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1.
Nutrients ; 16(11)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38892606

RESUMO

The prevalence of anaemia in India remains high in children, especially those in rural areas, and in women of childbearing age, and its impairment of neurological development can have serious lifelong effects. It is concerning that the most recent official data (2019-21) indicate an increased prevalence compared with 2015-16. There is also considerable variability in childhood anaemia between Indian states with socioeconomic factors, such as wealth and education contributing to the risk of anaemia among adolescent women and their children. Dietary iron deficiency is often regarded as the main contributor to anaemia but increasing evidence accumulated from the authors' ongoing literature database coupled with recent literature research suggests that it has a multifactorial aetiology, some of which is not related to nutrition. This narrative review focused on these multifactorial issues, notably the contribution of vitamin B12/folate deficiency, which also has a high prevalence in India. It was also noted that the dietary intake of bioavailable iron remains an important contributor for reducing anaemia, and the role of millets as an improved iron source compared to traditional staple cereals is briefly discussed. The overall conclusion is that anaemia has a multifactorial aetiology requiring multifactorial assessment that must include assessment of vitamin B12 status.


Assuntos
Anemia , Deficiência de Ácido Fólico , Deficiência de Vitamina B 12 , Humanos , Índia/epidemiologia , Prevalência , Deficiência de Vitamina B 12/epidemiologia , Feminino , Anemia/epidemiologia , Anemia/etiologia , Deficiência de Ácido Fólico/epidemiologia , Adolescente , Criança , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etiologia , Masculino , Ferro da Dieta/administração & dosagem , Estado Nutricional , Adulto , Fatores de Risco , Dieta/efeitos adversos , Vitamina B 12/administração & dosagem , Vitamina B 12/sangue
2.
Nutrients ; 16(11)2024 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-38892681

RESUMO

In pregnant women with multiple infections, nutrient deficiencies, and inflammation (MINDI), the study of anemia and iron status is limited. For this cross-sectional study (n = 213 Panamanian indigenous women), we investigated if hemoglobin, anemia (Hb < 110 g/L), ferritin, serum iron, serum transferrin receptor, and hepcidin were associated with (1) maternal nutritional status and supplementation practices, (2) biomarkers of inflammation, and (3) presence/absence of infections. Hierarchical generalized linear and logistic regression models and dominance analyses identified the relative importance of these predictors. Anemia (38%), which was likely underestimated due to low plasma volume (95%), was associated with lower ferritin, vitamin A, and weight-for-height, suggesting anemia of undernutrition. Inflammation was not associated with Hb or anemia; nevertheless, higher CRP was associated with increased odds of low serum iron and higher ferritin and hepcidin, indicating iron restriction due to inflammation. The length of iron supplementation did not enter models for anemia or iron indicators, but a multiple nutrient supplement was associated with higher ferritin and hepcidin. Moreover, iron supplementation was associated with higher odds of vaginal trichomoniasis but lower odds of caries and bacterial vaginosis. The complex pathogenesis of anemia and iron deficiency in MINDI settings may require other interventions beyond iron supplementation.


Assuntos
Anemia Ferropriva , Ferritinas , Hepcidinas , Inflamação , Ferro , Estado Nutricional , Humanos , Feminino , Gravidez , Inflamação/sangue , Adulto , Estudos Transversais , Ferro/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/sangue , Ferritinas/sangue , Hepcidinas/sangue , Suplementos Nutricionais , Biomarcadores/sangue , Adulto Jovem , Deficiências de Ferro , Hemoglobinas/análise , Hemoglobinas/metabolismo , Estudos de Coortes , Anemia/epidemiologia , Anemia/sangue , Anemia/etiologia , Receptores da Transferrina/sangue , Fenômenos Fisiológicos da Nutrição Materna
3.
Sci Rep ; 14(1): 13407, 2024 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862566

