Postnatal iron status of Hong Kong Chinese women in a longitudinal study of maternal nutrition

Abstract

Objective: To report postnatal iron nutritional status of Hong Kong Chinese women during the ®rst 6 months postpartum. Design and subjects: A longtitudinal study examining postnatal calcium and iron status of Hong Kong Chinese breastfeeding and formula-feeding women was conducted during 1998. Postpartum women aged 20 ± 40 y, with no bone or blood disorders were recruited and interviewed at 0 (baseline), 2, 6 weeks, 3 and 6 months postpartum. Dietary intake was assessed by a 3 day dietary record and cross checked by a 24 h recall. Complete blood count and serum ferritin level were measured to assess anaemia and iron status. In this report, subjects were divided into an anaemic group (haemoglobin level`10 gadl) and a non-anaemic group (haemoglobin level ! 10 gadl) according to baseline haemoglobin levels. Results: At baseline, 13a47 (27.7%) subjects were anaemic. Two of these 13 anaemic subjects were still anaemic at 3 and 6 months postpartum. Anaemic subjects showed signi®cantly (P`0.01) greater amounts of blood loss and a higher rate of primary postpartum haemorrhage than the non-anaemic subjects. Daily food intake and dietary nutrient intake did not differ signi®cantly between the two groups. During the ®rst 6 weeks postpartum, subjects in both groups consumed more poultry and egg, and comparable amounts of meat, compared with women in the Hong Kong general population. Iron and vitamin C intakes for the majority of subjects reached 60% of the US Recommended Daily Allowances. Regression analysis suggested that the rate of change in haemoglobin level in the ®rst 6 weeks postpartum was positively correlated with baseline MCV level and serum ferritin level, but negatively correlated with baseline haemoglobin level. Conclusions: Blood loss at delivery is an important factor for postpartum anaemia. Postnatal recovery of iron status of this group of women appeared to be more related to physiological factors than to dietary factors. The role of diet as well as other physiological changes in postpartum women requires further investigation. Finding ways to minimise blood loss at delivery could be the most practical strategy to reduce the rate of postpartum anaemia.

Women who experience obstetric haemorrhage are at higher risk of anaemia, in both rich and poor countries

“…The search process is outlined in Figure 1. Data were extracted from nine papers (with authors providing additional data for two of these) (Chan et al. 2001; Walraven et al.…”

“…Only one study (Walraven et al. 2005) described objectively measuring the amount of blood lost, although Chan et al. (2001) described estimating the volume from a standard kidney dish.…”

“…(2001) described estimating the volume from a standard kidney dish. In the studies by Chan et al. (2001), Nicol et al.…”

“…Post‐partum anaemia was most frequently defined as <10 g/dl of haemoglobin (Lao et al. 1996; Chan et al. 2001; Sserunjogi et al.…”

Assessment of maternal anemia in rural Western China between 2001 and 2005: a two-level logistic regression approach

“…Although anemia results from a wide variety of causes including folate or vitamin B-12 deficiency, infection, inflammation, heredity and so on, it is generally perceived that the most important contributing factor of anemia is iron deficiency, which accounts for about half of all anemia cases [3-5]. Because of depleting their iron stores by the end of their pregnancy, losing a large amount of blood during childbirth, secreting a large amount of nutrients in their breast milk, and recurrent menstrual loss, women of reproductive age are most at risk of anemia [6,7]. Many studies also showed that anemia could lead to not only impairment in work capacity and learning ability but also increases of morbidity from infections [8-11].…”