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      Magnitude of Anemia and Associated Risk Factors among Pregnant Women Attending Antenatal Care in Shalla Woreda, West Arsi Zone, Oromia Region, Ethiopia

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          Abstract

          Background

          Anemia during pregnancy is a common problem in developing countries and affects both the mother's and her child's health. The main objective of this study was to determine the prevalence of and the factors associated with anemia among pregnant women.

          Methods

          Facility based cross-sectional study design was conducted from June to August, 2011 on 374 pregnant women. Mothers who came for ANC during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer, and interviewer administered questionnaire was used to collect data. Data were cleaned, coded and fed into SPSS version 16.0 for analysis.

          Result

          The mean hemoglobin concentration was 12.05±1.5 g/dl and prevalence of anemia was 36.6%. Family sizes (COR=2.67, CI (1.65, 4.32), third trimester (COR=1.45, CI (1.11, 2.23), meat consumption <1x/wk (COR=3.47, CI (1.58, 7.64) and pica (COR=2.33, CI (1.52, 3.58) were significantly associated with anemia. Having five or more children (AOR=5.2, CI [1.29, 21.09]), intake of vegetables and fruits less than once per day (AOR= 6.7, CI [2.49, 17.89]), intake of tea always after meal (AOR = 12.83.CI [45-28.9]), and recurrence of illness during pregnancy (AOR=7.3, CI [2.12–25.39]) were factors associated with anemia.

          Conclusion

          This study showed that anemia is a moderate public health problem. Less frequent meat and vegetable consumption, parity ≥5 are risk factors for anemia. Therefore, reducing parity, taking balanced diet and use of mosquito nets during pregnancy are recommended.

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          Most cited references37

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          Iron status during pregnancy: setting the stage for mother and infant.

          Supplementation with iron is generally recommended during pregnancy to meet the iron needs of both mother and fetus. When detected early in pregnancy, iron deficiency anemia (IDA) is associated with a > 2-fold increase in the risk of preterm delivery. Maternal anemia when diagnosed before midpregnancy is also associated with an increased risk of preterm birth. Results of recent randomized clinical trials in the United States and in Nepal that involved early supplementation with iron showed some reduction in risk of low birth weight or preterm low birth weight, but not preterm delivery. During the 3rd trimester, maternal anemia usually is not associated with increased risk of adverse pregnancy outcomes and may be an indicator of an expanded maternal plasma volume. High levels of hemoglobin, hematocrit, and ferritin are associated with an increased risk of fetal growth restriction, preterm delivery, and preeclampsia. While iron supplementation increases maternal iron status and stores, factors that underlie adverse pregnancy outcome are considered to result in this association, not iron supplements. On the other hand, iron supplements and increased iron stores have recently been linked to maternal complications (eg, gestational diabetes) and increased oxidative stress during pregnancy. Consequently, while iron supplementation may improve pregnancy outcome when the mother is iron deficient it is also possible that prophylactic supplementation may increase risk when the mother does not have iron deficiency or IDA. Anemia and IDA are not synonymous, even among low-income minority women in their reproductive years.
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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.
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              Overview and mechanisms of iron regulation.

              There are two major disturbances of iron balance: iron deficiency and iron overload. Iron-deficiency anemia is a major problem in developing countries and affects between 500 million and 600 million people worldwide. While iron overload is much less prevalent, it has a number of major pathologic sequelae and there have been recent suggestions that even modest increases in the body's iron stores may have pathologic associations. To understand the ways in which iron balance can be disturbed, it is necessary to have an understanding of how losses from the body are matched by the absorption of iron in different dietary settings as well as the limits of this regulatory control.
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                Author and article information

                Journal
                Ethiop J Health Sci
                Ethiop J Health Sci
                Ethiopian Journal of Health Sciences
                Research and Publications Office of Jimma University (Jimma, Ethiopia )
                1029-1857
                July 2013
                : 23
                : 2
                : 165-173
                Affiliations
                [1 ]Department of Biomedical Sciences, Jimma University, Jimma, Ethiopia
                Author notes
                Corresponding Author: Teshome Gobena, Email: tgobena_2012@ 123456yahoo.com
                Article
                jEJHS.v23.i2.pg165
                3742894
                23950633
                7c39c22d-8e49-4afb-8e04-ceddd0641581
                Copyright © Jimma University, Research & Publications Office 2013
                History
                Categories
                Original Article

                Medicine
                hemoglobin,anemia,pregnancy,anc
                Medicine
                hemoglobin, anemia, pregnancy, anc

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