Correlates of anaemia in pregnant urban South Indian women: a possible role of dietary intake of nutrients that inhibit iron absorption

Samuel, Tinu Mary; Thomas, Tinku; Finkelstein, Julia L.; Bosch, Ronald J.; Rajendran, Ramya; Virtanen, Suvi Μ.; Srinivasan, Krishnamachari; Kurpad, Anura V; Duggan, Christopher

doi:10.1017/s136898001200119x

Cited by 21 publications

(14 citation statements)

References 31 publications

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“…Overall, 62% of the study patients were anemic, which is much more than prevalence of anemia among HIV uninfected women. 12 As expected, in group 2,78.5% women had anemia which may be explained by their advanced HIV disease state.…”

Section: Discussionsupporting

confidence: 67%

Perinatal Transmission of HIV in Women Receiving Antiretroviral Prophylaxis/Therapy during Pregnancy with Zidovudine, Lamivudine, and Nevirapine: Experience at Tertiary Care Center in India

Arora¹,

Meena²,

Arora³

2015

Journal of Postgraduate Medicine, Education and Research

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Objective: To compare the perinatal transmission rate, maternal and neonatal outcome among HIV positive women on triple drug antiretroviral therapy (ART) with women receiving antiretroviral (ARV) prophylaxis for prevention of mother to child transmission (MTCT). Materials and methods:This prospective study recruited all HIV positive antenatal women who delivered at Postgraduate Institute of Medical Education and Research, Chandigarh from June 2010 to December 2011. The rate of HIV perinatal transmission was calculated in the two groups. The perinatal outcome was studied in the form of birth weight, gestation at delivery, mode of delivery, maternal morbidity and mortality. Results:The overall HIV transmission rate was 13.3% (10% in ART group and 15% in ARV group). A trend was seen toward a lower MTCT among women in ARV prophylaxis group who delivered by elective cesarean section (CS) as compared to vaginal delivery (7.7 vs 16.7%). Conclusion:The vertical transmission rate of HIV was lower among women receiving triple drug ART. The mode of delivery did not affect the transmission rate in this group.

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Section: Discussionsupporting

confidence: 67%

Perinatal Transmission of HIV in Women Receiving Antiretroviral Prophylaxis/Therapy during Pregnancy with Zidovudine, Lamivudine, and Nevirapine: Experience at Tertiary Care Center in India

Arora¹,

Meena²,

Arora³

2015

Journal of Postgraduate Medicine, Education and Research

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“…Inadequate intake of iron, zinc, and calcium are also reported among pregnant women in rural South Asia [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Dietary phytate intake inhibits the bioavailability of iron and calcium in the diets of pregnant women in rural Bangladesh: a cross-sectional study

et al. 2016

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Background: Phytate, a potent inhibitor of calcium, iron, and zinc absorption, may hamper the bioavailability of these micronutrients at the time of pregnancy. This study assessed dietary phytate intake and its inhibitory effect on the bioavailability of calcium, iron, and zinc from the diets of pregnant women in rural Bangladesh. The study also explored significant determinants that predicted the absorption of these minerals from the diet. Methods: A multiple pass recall (MPR) approach was used for this study, with in-depth probing interview covering 24-h dietary recall conducted among 717 pregnant women who were in either their second or third trimester. Results: The mean daily phytate, calcium, iron and zinc intake of the pregnant women were found to be 695.1, 192.2, 5.1, and 5.7 mg respectively. The mean molar ratios of phytate to calcium, iron, zinc and (phytate x calcium)/zinc were 0.27, 12.8, 11.2, and 54.8 respectively. All the molar ratios were found to be significantly higher in a group with the highest phytate intake compared to other intake groups. Phytate inhibited iron absorption from the diet of all the pregnant women sampled, and inhibited calcium absorption among 52 % of the women while inhibition of zinc absorption was not found in a notable number (12 %) of the pregnant women. When using multivariate models, phytate intake, inadequate micronutrient intake, gestational age, and energy intake significantly predicted the variance in phytate to mineral molar ratios. The predicting models calculated about 92 %, 88 %, and 89 % variance in phytate to calcium, iron, and zinc molar ratios respectively. Phytate to calcium, iron, and zinc molar ratios would be expected to be respectively 0.05, 2.48, and 1.96 points higher for every 100 mg increment in daily phytate intake. Conclusions: Phytate intake was found to inhibit the bioavailability of iron and calcium from the diets of pregnant women. Moreover, phytate was one of the strongest inhibitory predictors of calcium, iron and zinc bioavailability.

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“…However, there is inconsistent evidence of an association between high parity (5+) and anaemia in pregnancy. While some studies show high parity increases risk [ 14 , 15 ], others show no increased risk [ 16 ]. Effective interventions to prevent anaemia in pregnancy include preconception and prenatal iron supplementation, and intermittent presumptive treatment of malaria (IPT) [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda

2014

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BackgroundAnaemia in pregnancy is a major public health problem especially in the low-income countries where it is highly prevalent. There has been no recent study in Uganda about the factors associated with anaemia in pregnancy. We aimed to assess the current haemoglobin (Hb) status and factors associated with anaemia (Hb < 11.0 g/dl) in pregnant women in Mpigi, Uganda.MethodsWe assessed Hb levels of 2436 pregnant women at 28+ weeks of gestation at six health facilities, who were approached to participate in a stepped-wedge cluster-randomised trial of antenatal distribution of misoprostol (for self-administration after home birth or when oxytocin is not available). Women were administered a questionnaire and their baseline blood haemoglobin was examined using portable HemoCueR Hb 301 system. Predictors of anaemia were estimated using linear and logistic regression analysis.ResultsThe mean Hb was 11.5 (±1.38) g/dl and prevalence of anaemia (Hb < 11.0 g/dl) was 32.5% (95% CI 30.6%, 34.3%). After adjusting for measured confounders, factors associated with increased risk of anaemia in pregnancy were malaria infection (OR: 1.32, 95% CI: 1.11, 1.58), Human Immuno-deficiency Virus infection (OR: 2.13, 95% CI: 1.36, 2.90) and lack of iron supplementation (OR: 1.66, 95% CI: 1.36, 2.03). Intermittent presumptive treatment of malaria, maternal age and parity showed a weak association with anaemia in pregnancyConclusionThe high prevalence of anaemia in pregnancy in our setting highlights the need to put more effort in the fight against malaria and HIV, and also ensure that pregnant women access iron supplements early in pregnancy.

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Correlates of anaemia in pregnant urban South Indian women: a possible role of dietary intake of nutrients that inhibit iron absorption

Cited by 21 publications

References 31 publications

Perinatal Transmission of HIV in Women Receiving Antiretroviral Prophylaxis/Therapy during Pregnancy with Zidovudine, Lamivudine, and Nevirapine: Experience at Tertiary Care Center in India

Perinatal Transmission of HIV in Women Receiving Antiretroviral Prophylaxis/Therapy during Pregnancy with Zidovudine, Lamivudine, and Nevirapine: Experience at Tertiary Care Center in India

Dietary phytate intake inhibits the bioavailability of iron and calcium in the diets of pregnant women in rural Bangladesh: a cross-sectional study

Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda

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