Differences in Hemoglobin Levels in Pregnant Women through Multi-Micronutrient Supplements and Iron Tablets

BACKGROUND: A high incidence of anemia, particularly severe anemia, among pregnant women has been a major cause of maternal mortality worldwide. Multi-micronutrient supplement (MMS) has been beneficial for health outcomes. AIM: The study was aimed to examine the effect of MMS compared to iron-folic acid supplement (IFA) on hemoglobin (Hb) levels among pregnant women. METHODS: The study was a quasi-experiment with a three-group pre-post-test design, namely, IFA group, MMS group, and MMS + IFA group. A total of 120 participants enrolled were divided equally in each group. The statistical analysis performed was paired t-test and one-way ANOVA using SPSS. RESULTS: The study result shows that there was a significant difference in the Hb levels of pregnant women after the intervention in all groups (p < 0.001). The highest increase in Hb levels was in the IFA + MMS combining group by 1.1 g/dL of Hb followed by MMS and IFA (0.8 ± 0.37 and 0.4 ± 0.31, respectively). CONCLUSION: The combination of Fe and MMS groups could increase Hb levels compared to IFA. Thus, replacing IFA with MMS is reasonably in preventing anemia among pregnant women.

Public Health Crisis in India: Prevalence of Anemia in Three Villages

Introduction Anemia, including Iron Deficiency Anemia (IDA), is a prevalent public health crisis around the world. In IDA, red blood cells are unable to oxygenate tissues in the body due to the lack of essential iron. India has had a particularly high consistent prevalence of IDA since the National Family Health Survey began in 1991. Other forms of anemia can arise due to a lack of vitamin B12, folic acid, and other micronutrients that make up hemoglobin, the oxygen-carrying in red blood molecules. The villages of Dhank, Kolki, and Bhimora in the state of Gujarat, India have not been focused on in great depth for the prevalence and severity of anemia. Researchers sought to understand the prevalence of anemia in rural areas from a public health standpoint. Understanding the prevalence of anemia in specific regions in India is imperative to identifying where to focus therapies that target iron deficiency and other causes of anemia, such as through the administration of iron, folic acid, vitamin B12, vitamin C, and deworming medications. Methods and Materials Blood samples were taken to measure hemoglobin levels (g/dl) utilizing the glucometer device from two samples: boys and girls ages 0-18, and women ages 18-45 in the villages of Dhank, Kolki, and Bhimora villages in the state of Gujarat. Sample sizes were n=17,111 children and n=9,151 women. Researchers at the University of California, Irvine School of Medicine teamed up with the public health research team to statistically analyze hemoglobin level data, understanding prevalence of anemia in in the three villages. Researchers calculated the prevalence of anemia in both groups based on World Health Organization (WHO) criteria. Results The results show levels of moderate and severe anemia within the states of Kolki, Bhimora, and Dhank for children aged 0-18 and women aged 18-45. In the children group, the highest level of "moderate" to "severe anemia" was in Bhimora. The lowest level of "severe anemia" and highest level of "no anemia" were in Kolki. Similar results were seen in the women's group. In the women's group, the highest level of "moderate" and "severe anemia" were in Bhimora. The lowest level of "severe anemia" and highest level of "no anemia" were in Kolki. Conclusion Anemia is a serious public health crisis within the state of Gujarat, specifically in the villages of Kolki, Bhimora, and Dhank for children 0-18 and women 18-45, as indicated by the high prevalence of moderate and severe anemia in these areas. These findings call for interventions to combat this public health issue. Future study of the data will show which specific socioeconomic factors (caste, class, working status, etc.) are associated with lower hemoglobin levels. These future studies, in turn, will guide the targeted deployment of iron, folic acid, vitamin B12, vitamin C, and deworming tablets along with extensive educational intervention. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Prevalence of anemia among school girl children and effectiveness of supplementation intervention

Background: Iron deficiency anemia (IDA) is a major public health issue worldwide, especially in developing countries. Anemia prevalence in young children, particularly girls, continues to remain high in most parts of India and Asia. Aims and objectives were to study the prevalence of anemia (IDA) among school girl children of age group between 5-16 years and to assess the effectiveness of iron-folic acid supplements and iron rich diet.Methods: The study was conducted among 558 school girls in the age group between 5-16 years (1st to 10th standard) at a Kendriya Vidyalaya in Punjab. The study group was checked for their hemoglobin level. Health education regarding prevention of anemia was imparted to girls and their parents followed by daily iron-folic acid supplement. Their hemoglobin was again checked after three months of supplementation.Results: The prevalence of anemia in the study group was 65%. After the intervention, the Hb level was significantly increased as shown by increase in mean and SD of Hb% from 9.75±1.24 to 11.66±0.98. The data was analyzed in two age groups, 5-10 years and 11-16 years, to check for any significant variation in their Hb levels. Though there was difference in prevalence of anemia in these age groups, the difference was not statistically significant.Conclusions: The study showed that prevalence of anemia is 65% and is still one of the major public health issues among school going girl children of all age. In addition to pre-school and adolescent girls, we also need to focus on pre-puberty girls, as anemia is equally prevalent among them.

