/10.1093/cdn/nzac061.096
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author Shah, Miloni
Bhaise, Shilpa
Gugel, Abigail
Lauer, Jacqueline M
Patel, Archana
Hibberd, Patricia L
Locks, Lindsey M
author_facet Shah, Miloni
Bhaise, Shilpa
Gugel, Abigail
Lauer, Jacqueline M
Patel, Archana
Hibberd, Patricia L
Locks, Lindsey M
author_sort Shah, Miloni
collection PubMed
description OBJECTIVES: Maternal anemia is a critical public health problem, especially in Low- and Middle-Income Countries (LMIC) like India. Anemia during pregnancy increases the risk of poor fetal outcomes, such as low birth weight. The Indian national Iron + Initiative includes iron & folic acid (IFA) supplementation for pregnant & lactating women. We sought out to assess the effectiveness of the IFA program in Nagpur, India. METHODS: We conducted a prospective cohort study of 200 pregnant women from four clusters in Nagpur (Eastern Maharashtra), India. Maternal hemoglobin was assessed using Hemocue and the finger prick method. Anemia was defined as hemoglobin < 110g/L. IFA receipt and consumption was assessed via questionnaire during the 1(st) and 3(rd) trimester of pregnancy. RESULTS: Hemocue/capillary assessment revealed prevalence of anemia in the third trimester of 69.52% (N = 187), as compared to 50.0% (N = 200) in the first trimester. In the first trimester, 44.5% of women reported consuming IFA the previous day, while 84.8% reported consuming it the previous day by the 3(rd) trimester. In the first trimester, 61% (n = 122) of women reported receiving IFA: 43% for free from a public health facility, 14% purchased it from a store/pharmacy, and 4% from other locations. By the 3(rd) trimester, 99.5% of women had received IFA: 75.4% for free from a facility, 11.8% from a pharmacy/store and 8.02% from other locations. CONCLUSIONS: We noted a markedly high prevalence of anemia in pregnancy that increased from the first to third trimester, characteristic of physiologic amenia, despite an increase IFA coverage and consumption. Other nutritional and non-nutritional interventions to reduce anemia in pregnancy need to be explored to prevent maternal anemia in Nagpur, India and possibly other LMIC contexts. FUNDING SOURCES: This study was funded by the Thrasher Research Fund grant.
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spelling pubmed-91944282022-06-15 The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India Shah, Miloni Bhaise, Shilpa Gugel, Abigail Lauer, Jacqueline M Patel, Archana Hibberd, Patricia L Locks, Lindsey M Curr Dev Nutr Maternal, Perinatal and Pediatric Nutrition OBJECTIVES: Maternal anemia is a critical public health problem, especially in Low- and Middle-Income Countries (LMIC) like India. Anemia during pregnancy increases the risk of poor fetal outcomes, such as low birth weight. The Indian national Iron + Initiative includes iron & folic acid (IFA) supplementation for pregnant & lactating women. We sought out to assess the effectiveness of the IFA program in Nagpur, India. METHODS: We conducted a prospective cohort study of 200 pregnant women from four clusters in Nagpur (Eastern Maharashtra), India. Maternal hemoglobin was assessed using Hemocue and the finger prick method. Anemia was defined as hemoglobin < 110g/L. IFA receipt and consumption was assessed via questionnaire during the 1(st) and 3(rd) trimester of pregnancy. RESULTS: Hemocue/capillary assessment revealed prevalence of anemia in the third trimester of 69.52% (N = 187), as compared to 50.0% (N = 200) in the first trimester. In the first trimester, 44.5% of women reported consuming IFA the previous day, while 84.8% reported consuming it the previous day by the 3(rd) trimester. In the first trimester, 61% (n = 122) of women reported receiving IFA: 43% for free from a public health facility, 14% purchased it from a store/pharmacy, and 4% from other locations. By the 3(rd) trimester, 99.5% of women had received IFA: 75.4% for free from a facility, 11.8% from a pharmacy/store and 8.02% from other locations. CONCLUSIONS: We noted a markedly high prevalence of anemia in pregnancy that increased from the first to third trimester, characteristic of physiologic amenia, despite an increase IFA coverage and consumption. Other nutritional and non-nutritional interventions to reduce anemia in pregnancy need to be explored to prevent maternal anemia in Nagpur, India and possibly other LMIC contexts. FUNDING SOURCES: This study was funded by the Thrasher Research Fund grant. Oxford University Press 2022-06-14 /pmc/articles/PMC9194428/ http://dx.doi.org/10.1093/cdn/nzac061.096 Text en © The Author 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Maternal, Perinatal and Pediatric Nutrition
Shah, Miloni
Bhaise, Shilpa
Gugel, Abigail
Lauer, Jacqueline M
Patel, Archana
Hibberd, Patricia L
Locks, Lindsey M
The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India
title The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India
title_full The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India
title_fullStr The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India
title_full_unstemmed The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India
title_short The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India
title_sort effectiveness of the ifa supplementation in reducing the prevalence of anemia during pregnancy among women in eastern maharashtra, india
topic Maternal, Perinatal and Pediatric Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194428/
http://dx.doi.org/10.1093/cdn/nzac061.096
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