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Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
摘要：
背景：妊娠期贫血会对女性和胎儿造成不良结局，包括贫血症性心力衰竭,早产,和宫内生长受限.缺铁性贫血（IDA）是贫血的主要原因，广泛建议在怀孕期间口服补铁。然而,很少关注饮食摄入。这项研究估计了孕妇中IDA的贡献，并检查了拉各斯和卡诺州中度或重度IDA患者的危险因素（包括饮食）。尼日利亚。
方法：在这项横断面研究中，11,582名妇女在妊娠20-32周时进行了贫血筛查。这项研究包括872名中度或重度贫血（血红蛋白浓度<10g/dL）。铁缺乏定义为血清铁蛋白水平<30ng/mL。我们描述了样本的社会人口统计学和产科特征以及他们对常见食品消费的自我报告。我们进行了双变量和多变量逻辑回归分析，以确定与IDA相关的危险因素。
结果：在41％（95CI：38-45）的中度或重度贫血妇女中观察到缺铁，并且患病率随着胎龄增加而增加。在每2-3周食用绿叶蔬菜的孕妇中，IDA的几率从aOR：0.36（95CI：0.13-0.98）降低，至每日消费者的0.26（95CI：0.09-0.73），与那些不吃它的人相比。与不食用相比，每日食用高岭土粘土与具有IDA的几率增加有关，OR9.13(95CI:3.27-25.48)。与不消费相比，每周消费三到四次大豆与更高的IDA几率相关，OR:1.78(95CI:1.12-2.82)。
结论：在怀孕期间有中度或重度贫血的10名妇女中约有4名患有IDA。我们的研究为绿叶蔬菜对IDA的保护作用提供了证据，而自我报告的食用高岭土和大豆的食用似乎增加了怀孕期间患IDA的几率。需要加强对怀孕期间饮食的健康教育，因为这可能会提高人们的认识并改变行为，从而减少尼日利亚和其他国家中度或重度贫血孕妇的IDA。
方法：在这项横断面研究中，11,582名妇女在妊娠20-32周时进行了贫血筛查。这项研究包括872名中度或重度贫血（血红蛋白浓度<10g/dL）。铁缺乏定义为血清铁蛋白水平<30ng/mL。我们描述了样本的社会人口统计学和产科特征以及他们对常见食品消费的自我报告。我们进行了双变量和多变量逻辑回归分析，以确定与IDA相关的危险因素。
结果：在41％（95CI：38-45）的中度或重度贫血妇女中观察到缺铁，并且患病率随着胎龄增加而增加。在每2-3周食用绿叶蔬菜的孕妇中，IDA的几率从aOR：0.36（95CI：0.13-0.98）降低，至每日消费者的0.26（95CI：0.09-0.73），与那些不吃它的人相比。与不食用相比，每日食用高岭土粘土与具有IDA的几率增加有关，OR9.13(95CI:3.27-25.48)。与不消费相比，每周消费三到四次大豆与更高的IDA几率相关，OR:1.78(95CI:1.12-2.82)。
结论：在怀孕期间有中度或重度贫血的10名妇女中约有4名患有IDA。我们的研究为绿叶蔬菜对IDA的保护作用提供了证据，而自我报告的食用高岭土和大豆的食用似乎增加了怀孕期间患IDA的几率。需要加强对怀孕期间饮食的健康教育，因为这可能会提高人们的认识并改变行为，从而减少尼日利亚和其他国家中度或重度贫血孕妇的IDA。