Re-evaluating the need for universal iron supplementation in pregnant Indian women in the light of gestational age specific low hemoglobin prevalence

Background: Anemia prevalence among Indian pregnant women in 2015-16 was 50.4% and has not declined from 49.7% in 1998-99 despite the national policies on iron-folic acid supplementation. New gestational age-specific cut-offs (INTERGROWTH cut-off) for risk of low Hemoglobin (Hb) have been identified. Aims and objectives: Compare prevalences of low Hb based on WHO and INTERGROWTH cut-offs Methods: The prevalence of anemia/low Hb among pregnant women in trimesters 2 and 3 from NFHS-4 data were estimated using the current WHO recommendations and the INTERGROWTH cut-offs. Results: Prevalence of low Hb by the INTERGROWTH cut-off was 28.1%(95% CI:26.9-29.4) and 21.7%(95% CI:20.6-22.9) in trimesters 2 and 3. Anemia prevalence by WHO cut-off was much higher at 41.2%(95% CI:39.8-42.5) and 54.8%(95 CI:53.2-56.3) in trimesters 2 and 3. The prevalence of low-Hb was similar between ANC and no-ANC reported groups in both trimesters (26.1% and 28.9% in trimester-2; 20.1% and 22.4% in trimester-3). Conclusion: The prevalence of low-Hb with gestational age specific cut-offs is much lower compared to earlier estimates using WHO cut-off. The universal iron supplementation program for pregnant women in India need to be re-examined in this light and a tragetter Hb testing based supplementation may be more beneficial in reducing anemia prevalence.

Anemia during pregnancy: Epidemiological, clinical and therapeutic aspects at the obstetric gynecology department of Labe Regional Hospital, Guinee

Objectives: Calculate the frequency of anemia during pregnancy, describe the epidemiological profile and describe the management of anemia during pregnancy in the gynecology-obstetrics Department of the Labé regional hospital. Methodology: This was a prospective, descriptive study lasting six (6) months from September 1, 2020 to February 28, 2021 All pregnant women who developed anemia and treated were considered for the study in the service. All pregnant women without anemia were included. Our data were analyzed by Epi-Info version 7.2.2.6 software, entered and presented by Pack office 2016 software. Results: The frequency of anemia in pregnant women was 27.61% in the department. The epidemiological profile of anemia in pregnant women at the Labé regional hospital was that of: a woman aged 25-29 (30.63%), housewives (72.97%), women not attending school (66, 67 %.), those Coming from the rural areas (76.58%), married women (100%), pauciparous (29.73%) and only 14.42% did not carry out an antenatal consultation. The anemia occurred in the 3rd trimester (76.58 %,). The main reason for consultation was paleness of the conjunctivae and integuments (92.79%) and malaria the dominant antecedent (60.36%). Severe anemia was the most dominant clinical form (54.96%). Transfusion was performed in 54.95% of women with anemia. The average length of stay was 4.9 days with extremes of 1 and 10 days. The maternal prognosis was favorable in 96.40% with a maternal death rate of 3.60%. Conclusion: Anemia is a major problem for pregnant women in the Gynecology-Obstetrics department at the Labé regional hospital. The improvement of the maternal prognosis would pass by chemoprophylaxis of malaria, the use of impregnated mosquito nets with long-lasting insecticide (LLINs), the prevention of intestinal parasitoses, the regular administration of iron, folic acid and the provision of quality prenatal consultation.

Literature Review Pengaruh Asam Folat Pada Kadar Hemoglobin Untuk Wanita Prakonsepsi Dengan Anemia