RESUMO

Iron deficiency is a widespread micronutrient deficiency, impacting over 30% of the global population. Iron Folic Acid supplement is recommended for pregnant women to counter iron deficiency anemia and neural tube anomalies. Although Iron Folic Acid supplementation is integral to Ethiopian antenatal care, one in four women in Ethiopia experiences anemia during pregnancy suggesting poor compliance. This study aimed to investigate compliance level and associated factors of Iron Folic Acid supplementation among pregnant women attending antenatal care in Wuchale Woreda of North Shoa Zone, Ethiopia. An institutional-based cross-sectional study was conducted among 302 pregnant women from March 20 to April 5, 2021, who were selected using a systematic random sampling technique. Data were collected through face-to-face interview, entered epi-data, and exported to Statistical Package for the Social Sciences for analysis. A multivariable logistic regression was used to identify factors associated with compliance level. All the results were presented with 95% confidence intervals. The compliance with Iron Folic Acid supplementation was 47.0%. Residing nearest to the health facility (AOR = 2.46; 95% CI 1.32, 4.57), initiating antenatal care at health center (AOR = 2.23; 95% CI 1.17, 4.51), having a family size of 4 and above (AOR = 4.99; 95% CI 2.43, 10.24), and receiving information from health extension workers (AOR = 5.52; 95% CI 1.30, 23.54) increased compliance with Iron Folic Acid supplementation. Less than half of the pregnant women were compliant with Iron Folic Acid utilization. There is a need to prioritize promoting the importance of Iron Folic Acid supplementation through health education particularly by targeting pregnant women with identified factors.


Assuntos
Anemia Ferropriva , Suplementos Nutricionais , Ácido Fólico , Ferro , Cuidado Pré-Natal , Humanos , Feminino , Ácido Fólico/administração & dosagem , Gravidez , Etiópia , Adulto , Estudos Transversais , Ferro/administração & dosagem , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/tratamento farmacológico , Adulto Jovem , Adolescente , Gestantes/psicologia , Cooperação do Paciente/estatística & dados numéricos
4.
Open Heart ; 11(1)2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839367

RESUMO

BACKGROUND: Iron deficiency (ID) has been reported in patients with congenital heart disease. There is, however, a scarcity of data on its prevalence in patients with a Fontan circulation. The aim of this study is to investigate the prevalence of ID in Fontan patients and to investigate the association between ID and exercise capacity in this population. METHODS AND RESULTS: Blood count and haematological parameters were determined in plasma of 61 Fontan patients (51% female, mean age 29±9 years). ID was defined as transferrin saturation (TSAT) ≤19.8%. The prevalence of ID was 36% (22/61 patients). Especially among women, the diagnosis of ID was highly prevalent (52%) despite normal haemoglobin levels (153.7±18.4 g/L). Mean ferritin levels were 98±80 µg/L and mean TSAT levels were 22%±12%. Cardiopulmonary exercise testing was performed in 46 patients (75%). Patients with ID had a lower peak oxygen uptake (V̇O2peak) (1397±477 vs 1692±530 mL/min; p=0.039), although this relationship was confounded by sex. The presence of ID increased the likelihood of not achieving a respiratory exchange ratio (RER) ≥1.1 by 5-fold (p=0.035). CONCLUSION: ID is highly prevalent among patients with a Fontan circulation. V̇O2peak is lower in patients with ID. Fontan patients with ID are less likely to achieve an RER≥1.1 during cardiopulmonary exercise testing.


Assuntos
Teste de Esforço , Tolerância ao Exercício , Técnica de Fontan , Cardiopatias Congênitas , Humanos , Feminino , Masculino , Técnica de Fontan/efeitos adversos , Cardiopatias Congênitas/cirurgia , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/fisiopatologia , Cardiopatias Congênitas/epidemiologia , Tolerância ao Exercício/fisiologia , Adulto , Prevalência , Adulto Jovem , Biomarcadores/sangue , Anemia Ferropriva/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/fisiopatologia , Consumo de Oxigênio/fisiologia , Ferro/sangue , Deficiências de Ferro , Adolescente , Ferritinas/sangue
5.
JAMA Netw Open ; 7(6): e2413967, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38848068

