Reduction in antenatal anaemia over a 10-year period in Montserrat

Anemia during pregnancy is associated with adverse outcomes including maternal and perinatal mortality. However, health education and other public health strategies seeking to reduce its prevalence have usually met with only limited success. The study reported here surveyed anemia of pregnancy on the island of Montserrat in 1980, 1985, and 1990. This involved examination of clinic and hospital records for over 90 percent of all women giving birth in 1990. This examination showed a dramatic reduction in the prevalence of anemia at the time of the first prenatal visit (a drop from 82 percent of the study women in 1980 to 23 percent in 1985 and 19 percent in 1990) and also a marked drop at three days postpartum (from 91 percent in 1980 to 41 percent in 1985 and 39 percent in 1990). Logistic regression analyses indicated that after controlling for three possible confounding factors (maternal age, parity, and weeks of gestation at first prenatal visit) the difference between the risk of developing anemia during pregnancy in 1980 as compared to 1985 or 1990 was still highly significant. The reasons for the observed drop in anemia's prevalence during the survey period are not entirely clear, partly because of the retrospective nature of study. However, better nutrition resulting from improvement in the standard of living on Montserrat during the survey period could have been important, as could changes in health education and food supplementation activities (AU)

Social factors mediating social class differences in blood pressure in a Jamaican community

Research on the factors mediating social class differences in blood pressure was carried out in a Jamaican community. It was found in a previous report that higher social class is related to higher blood pressure. These differences are examined in greater detail here, especially in terms of the historical context of the specific community studies, which is on the fringe of the Kingston urban area, and in terms of the continuing importance of a social class system established under colonial rule. In the current study it is shown that social class differences in blood pressure for males are mediated by perceptions of economic stress. It is suggested that specific patterns of the growth of the city, and the the historically-based social class system, have resulted in the juxtaposition of lower and middle class Jamaican within this community, who in turn are influenced by different factors affecting blood pressure (AU)

Social factors mediating social class differences in blood pressure in a Jamaican community

Research on the factors mediating social class differences in blood pressure was carried out in a Jamaican community. It was found in a previous report that higher social class is related to lower blood pressure for females, while for males higher social class is related to higher blood pressure. These differences are examined in greater detail here, especially in terms of the historical context of the specific community studied, which is on the fringe of Kingston urban area, and in terms of the continuing importance of a social class system established under colonial rule. In the current study it is shown that class differences in blood pressure for males are mediated by perceptions of social support. Social class differences in blood pressure for females are mediated by perceptions of economic stress. It is suggested that specific patterns of the growth of the city, and the historically-based social class system, have resulted in the juxtaposition of lower and middle class Jamaicans within this community, who in turn are influenced by different factors affecting blood pressure(AU)

Blood pressure and social class in a Jamaican community

A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension (and other covariates), interaction effects of social class x sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing social class for females. (AU)

Blood pressure and social class in a Jamaican community

A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension(and other covariates), interaction effects of social class and sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing class for females(AU)

Haemoglobin levels in West Indian antenatals

Studies conducted in the English-speaking Caribbean have shown that anaemia is a public health problem in pregnancy. However, these studies have been questioned because the World Health Organization (WHO) haemoglobin criteria, which are based on studies of North American and European women, may not apply to Caribbean women. Antenatal clinic records were studied at the University of the West Indies (UHWI), Kingston, Jamaica. Over half of the antenatal women were between the ages of 21 and 27 years. Modal parity was 1 (41 percent) followed by a parity of 2 (31 percent). Median value for gestation was 13 weeks. The mean haemoglobin level was 12.4+1.5 gm/dl (median - 12.6). Twenty-one antenatal women (3.9 percent) had haemoglobin levels below 11 gm/dl and only 4 (0.6 percent) had haemoglobin levels below 10 gm/dl. The mean haemoglobin at the UHWI was 1.9 gm/dl higher than that of 159 patients from Antigua. However, the Antiguans were an average of 6 weeks further advanced in pregnancy. In Montserrat, the mean of 138 antenatal haemoglobin levels was 2.4 gm/dl lower than the UHWI mean; these patients were also about 6 weeks further advanced in pregnancy. This study suggests that, given the right environment, the antenatal women in Montserrat and Antigua, who are roughly the same ethnic origin as those from Jamaica, could achieve the same haemoglobin levels as those of pregnant women attending antenatal clinic at the UHWI, Kingston, Jamaica (AU)

