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      Prevalence of anemia during pregnancy: Results of Valencia (Venezuela) anemia during pregnancy study


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          To determine the prevalence of anemia during pregnancy in Venezuelan pregnant women. By using a cross-sectional study, 630 Venezuelan pregnant women in their third trimester at labor from the Valencia Anemia during Pregnancy Study were studied. Anemia during pregnancy was defined according to WHO guidelines (Hb < 11g/dl), iron deficiency was considered when serum ferritin level was < 12 ng/ml, and when serum folate level was < 3ng/ml, it was considered as folate deficiency. 630 pregnant women (mean [± SD] age, 24± 6.4 years) having an average of Hb 11.38±1.47 g/dl [95%CI = 11.27 to 11.50] were studied. No patient had hemolytic anemia nor clinical infections. Almost all patients were from low or very low socioeconomic status. Prevalence of anemia was 34.44% (severe: 1.8%, moderate: 15.2%, and mild: 83%). Iron deficiency anemia (IDA) was present in 39.2% (95%CI= 32.7 to 45.7), prevalence of folate deficiency anemia (FDA) was 11.98% (95%CI = 7.6% to 16.3%). Combined anemia (IDA and FDA) occurred in 11.52% (95%CI= 7.27% to 15.7%). Multivariate analysis showed that multiparous (odds ratio -OR-: 1.95, 95%CI= 1.28 to 2.97, p =.002) and supplement use of iron (OR: .55 (95%CI= .33 to .91 , p= .02) are associated with IDA. The factors associated with FDA were: supplement use of folic acid (OR: .37 (95%CI=.19 to .71 , p = .003) and appropriate prenatal control (OR: .51 95%CI= .27 to .96, p = .04). Prevalence of anemia during pregnancy was found to be high. Educational efforts should be stressed in order to encourage improvements in the prenatal care visits

          Translated abstract

          Prevalencia de anemia durante el embarazo: Resultados del grupo de estudio de anemia durante el embarazo en Valencia, Venezuela. El objetivo fue determinar la prevalencia de anemia durante el embarazo. Se utilizó un diseño de corte transversal. El estudio fue realizado en la Maternidad " Dr. J.L. Facchín de Boni", principal hospital obstétrico y ginecológico de Valencia, Venezuela. Se estudiaron 630 embarazadas durante el tercer trimestre gestacional, en trabajo de parto. Anemia durante el embarazo fue definida como hemoglobina menor de 11g/dl (OMS). Deficiencia de hierro fue considerada cuando el nivel de ferritina sérica era menor de 12 ng/ml y se diagnosticó deficiencia de folatos cuando el nivel era menor de 3ng/ml. La edad promedio de las pacientes fue 24± 6.4 años, siendo la media de la Hb de 11.38±1.47 g/dl [IC 95% = 11.27 a 11.50]. Ninguna paciente tenía anemia hemolítica o infección clínica. Casi todas provienen de estratos socioeconómicos bajo o muy bajo. La prevalencia de anemia fue 34.44% (severa: 1,8%, moderada: 15,2% y leve: 83%). La anemia por deficiencia de hierro (ADFe) estuvo presente en 39.2% (IC95% = 32.7 a 45.7), mientras que la prevalencia de anemia por deficiencia de folatos (ADFo) fue 11.98% (IC95% = 7.6% a 16.3%). La anemia combinada (ADFe y ADFo) se diagnóstico en 11.52% (IC95%= 7.27% a 15.7%). El análisis multivariable mostró que la multiparidad (odds ratio -OR-: 1.95 , IC95%= 1.28 a 2.97 , p =.002) y el aporte de hierro (OR: .55 (IC95%= .33 a .91 , p= .02) están asociados con ADFe. Los factores asociados con ADFo fueron el aporte de ácido fólico ( OR: .37 (IC95%=.19 a .71 , p = .003) y adecuado control prenatal (OR: .51 IC95% = .27 a .96 , p = .04). Se concluye que la prevalencia de anemia durante el embarazo es alta. Esfuerzos educacionales deben ser realizados para incrementar el control prenatal

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          Most cited references57

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          Prevalence of iron deficiency in the United States.

          To determine the prevalence of iron deficiency and iron deficiency anemia in the US population. Nationally representative cross-sectional health examination survey that included venous blood measurements of iron status. Iron deficiency, defined as having an abnormal value for at least 2 of 3 laboratory tests of iron status (erythrocyte protoporphyrin, transferrin saturation, or serum ferritin); and iron deficiency anemia, defined as iron deficiency plus low hemoglobin. A total of 24,894 persons aged 1 year and older examined in the third National Health and Nutrition Examination Survey (1988-1994). Nine percent of toddlers aged 1 to 2 years and 9% to 11% of adolescent girls and women of childbearing age were iron deficient; of these, iron deficiency anemia was found in 3% and 2% to 5%, respectively. These prevalences correspond to approximately 700,000 toddlers and 7.8 million women with iron deficiency; of these, approximately 240,000 toddlers and 3.3 million women have iron deficiency anemia. Iron deficiency occurred in no more than 7% of older children or those older than 50 years, and in no more than 1% of teenage boys and young men. Among women of childbearing age, iron deficiency was more likely in those who are minority, low income, and multiparous. Iron deficiency and iron deficiency anemia are still relatively common in toddlers, adolescent girls, and women of childbearing age.
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            Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study.

            Using criteria from the Centers for Disease Control, anemia and iron-deficiency anemia (anemia with serum ferritin concentrations less than 12 micrograms/L) were assessed in greater than 800 inner-city gravidas at entry to prenatal care. Iron-deficiency anemia was associated with significantly lower energy and iron intakes early in pregnancy and a lower mean corpuscular volume. The odds of low birth weight were tripled and of preterm delivery more than doubled with iron deficiency, but were not increased with anemia from other causes. When vaginal bleeding at or before entry to care accompanied anemia, the odds of a preterm delivery were increased fivefold for iron-deficiency anemia and doubled for other anemias. Inadequate pregnancy weight gain was more prevalent among those with iron-deficiency anemia and in those with anemias of other etiologies. The prevalence of iron-deficiency anemia (3.5%), however, was lower than anticipated for an inner-city, minority population in whom most anemias had been attributed clinically to iron deficiency.
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              Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome.

              Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preterm delivery. In several studies, the association between anemia and outcomes reversed direction during the third trimester; maternal anemia was no longer a risk factor for poor pregnancy outcomes. Camden study data were used to examine the probable cause of this observation. Maternal iron-deficiency anemia, diagnosed at entry to prenatal care, was associated with low dietary energy and iron, inadequate gestational gain, and twofold or greater increases in the risks of preterm delivery and low birth weight. During the third trimester, these associations (except with inadequate gestational gain) were no longer present. This reversal of risk status may be attributable to the poor predictive value of anemia and iron deficiency tests during the third trimester. However, the relationship between poor diet (with inadequate iron intake) and increased likelihood of preterm delivery persisted during the third trimester.

                Author and article information

                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Archivos Latinoamericanos de Nutrición
                Sociedad Latinoamericana de Nutrición (Caracas )
                March 2002
                : 52
                : 1
                : 5-11
                [1 ] Universidad de la Frontera Chile



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Anemia,pregnancy,prevalence,Venezuela,third trimester,embarazo,prevalencia,tercer trimestre


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