RESUMO

Importance: The prevalence of iron deficiency varies widely according to how it is defined. Objective: To compare the prevalence of iron deficiency among women using 3 different definitions. Design, Setting, and Participants: The cross-sectional Hemochromatosis and Iron Overload Screening Study (HEIRS; 2000-2006) evaluated the prevalence, determinants, and outcomes of hemochromatosis and other iron-related disorders. Multiethnic, primary care-based screening (2001-2003) was performed at 5 field centers (4 in the US and 1 in Canada). Volunteer women aged 25 years and older were recruited at primary care venues associated with the field centers. Data were analyzed from June to December 2023. Main Outcomes and Measures: Measures included transferrin saturation, serum ferritin level, and self-reported age, pregnancy, and race and ethnicity. Three iron deficiency definitions were studied: (1) combined transferrin saturation less than 10% and serum ferritin less than 15 ng/mL (HEIRS), (2) serum ferritin less than 15 ng/mL (World Health Organization [WHO]), and (3) serum ferritin less than 25 ng/mL (a threshold for iron-deficient erythropoiesis [IDE]). Results: Among 62 685 women (mean [SD] age, 49.58 [14.27] years), 1957 women (3.12%) had iron deficiency according to the HEIRS definition, 4659 women (7.43%) had iron deficiency according to the WHO definition, and 9611 women (15.33%) had iron deficiency according to the IDE definition. Among 40 381 women aged 25 to 54 years, 1801 women (4.46%) had iron deficiency according to HEIRS, 4267 women (10.57%) had iron deficiency according to WHO, and 8573 women (21.23%) had iron deficiency according to IDE. Prevalence rates of iron deficiency among 2039 women aged 25 to 44 years who reported pregnancy were 5.44% (111 women) according to HEIRS, 18.05% (368 women) according to WHO, and 36.10% (736 women) according to IDE. Iron deficiency prevalence by the 3 respective definitions increased significantly in each racial and ethnic group and was significantly higher among Black and Hispanic participants than Asian and White participants. The relative iron deficiency prevalence among the 62 685 women increased 2.4-fold (95% CI, 2.3-2.5; P < .001) using the WHO definition and increased 4.9-fold (95% CI, 4.7-5.2; P < .001) using the IDE definition. Conclusions and Relevance: Three definitions of iron deficiency were associated with significantly different prevalence of iron deficiency in women, regardless of self-reported age, pregnancy, or race and ethnicity. Using higher serum ferritin thresholds to define iron deficiency could lead to diagnosis and treatment of more women with iron deficiency and greater reduction of related morbidity.


Assuntos
Anemia Ferropriva , Ferritinas , Humanos , Feminino , Prevalência , Canadá/epidemiologia , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico , Ferritinas/sangue , Transferrina/análise , Transferrina/metabolismo , Gravidez , Deficiências de Ferro , Idoso
7.
J Sci Med Sport ; 27(7): 437-450, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38749874

RESUMO

OBJECTIVES: Iron deficiency, anaemia, and menorrhagia - or heavy menstrual bleeding - are interrelated conditions that are highly prevalent and commonly underrecognised in exercising females of reproductive age. This study utilised a screening tool to identify risk factors and symptoms associated with heavy menstrual bleeding, iron deficiency, and anaemia in this population. DESIGN: An observational, cross sectional survey study was employed. METHODS: 1042 active females (aged 18-65) completed a comprehensive screening questionnaire and 887 (85 % compliance) provided a fingerprick blood sample for haemoglobin (Hb) concentration measurement. Women that presented as anaemic (defined as a [Hb] < 120 g/L) or deemed to be at risk of iron deficiency (120 < [Hb] < 130 g/L) were asked to complete follow-up blood tests to screen for iron studies. RESULTS: Average [Hb] was 134.2 ±â€¯12.1 g/L, with 94 individuals considered anaemic (10.6 %). Of the sample, 104 underwent follow-up blood tests; 51 (~49 %) presented with iron deficiency (defined as ferritin <30 µg/L). Based on survey responses, 274 (30.9 %) participants were determined to have heavy menstrual bleeding. Those presenting with heavy menstrual bleeding were younger, exercised fewer hours per week, and were more likely to have a history of iron deficiency or anaemia (all p < 0.05). Participants reporting a history of anaemia or iron deficiency were more likely to have heavy menstrual bleeding (anaemia: 39.7 %; iron deficiency; 36.9 %; both p < 0.05). CONCLUSIONS: In this cohort of exercising females of reproductive age, the prevalence of anaemia was 10.6 %. There is a strong association between heavy menstrual bleeding and a self-reported history of iron deficiency and anaemia. Greater awareness of heavy menstrual bleeding and its relationship with iron deficiency and anaemia is needed in this population. Non-invasive screening should be conducted to raise awareness and further understand the associated risk factors and symptomatology.


