Anaemia during pregnancy in southern Tanzania

Tanya Marchant, J. A. Armstrong Schellenberg, T. Edgar, C. Ronsmans, R. Nathan, S. Abdulla, O. Mukasa, H. Urassa, C. Lengeler
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引用次数: 42

Abstract

Abstract Anaemia in pregnancy is associated with maternal morbidity and mortality and is a risk factor for low birth-weight. Of 507 pregnant women recruited in a community, cross-sectional study in southern Tanzania, 11% were severely anaemic (<8g haemoglobin/dl). High malarial parasitaemia [odds ratio (OR)=2.3] and iron deficiency (OR=2.4) were independent determinants of anaemia. Never having been married (OR=2.9) was the most important socio-economic predictor of severe anaemia. A subject recruited in the late dry season was six times more likely to be severely anaemic than a subject recruited in the early dry season. Compared with the women who were not identified as severely anaemic, the women with severe anaemia were more likely to present at mother-and-child-health (MCH) clinics early in the pregnancy, to seek medical attention beyond the MCH clinics, and to report concerns about their own health. Pregnancy-related food taboos in the study area principally restrict the consumption of fish and meat. Effective anti-malaria and iron-supplementation interventions are available but are not currently in place; improvements in the mechanisms for the delivery of such interventions are urgently required. Additionally, opportunities for contacting the target groups beyond the clinic environment need to be developed.
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坦桑尼亚南部孕妇贫血
妊娠期贫血与孕产妇发病率和死亡率相关,是低出生体重的危险因素。在坦桑尼亚南部的一项社区横断面研究中招募的507名孕妇中,11%为严重贫血(<8g血红蛋白/分升)。高疟原虫血症[比值比(OR)=2.3]和缺铁(OR=2.4)是贫血的独立决定因素。从未结婚(OR=2.9)是严重贫血最重要的社会经济预测指标。在旱季后期招募的受试者发生严重贫血的可能性是旱季早期招募的受试者的6倍。与未被确定为严重贫血的妇女相比,患有严重贫血的妇女更有可能在怀孕早期到妇幼保健诊所就诊,在妇幼保健诊所以外寻求医疗照顾,并报告对自身健康的担忧。研究地区与怀孕有关的食物禁忌主要限制鱼类和肉类的消费。有有效的抗疟疾和补铁干预措施,但目前尚未到位;迫切需要改进提供这种干预措施的机制。此外,需要开发在诊所环境之外接触目标群体的机会。
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