Folic acid is important in the process of formation and maturation of erythrocytes, so that folic acid deficiency can manifest in anemia. Anemia is defined by hemoglobin levels in preconception women <12.0 g/dl, one of which is due to the lack of erythrocyte. Globally, the prevalence of anemia in women not pregnant (childbearing age) is 1.1%, and affects 19 million women not pregnant. Prevention of anemia in women of childbearing age can improve the degree of health of pregnant women, which ultimately contributes to a decrease in maternal and perinatal death. So that in preconception care is recommended anemia prevention measures in the form of nutritional interventions, one of which is recommended to prevent folic acid deficiency. The purpose of the study was to find out the influence of folic acid on hemoglobin levels of preconception women with anemia. literature review study, study 5 articles that meet inclusion and exclusion criteria. Search through Google Scholar, Garuda, and Pubmed, keywords that iron folic acid, folic acid, and anemia in preconception. from 5 articles examined there was an influence of folic acid on hemoglobin levels in preconception women. hemoglobin levels in preconception women are influenced by the adequacy of folic acid. So folic acid deficiency has an effect on the incidence of anemia in preconception women ABSTRAK Asam folat penting dalam proses pembentukan dan pematangan eritrosit, sehingga defisiensi asam folat bisa bermanifestasi pada anemia. Anemia didefinisikan dengan kadar hemoglobin pada wanita prakonsepsi <12,0 g/dl yang salah satunya dikarenakan kurangnya jumlah eritrosit. Secara global, prevalensi anemia pada wanita tidak hamil (usia subur) yaitu 1,1%, dan mempengaruhi 19 juta wanita tidak hamil. Pencegahan anemia pada wanita usia subur dapat meningkatkan derajat kesehatan wanita hamil, yang pada akhirnya berkontribusi pada penurunan kematian ibu dan perinatal. Sehingga dalam pelayanan kesehatan prakonsepsi (preconception care) dianjurkan tindakan pencegahan anemia berupa intervensi gizi yang salah satunya dianjurkan untuk mencegah defisiensi asam folat. Tujuan penelitian untuk mengetahui pengaruh asam folat pada kadar hemoglobin wanita prakonsepsi dengan anemia. Studi literature review, menelaah 5 artikel yang memenuhi kriteria inklusi dan eksklusi. Pencarian melalui Google Scholar, Garuda, dan Pubmed, kata kunci yang iron folic acid, asam folat, dan anemia in preconception. Dari 5 artikel yang ditelaah didapatkan adanya pengaruh asam folat terhadap kadar hemoglobin pada wanita prakonsepsi. Kadar hemoglobin pada wanita prakonsepsi salah satunya dipengaruhi oleh tingkat kecukupan asam folat. Sehingga defisiensi asam folat berpengaruh pada kejadian anemia pada wanita prakonsepsi.

STANDAR KUANTITAS ANTENATAL CARE DAN SOSIAL BUDAYA DENGAN RISIKO ANEMIA PADA KEHAMILAN

Background: There was an increase of anemia in pregnant women and maternal death due to obstetric hemorrhage with hemoglobin (Hb) levels during pregnancy <10 gr/dl in Indragiri Hilir District, Riau Province. Objective: This study aimed to analyze the association between standard of antenatal care (ANC) and socio-cultural factors and the risk of anemia during pregnancy. Methods: A cross-sectional design was used in this study. This study included 172 pregnant women in the 2nd and 3rd trimesters from the Sungai Piring Public Health Center's working area. Data of Hb level of pregnant women was obtained from the maternal register and the MCH book. Data on the quantity of ANC, socio-cultural, adherence to iron-folic acid tablet consumption, and characteristics of pregnant women were collected through questionnaire interviews. Bivariate and multivariate analyses were conducted by using chi-square test and multiple logistic regressions respectively. Results: As many as 71.5% of pregnant women experienced anemia. Anemia in pregnant women was significantly associated with standard of ANC quantity, sociocultural status, and economic status (p<0.05). Inadequate ANC, poor socio-cultural, and low economic status increased the risk of anemia in pregnant women by 6.6 times, 11.4 times, and 3 times respectively. Conclusion: Standard of ANC quantity, socio-cultural, and economic status were dominant factors for anemia in pregnancy. Home visits or counseling through messaging applications can be carried out by health workers for pregnant mothers who do not attend ANC visits. Keywords: Anemia, antenatal care, pregnancy, socio-culture Abstrak Latar belakang: Terjadi peningkatan kasus anemia ibu hamil dan adanya kasus kematian ibu akibat perdarahan dengan kadar haemoglobin (Hb) darah saat hamil di bawah 10gr/dl di Kabupaten Indragiri Hilir Provinsi Riau. Tujuan: Menganalisis hubungan antara standar antenatal care (ANC) dan sosial budaya dengan risiko anemia pada kehamilan. Metode: Studi ini menggunakan desain cross sectional. Sampel studi yaitu 172 ibu hamil trimester dua dan tiga di wilayah kerja Puskesmas Sungai Piring. Data kadar hemoglobin (Hb) darah ibu hamil diperoleh dari register ibu dan Buku KIA. Data kuantitas ANC, sosial budaya, kepatuhan konsumsi tablet tambah darah, dan karakteristik ibu hamil dikumpulkan melalui wawancara kuesioner. Analisis bivariat dilakukan dengan uji chi square dan multivariat dengan uji regresi logistik ganda. Hasil: Sebanyak 71,5% ibu hamil mengalamani anemia. Kuantitas ANC, sosial budaya, dan status ekonomi berhubungan signifikan dengan anemia pada ibu hamil (p<0,05). Ibu hamil dengan kuantitas ANC tidak sesuai standar, sosial budaya tidak baik, dan status ekonomi rendah berpeluang berturut-turut sebesar 6,6 kali, 11,4 kali, dan 3 kali untuk mengalami anemia. Kesimpulan: Standar kuantitas ANC, sosial budaya, dan status ekonomi merupakan variabel yang dominan terhadap anemia pada kehamilan. Kunjungan rumah atau konseling melalui aplikasi perpesanan dapat dilakukan oleh petugas kesehatan bagi ibu yang tidak melakukan ANC. Kata kunci: Anemia, antenatal care, kehamilan, sosial budaya