Assuntos
Anemia Ferropriva , Menorragia , Humanos , Feminino , Menorragia/sangue , Menorragia/epidemiologia , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico , Hemoglobinas/análise , Fatores de Risco , Deficiências de Ferro , Exercício Físico , Idoso , Inquéritos e Questionários , Prevalência , Ferritinas/sangue , Anemia/epidemiologia , Anemia/sangue , Anemia/diagnóstico
8.
BMC Pregnancy Childbirth ; 24(1): 381, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778245

RESUMO

BACKGROUND: Iron deficiency anemia (IDA) is a global health challenge, especially affecting females and children. We aimed to conduct an umbrella systematic review of available evidence on IDA's prevalence in Iranian pregnant women and children. METHODS: We searched the Web of Science, Science Direct, PubMed, Scopus, and Google Scholar databases for articles published by April 2023. Meta-analyses investigating the status of IDA in Iran were included. The findings of seven meta-analyses comprising 189,627 pregnant women with a mean age of 26 and 5,890 children under six years old were included in this study. The methodological quality of each study was evaluated with the Assessment of Multiple Systematic Reviews (AMSTAR2) instrument. RESULTS: We estimated the prevalence of IDA at 15.71% in pregnant women and 19.91% in young children. According to our subgroup analysis of pregnant women, IDA's prevalence in urban and rural regions was 16.32% and 12.75%; in the eastern, western, central, southern, and northern regions of Iran, it was estimated at 17.8%, 7.97%, 19.97%, 13.45%, and 17.82%, respectively. CONCLUSION: IDA is common in young children and pregnant females and is a significant public health concern in Iran. The present umbrella review results estimated that Iran is in the mild level of IDA prevalence based on WHO classification. However, due to sanctions and high inflation in Iran, the prevalence of anemia is expected to increase in recent years. Multi-sectoral efforts are required to improve the iron status of these populations and reduce the burden of IDA in the country.


Assuntos
Anemia Ferropriva , Humanos , Anemia Ferropriva/epidemiologia , Feminino , Irã (Geográfico)/epidemiologia , Gravidez , Prevalência , Criança , Pré-Escolar , Lactente , Complicações Hematológicas na Gravidez/epidemiologia , Adulto
9.
Nutrients ; 16(10)2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38794732

RESUMO

Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.


Assuntos
Ferro , Estado Nutricional , Desmame , Humanos , Nova Zelândia/epidemiologia , Lactente , Feminino , Masculino , Ferro/sangue , Fenômenos Fisiológicos da Nutrição do Lactente , Alimentos Infantis/análise , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/sangue , Deficiências de Ferro
10.
Clin Transplant ; 38(6): e15367, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38809215

RESUMO

INTRODUCTION: The prevalence of iron deficiency and anemia in the setting of modern-day maintenance immunosuppression in pediatric heart transplant (HTx) recipients is unclear. The primary aim was to determine the prevalence of iron deficiency (serum ferritin < 30 ng/mL ± transferrin saturation < 20%) and anemia per World Health Organization diagnostic criteria and associated risk factors. METHODS: Single-center, cross-sectional analysis of 200 consecutive pediatric HTx recipients (<21 years old) from 2005 to 2021. Data were collected at 1-year post-HTx at the time of annual protocol biopsy. RESULTS: Median age at transplant was 3 years (IQR .5-12.2). The median ferritin level was 32 ng/mL with 46% having ferritin < 30 ng/mL. Median transferrin saturation (TSAT) was 22% with 47% having TSAT < 20%. Median hemoglobin was 11 g/dL with 54% having anemia. Multivariable analysis revealed lower absolute lymphocyte count, TSAT < 20%, and estimated glomerular filtration rate <75 mL/min/1.73 m2 were independently associated with anemia. Ferritin < 30 ng/mL in isolation was not associated with anemia. Ferritin < 30 ng/mL may aid in detecting absolute iron deficiency while TSAT < 20% may be useful in identifying patients with functional iron deficiency ± anemia in pediatric HTx recipients. CONCLUSION: Iron deficiency and anemia are highly prevalent in pediatric HTx recipients. Future studies are needed to assess the impact of iron deficiency, whether with or without anemia, on clinical outcomes in pediatric HTx recipients.


Assuntos
Anemia Ferropriva , Transplante de Coração , Humanos , Transplante de Coração/efeitos adversos , Masculino , Feminino , Estudos Transversais , Criança , Prevalência , Pré-Escolar , Seguimentos , Fatores de Risco , Prognóstico , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/sangue , Deficiências de Ferro , Lactente , Adolescente , Anemia/epidemiologia , Anemia/etiologia , Anemia/diagnóstico , Transplantados/estatística & dados numéricos , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/epidemiologia , Rejeição de Enxerto/sangue , Rejeição de Enxerto/diagnóstico
11.
J Pak Med Assoc ; 74(4): 626-630, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38751252

