A comparative study of pregnancy outcome in anaemic and non-anaemic women attending government health facilities in St. Ann, Jamaica

Worldwide 50 percent of pregnant women are reported to be anaemic, with 18.6 percent and 14.6 percent anaemic during 1998 in Jamaica and St. Ann respectively. A study was designed to describe and compare pregnancy outcome for 176(1:1 match)women with and without anaemia on first visit to antenatal clinic attending government health facilities in St. Ann during 1998, and to assess and compare the physical growth and developmental milestones in 46(1:1 match) of their offspring at various age intervals. Sources from which data were obtained were secondary (records), primary (community visits) and qualitative (focus group). The hypotheses proposed were that (1) anaemic women have poorer pregnancy outcome that non-anaemic women, (2) babies born to anaemic women have slower growth and development milestones and (3) the problem of anaemia in pregnancy persist due to poor knowledge, attitude and practices among pregnant women. Significant differences found between pregnancy outcome of the groups being compared were: mean first visit ... Weight of babies assessed was lower for the anaemic group (P,0.01); mom's age for babies assessed in the community were lower of the anaemic group (p<0.02); and babies born to anaemic women were 3.8 times more likely to be stunted i.e. low length for age (p,0.05). Mean age for first pregnancy was lower for the anaemic group (p<0.05). From the qualitative data it was found that only a few of the pregnant women were knowledgeable about anaemia. Most had positive attitudes towards taking iron supplements but did not seem to practice it as expected. These findings have implications for the level of health and nutrition education offered in government health facilities and the educational level of women in the society. Health measures taken in pregnancy and early life have potential long-term effectiveness and health impact. Haemoglobin levels of pregnant women need to be assessed at the ANC for each trimesters of pregnancy to ensure appropriate and early interventions. More research is needed to assess impact of anaemia on women during lacation, and also on the later growth, development and academic attainment of children born to anaemic women (AU)

Neonatal Screening for Haemoglobinopathies in South East London: findings and comparisons with Jamaica

INTRODUCTION: Neonatal screening for sickle cell disorders has been shown to reduce mortality and morbidity. Methods of screening vary but in 1994, the local Health Authority funded universal neonatal screening across the whole of Lambeth, Southwark and Lewisham. This paper will report the findings of the first three years of operation of the programme and compare findings with the screening programme currently operating in Jamaica. METHOD: since May 1994 dried bloo[d] spots of all infants have been screened at King's College Hospital and screen positive cases followed up by counsellors. Infants are followed up at four sites (Guy's, King's, Lewisham and St.Thomas') according to parental preference. Minimum standards for follow-ups have been agreed by clinicians across all four sites and information of the success in achieving these standards is now being collected. RESULTS: Overall there have been 122 affected infants detected in the first two years 10 months of the programmes operation. This is made up of 83 HbSS, 35 HbSC, 4HbSBThal. This gives a birth preference of 23.4 per 1000 total population (2.3HbSS, 1.0 HbSC). Allowing for a termination rate of 20 percent this indicates that the expected birth prevalence in the district would be 4.2 per 1000 births. This compares with birth prevalence of of 0.3 per 1000 for congenital hypothyroidism, 06. per 1000 for cystic fibrosis and 0.1 for phenylketonuria. The distribution of the births is unevem with 57 in Southwark, 40 in Lambeth and 25 in Lewisham. The paper will report on the follow-up and outcome of care provided for this population to date. Discussion: South East London has the highest prevalence of sickle cell disorders of any district in the UK. Sickle cell disorder is now as common in South East London as it is in Jamaica. The follow-up arrangements established in South East London provide an opportunity for colloboration with the West Indies which may help to determine some of the reasons for differences in the natural course of the disease in these populations. The population based approach established should allow monitoring of the impact of community education and antenatal screening programmes on the birth prevalence over time. (AU)