Estado nutricional e anemia ferropriva em gestantes: relação com o peso da criança ao nascer

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Abstract

OBJETIVO: Avaliar o estado nutricional e a prevalência de anemia durante a gestação e correlacioná-los com o peso do recém-nascido. MÉTODOS: Foi realizado estudo transversal com gestantes que realizaram o pré-natal no único serviço público de saúde do município de Viçosa, MG, no período de dezembro de 2002 a maio de 2003. Foi aplicado questionário com informações maternas e realizada dosagem de hemoglobina através do Hemocue, além da obtenção de dados de peso e estatura da gestante. As informações referentes aos recém-nascidos foram obtidas no programa Sistema de Informação de Nascidos Vivos/MS. RESULTADOS: Foram avaliadas 168 gestantes de baixo nível socioeconômico e baixa escolaridade. Encontraram-se 41,3% de gestantes com estado nutricional pré-gestacional inadequado, sendo 25,7% com baixo peso e 17,4% com sobrepeso ou obesidade. A maioria das gestantes apresentou ganho de peso inadequado durante a gestação. A prevalência total de anemia ferropriva foi de 21,4%, sendo que essa aumentou com a idade gestacional. A freqüência de baixo peso e peso insuficiente ao nascer foi de 8,9% e 28,6%, respectivamente. As variáveis antropométricas (peso pré-gestacional, estatura, índice de massa corporal pré-gestacional e ganho de peso total) apresentaram associação estatisticamente significante com o peso ao nascer. CONCLUSÃO: As variáveis antropométricas maternas apresentaram correlação com o peso ao nascer. Neste estudo não houve relação entre o estado nutricional de ferro das gestantes e o peso de nascimento.

Translated abstract

OBJECTIVE: The purpose of the study was to evaluate the nutritional status and prevalence to anemia during pregnancy, and to correlate these factors with the weight at birth. METHODS: A transversal study was carried out with pregnant women who underwent prenatal care at the only public health service in the municipality of Viçosa, MG, Brazil, from December 2002 to May 2003. A questionnaire was applied to obtain information on the mothers, and their hemoglobin levels were dosed using Hemocue, also registering the mothers' height and weight. Information on the newborns was obtained from the Birth Registries Information System. RESULTS: A total of 168 low-income, low-schooling level pregnant women were evaluated, 41.3% showing inadequate pre-gestational nutritional status, 25.7% being underweight and 17.4% overweight or obese. The majority of the pregnant women presented inadequate weight gain during pregnancy. The prevalence of total iron deficiency anemia was 21.4%, increasing with gestational age. The frequencies of low birth weight and insufficient birth weight were 8.9% and 28.6%, respectively. The anthropometrical variables (pre-gestational weight, height, pre-gestational Body Mass Index and total weight gain) presented a statistically significant association with weight at birth. CONCLUSION: The mother's anthropometrical variables correlated with the weight at birth. No correlation was found between the nutritional iron status of the pregnant women and weight at birth.

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Is There a Causal Relationship between Iron Deficiency or Iron-Deficiency Anemia and Weight at Birth, Length of Gestation and Perinatal Mortality?

K Rasmussen (2001)

An extensive literature review was conducted to identify whether iron deficiency, iron-deficiency anemia and anemia from any cause are causally related to low birth weight, preterm birth or perinatal mortality. Strong evidence exists for an association between maternal hemoglobin concentration and birth weight as well as between maternal hemoglobin concentration and preterm birth. It was not possible to determine how much of this association is attributable to iron-deficiency anemia in particular. Minimal values for both low birth weight and preterm birth occurred at maternal hemoglobin concentrations below the current cut-off value for anemia during pregnancy (110 g/L) in a number of studies, particularly those in which maternal hemoglobin values were not controlled for the duration of gestation. Supplementation of anemic or nonanemic pregnant women with iron, folic acid or both does not appear to increase either birth weight or the duration of gestation. However, these studies must be interpreted cautiously because most are subject to a bias toward false-negative findings. Thus, although there may be other reasons to offer women supplemental iron during pregnancy, the currently available evidence from studies with designs appropriate to establish a causal relationship is insufficient to support or reject this practice for the specific purposes of raising birth weight or lowering the rate of preterm birth.