RESUMO

Objective: To evaluate vitamin D deficiency in children with iron-deficiency anaemia, and to identify the risk factors for such deficiency. METHODS: The cross-sectional study was conducted at the Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from October 2021 to March 2022, and comprised children aged 1-5 years who had been diagnosed with iron-deficiency anaemia. Quantitative variables, like age, height, weight, gender, socioeconomic status and sibling status, were controlled by stratification. Data was compared to assess the risk factors of vitamin D deficiency among the subjects. Data was analysed using SPSS 22. RESULTS: Of the 236 children with iron-deficiency anaemia, 159(67.5%) also had vitamin D deficiency; 95(59%) girls and 65(41%) boys. Overall, 104(65.4%) subjects were aged 4-5 years and 55(34.6%) were aged 1-3 years. Vitamin D deficiency had significant association with female gender, older age, height and weight <5th centiles, educated parents, low to middle socioeconomic status, urban residence and higher number of siblings (p<0.05). CONCLUSIONS: The prevalence of vitamin D deficiency among children with iron-deficiency anaemia was found to be high.


Assuntos
Anemia Ferropriva , Deficiência de Vitamina D , Humanos , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/complicações , Anemia Ferropriva/epidemiologia , Feminino , Masculino , Pré-Escolar , Paquistão/epidemiologia , Estudos Transversais , Lactente , Fatores de Risco , Prevalência , Fatores Sexuais , Estatura , Fatores Etários , Peso Corporal , Escolaridade , Classe Social , Irmãos
12.
Sci Rep ; 14(1): 9980, 2024 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-38693315

RESUMO

Iron deficiency anemia is a public health problem among adolescents that could be addressed by weekly Iron Folic Acid Supplementation (IFAS). The Ethiopian government piloted weekly IFAS in schools, where its effectiveness depends on compliance. We assessed the determinants of compliance with the weekly IFAS in Ethiopia. A school-based survey was conducted in 506 adolescent girls on weekly IFAS. Compliance was considered when girls reported WIFAS for at least three months without discontinuation. Bivariable and multivariable logistic regression models were modeled, with odds ratios reported. Out of 506, 25.8% had limited access to educational resources, and 79.4% had no information on IFAS. Among these, 47.9% (95% CI: 45.5-49.9%) had poor compliance with weekly IFAS. Non-compliance was mainly due to school absenteeism (55.9%). Important predictors of poor compliance were adolescent girls' marital status (AOR = 5.21; 1.55-17.6), academic standing (AOR = 4.37; 2.20-8.70), family income (AOR = 1.85; 1.09-3.15), access to health education materials (AOR = 1.57; 1.02-2.40), problems with IFAS (AOR = 2.44; 1.26-4.74), a discouraging home environment for the program (AOR = 2.27; 1.54-3.34), and a lack of knowledge of the IFAS program (AOR = 1.40; 0.97-2.03). Compliance with weekly IFAS is optimal, which could be improved via strong adherence support and feasible supplementation schedules.


Assuntos
Suplementos Nutricionais , Ácido Fólico , Ferro , Humanos , Feminino , Adolescente , Ácido Fólico/administração & dosagem , Etiópia , Estudos Transversais , Ferro/administração & dosagem , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/epidemiologia , Instituições Acadêmicas , Cooperação do Paciente/estatística & dados numéricos
13.
BMC Pregnancy Childbirth ; 24(1): 332, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724919

RESUMO

BACKGROUND: Anemia remains a major global public health issue, affecting around 24.8% of the world's population in both developing and developed countries. Pregnant women in developing countries are particularly susceptible, with 38.2% affected worldwide. Anemia is also a major contributor to maternal mortality, with 510,000 maternal deaths globally, of which 20% occur in developing countries and are related to anemia. Iron deficiency anemia is the most prevalent form, impacting 1.3 to 2.2 billion individuals, with 50% being women of reproductive age. AIM: This study aimed to assess the prevalence and associated factors of anemia in pregnant women attending antenatal care (ANC) at Hargeisa Group Hospital (HGH), Somaliland. METHODS: A cross-sectional study included 360 pregnant women, who sought ANC at HGH from July 15 to August 6, 2023. The study subjects were selected using systematic random sampling. Data were collected through structured questionnaires and participants' current medical charts, including hemoglobin levels. Data analysis was performed using SPSS software (version 20). RESULTS: The study revealed an overall prevalence of anemia among pregnant women at 50.6% (95% CI: 45.40 - 55.72%). Anemia severity was categorized as mild (33.0%), moderate (54.9%), and severe (12.1%). Factors statistically associated with anemia included gestational age in the third trimester (AOR = 3.248, 95% CI: 1.491-7.074), lack of ANC visits (AOR = 6.828, 95% CI: 1.966-23.721), and absence of iron supplementation (AOR = 29.588, 95% CI: 2.922-299.713). Notably, a higher consumption of meat per week was associated with a reduced risk of anemia (AOR = 0.198, 95% CI: 0.104-0.379). CONCLUSION: The study underscores the severity of anemia in pregnant women within the range considered as severe public health problem by WHO. It is crucial to emphasize effective prenatal care, improve dietary practices, and promote the provision of iron supplements. Enhanced maternal education on Anemia during ANC visits has the potential to reduce Anemia prevalence and mitigate adverse maternal and neonatal outcomes.