Anaemia in antenatals in the Turks & Caicos Islands

Anaemia in the Turks & Caicos Islands was studied by examining all antenatal records for a four-year period from 1981 to 1984. If the World Health Organization (WHO) standards were used, 60-70 per cent of the antenatals were classified as anaemic over the four-year period. The per cent of antenatals with haemoglobin levels below 9.0 gm/dl varied from 7 to 9 percent. There was a statistical difference between the four years of data from the Turks & Caicos Islands and the haemoglobin levels of the University Hospital of the West Indies antenatals (AU)

Techniques for analysing and minimizing observer effects upon auscultatory blood pressure measurements - abstract

Using bloodpressure measurements collected by four interviewers, measurement error introduced by terminal digit preference and observer bias is analyzed, using descriptive techniques (digit preference tables and range cumulative frequency distributions) which are simple enough to be done by hand. Comparison with subjectivity-free measurements shows that the artifically small within-visit variability which results from digit preference and remembering of previous measurements results in increased overall variance and an increased number of patient visists to achieve satifactory diagnosis of hypertension or confidence limits on bloodpressure estimates. Three approaches for decreasing digit preference and observer bias measurement error are offered: education about the problems and their consequences, organising patient visits to obtain truly independent measurements, and using the digit preference and range cumulative frequency distribution tables as feedback to the observers (AU)

Arterial bloodpressure levels and social class in a Jamaican Community - abstract

Arterial bloodpressure levels were studied in relationship to a variety of biomedical and sociocultural factors in a community survey of a town on the edge of Kingston, Jamaica. The aim was to examine the distribution of average bloodpressures in relation to social class. Individuals between the ages of 30 and 50 years were sampled (73 males and 126 females). Respondents were interviewed in their homes by nurses, who also took bloodpressure (using the standard auscultatory method) and measured the respondents' height and weight. Nine bloodpressure readings were taken at the interview, and the average of these used as the dependent variable. Individuals were assigned a social class ranking (lower class, emergent middle class, middle/upper class) on the basis of the occupation of the head of the household in which they lived, using a ranking of occupational prestige previously validated for Jamaica. To assess effects, a three-way analysis of co-variance, controlling for body mass (the Quetelet Index) and self-reported physical activity, was used. Social class had no significan main effect; the interaction effects of social class and sex (p<.02) and social class and age (p<.05) were significant for both systolic and diastolic bloodpressure levels. Higher social class was associated with higher bloodpressures for males; lower social class was associated with higher bloodpressures for females. These differences were most pronounced among persons aged 40-50 years. Potential dietary and/or psychological factors mediating these relationships are suggested. (Table Included) (AU)

Haemoglobin levels in West Indian antenatals - abstract

Studies conducted in the English-speaking Caribbean have shown that anaemia is a public health problem in pregnancy. However, these studies have been questioned because the WHO haemoglobin criteria, which are based on studies of North American and European women, may not apply to Caribbean women. Antinatal clinic records were studied at the University of the West Indies (UWI), Kingston, Jamaica. Over half of the antenatal women were between the ages of 21 and 27 years. Modal parity was 1 (41 percent) followed by a parity of 2 (31 percent). Median value for gestation was 13 weeks. The mean haemoglobin level was 12.4 ñ 1.5 gm/dl (median - 12.6) Twenty-one antenatal women (3.9 percent) had haemoglobin levels 11 gm/dl and only 4 (0.6 percent) had haemoglobin levels below 10 g/dl. The mean haemoglobin at the University Hospital of the West Indies (UHWI) was 1.9 gm/dl higher that of 159 patients from Antigua. However, the Antiguans were an average of 6 wk further advanced in pregnancy. In Montserrat, the mean of 138 antenatal haemoglobin levels was 2.4 gm/dl lower than the UWI mean; these patients were also about 6 weeks further advanced in pregnancy. This study suggests that, given the right environment, the antenatal women in Monsterrat and Antigua, who are of roughly the same ethnic origin as those from Jamaica, could achieve the same haemoglobin levels as those of pregnant women attending the antenatal clinic at the UHWI, Kingston, Jamaica (AU)