Assuntos
Anemia , Complicações Hematológicas na Gravidez , Cuidado Pré-Natal , Humanos , Feminino , Gravidez , Prevalência , Estudos Transversais , Adulto , Anemia/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Complicações Hematológicas na Gravidez/epidemiologia , Adulto Jovem , Fatores de Risco , Somália/epidemiologia , Anemia Ferropriva/epidemiologia
14.
Nutrients ; 16(9)2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38732532

RESUMO

Anemia in breastfeeding women is a neglected global health issue with significant implications for maternal and child health. Despite its widespread occurrence and adverse effects, this problem remains largely unknown and overlooked on the global health agenda. Despite efforts to improve health access coverage and provide iron and folic acid supplementation, anemia persists. This underscores the need for a comprehensive approach to address the problem. Urgent action must be taken to prioritize education and awareness campaigns, ensure access to nutritious food, and enhance healthcare services. Education programs should focus on promoting iron-rich diets, dispelling cultural myths, and providing practical guidance. Improving healthcare services requires increasing availability, ensuring a consistent supply of iron supplements, and providing adequate training for healthcare providers. A successful implementation relies on a strong collaboration between the government, healthcare providers, and community. It is crucial that we acknowledge that high coverage alone is insufficient for solving the issue, emphasizing the importance of targeted interventions and a strategic implementation. By adopting a comprehensive approach and addressing the underlying causes of anemia, Indonesia can make significant progress in reducing its prevalence and improving the overall health of its population, particularly among breastfeeding women.


Assuntos
Aleitamento Materno , Suplementos Nutricionais , Humanos , Indonésia/epidemiologia , Feminino , Anemia/epidemiologia , Anemia/prevenção & controle , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/prevenção & controle , Lactente , Saúde da Criança , Ferro/administração & dosagem , Ácido Fólico/administração & dosagem
15.
Womens Health Issues ; 34(3): 317-324, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38658289

RESUMO

BACKGROUND: Endometriosis may be linked to the risk of iron deficiency through chronic systemic inflammation or heavy menstrual bleeding. No longitudinal studies, however, have examined the relationship between endometriosis and the risk of iron deficiency. METHODS: This study included 3,294 participants born from 1973 to 1978 and followed as part of the Australian Longitudinal Study on Women's Health from 2000 to 2018. Participants with endometriosis were identified using self-reported longitudinal surveys linked to administrative health records. During each survey, participants were also asked to report the diagnosis of iron deficiency, and we validated diagnoses using an administrative health database. Generalized estimating equations for binary responses with an autoregressive correlation matrix were used to examine the association between endometriosis and the risk of iron deficiency over the seven time points. FINDINGS: We found that women with endometriosis had a significantly higher risk of iron deficiency than those without endometriosis after adjusting for sociodemographic, lifestyle, reproductive, and nutrition factors (adjusted odds ratio [aOR] = 1.46; 95% confidence interval [CI] [1.29, 1.66]; p < .0001). Women with a surgically confirmed diagnosis and those with clinically suspected endometriosis had a higher risk of iron deficiency (aOR = 1.38; 95% CI [1.17, 1.64] and aOR = 1.53; 95% CI [1.30, 1.81]), respectively. These associations, however, were slightly attenuated (by 8%) when adjusted for the presence of heavy menstrual bleeding. CONCLUSIONS: Women with endometriosis are at a higher risk of developing iron deficiency than those without endometriosis. The findings suggest that iron deficiency should be concomitantly addressed during initial diagnosis and successive management of endometriosis.


Assuntos
Anemia Ferropriva , Endometriose , Deficiências de Ferro , Humanos , Feminino , Endometriose/complicações , Endometriose/epidemiologia , Adulto , Estudos Prospectivos , Austrália/epidemiologia , Estudos Longitudinais , Anemia Ferropriva/epidemiologia , Fatores de Risco , Pessoa de Meia-Idade , Estudos de Coortes , Ferro , Menorragia/etiologia , Menorragia/epidemiologia
17.
J Affect Disord ; 356: 34-40, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38583601

RESUMO

BACKGROUND: Postpartum anemia and iron deficiency are associated with postpartum depression. This study investigated the association between a low mean corpuscular volume (MCV) without anemia (which implies early-stage iron deficiency) in early pregnancy and perinatal mental health outcomes. METHODS: The fixed data from the Japan Environment and Children's Study (JECS), a Japanese nationwide birth cohort, were used. Perinatal mental health was assessed using the Kessler 6-item psychological distress scale (K6) in mid-pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at 1- and 6-months postpartum. RESULTS: Among the 3635 women with MCVs <85 fL in early pregnancy, the proportions of women with K6 scores ≥13 in mid-pregnancy and EPDS scores ≥9 at 1- and 6-months postpartum were 2.7 %, 12.8 %, and 9.9 %, respectively, compared with the 33,242 women with MCVs ≥85 fL at 1.9 %, 11.9 %, and 9.0 %, respectively. Multivariate logistic regression models showed that an MCV <85 in early pregnancy was associated with a K6 score ≥ 13 in mid-pregnancy and an EPDS score ≥ 9 at 1- and 6-months postpartum (adjusted odds ratio (95 % confidence interval): 1.48 (1.16-1.87), 1.14 (1.01-1.28), and 1.09 (0.95-1.24), respectively). LIMITATIONS: Low MCV values do not necessarily represent iron deficiency. Ferritin, currently the best indicator of iron deficiency, was not measured in the JECS. CONCLUSIONS: This study results suggest that a low MCV without anemia in early pregnancy is associated with a slightly increased risk of perinatal mental health deterioration.


Assuntos
Depressão Pós-Parto , Índices de Eritrócitos , Humanos , Feminino , Gravidez , Japão/epidemiologia , Adulto , Depressão Pós-Parto/sangue , Depressão Pós-Parto/epidemiologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/sangue , Saúde Mental/estatística & dados numéricos , Deficiências de Ferro , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/sangue , Estudos de Coortes , Período Pós-Parto/sangue , Período Pós-Parto/psicologia
18.
J Am Heart Assoc ; 13(9): e032540, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38639356

RESUMO

BACKGROUND: Iron deficiency (ID) is a frequent comorbidity in patients with acute (AHF) and chronic heart failure (CHF) associated with morbidity and death. We aimed to better characterize iron homeostasis in patients with heart failure applying different biomarkers and to evaluate the accuracy of current ID definition by the European Society of Cardiology/American College of Cardiology/American Heart Association to indicate tissue iron availability and demand. METHODS AND RESULTS: We performed a retrospective cohort study investigating 277 patients with AHF and 476 patients with CHF between February 2021 and May 2022. Patients with AHF had more advanced ID than patients with CHF, reflected by increased soluble transferrin receptor and soluble transferrin receptor-ferritin index, and lower ferritin, serum iron, transferrin saturation, hepcidin, and reticulocyte hemoglobin. Decreased iron availability or increased tissue iron demand, reflected by increased soluble transferrin receptor-ferritin index and decreased reticulocyte hemoglobin, was found in 84.1% (AHF) and 28.0% (CHF) with absolute ID and in 50.0% (AHF) and 10.5% (CHF) with combined ID according to the current European Society of Cardiology/American College of Cardiology/American Heart Association-based ID definition. Low hepcidin expression as an indicator of systemic ID was found in 91.1% (AHF) and 80.4% (CHF) of patients with absolute ID and in 32.3% (AHF) and 18.8% (CHF) of patients with combined ID. ID definitions with higher specificity reduce the need for iron supplementation by 25.5% in patients with AHF and by 65.6% in patients with CHF. CONCLUSIONS: Our results suggest that the current European Society of Cardiology/American College of Cardiology/American Heart Association-based ID definition might overestimate true ID, particularly in CHF. More stringent thresholds for ID could more accurately identify patients with heart failure with reduced tissue iron availability who benefit from intravenous iron supplementation.


Assuntos
Biomarcadores , Insuficiência Cardíaca , Ferro , Humanos , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/diagnóstico , Feminino , Masculino , Estudos Retrospectivos , Idoso , Ferro/metabolismo , Ferro/sangue , Biomarcadores/sangue , Ferritinas/sangue , Doença Crônica , Pessoa de Meia-Idade , Receptores da Transferrina/sangue , Anemia Ferropriva/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/diagnóstico , Doença Aguda , Hepcidinas/sangue , Hepcidinas/metabolismo , Idoso de 80 Anos ou mais , Deficiências de Ferro
19.
BMC Public Health ; 24(1): 1026, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609881

RESUMO

BACKGROUND: Patients with sickle cell disease (SCD) are prone to iron profile derangements. This study aimed to determine the prevalence of iron deficiency anaemia (IDA) and their predictors among children with SCD aged between 6 months and 14 years. Assessment of the prevalence of IDA and its predictors helps to understand ways of alleviating the magnitude of the problem so as to prevent possible complications such as shortness of breath and chest pain. METHODS: This was a cross-sectional analytical hospital-based study which included 174 patients with SCD attending SCD clinics at St. Gema hospital and Dodoma regional referral hospital in Dodoma city from October 2020 to March 2021. The cut-off points for detection of IDA was serum ferritin level < 30 µg/L and low mean corpuscular volume (MCV) for age. Data were analyzed using SPSS software version 25.0. Multivariate logistic regression analysis was used to determine the predictors of IDA. P-value less than 0.05 was considered significant. RESULTS: The prevalence of IDA in this study was (16.1%, n = 28). Family income of less than 70,000/= TZS/month (AOR = 2.2, 95% CI = 1.07-2.49, p = 0.023), being transfused with blood less than 3 times from the time of being diagnosed with SCD (AOR = 5.5, 95% CI = 1.03-8.91, p = 0.046), and eating red meat at least once per month (AOR = 3.60, 95% CI = 1.37-9.46, p = 0.010) remained the independent predictors of IDA in multivariate regression analysis. CONCLUSION: The findings of this study have shown that, support of families with children suffering from SCD in terms of financial support for improving medical services including optimal blood transfusion and affordability of diet which is rich in iron such as red meat is imperative.


Assuntos
Anemia Ferropriva , Anemia Falciforme , Criança , Humanos , Lactente , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/epidemiologia , Prevalência , Tanzânia/epidemiologia , Estudos Transversais , Ferro , Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia
20.
Circ Heart Fail ; 17(4): e011351, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38572652

RESUMO

BACKGROUND: Studies have shown an association between iron deficiency (ID) and clinical outcomes in patients with heart failure (HF), irrespective of the presence of ID anemia (IDA). The current study used population-level data from a large, single-payer health care system in Canada to investigate the epidemiology of ID and IDA in patients with acute HF and those with chronic HF, and the iron supplementation practices in these settings. METHODS: All adult patients with HF in Alberta between 2012 and 2019 were identified and categorized as acute or chronic HF. HF subtypes were determined through echocardiography data, and ID (serum ferritin concentration <100 µg/L, or ferritin concentration between 100 and 300 µg/L along with transferrin saturation <20%), and IDA through laboratory data. Broad eligibility for 3 clinical trials (AFFIRM-AHF [Study to Compare Ferric Carboxymaltose With Placebo in Patients With Acute HF and ID], IRONMAN [Intravenous Iron Treatment in Patients With Heart Failure and Iron Deficiency], and HEART-FID [Randomized Placebocontrolled Trial of Ferric Carboxymaltose as Treatment for HF With ID]) was determined. RESULTS: Among the 17 463 patients with acute HF, 38.5% had iron studies tested within 30 days post-index-HF episode (and 34.2% of the 11 320 patients with chronic HF). Among tested patients, 72.6% of the acute HF and 73.9% of the chronic HF were iron-deficient, and 51.4% and 49.0% had IDA, respectively. Iron therapy was provided to 41.8% and 40.5% of patients with IDA and acute or chronic HF, respectively. Of ID patients without anemia, 19.9% and 21.7% were prescribed iron therapy. The most common type of iron therapy was oral (28.1% of patients). Approximately half of the cohort was eligible for each of the AFFIRM-AHF, intravenous iron treatment in patients with HF and ID, and HEART-FID trials. CONCLUSIONS: Current practices for investigating and treating ID in patients with HF do not align with existing guideline recommendations. Considering the gap in care, innovative strategies to optimize iron therapy in patients with HF are required.


Assuntos
Anemia Ferropriva , Compostos Férricos , Insuficiência Cardíaca , Deficiências de Ferro , Maltose/análogos & derivados , Adulto , Humanos , Ferro/uso terapêutico , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/epidemiologia , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/epidemiologia , Ferritinas , Suplementos Nutricionais , Alberta/epidemiologia
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