Urban-rural differences in the pregnancy-related adverse outcome

Mehrnoush, Vahid; Ranjbar, Amene; Banihashemi, Farzaneh; Darsareh, Fatemeh; Shekari, Mitra; Jahromi, Malihe Shirzadfard

doi:10.1016/j.gocm.2022.12.001

“…Among other demographic variables, living residency was linked to iron-deficiency anemia. Iron-deficiency anemic women mostly lived in rural areas, consistent with previous studies [13,14].…”

Section: Discussionsupporting

confidence: 90%

Maternal and Neonatal Outcomes of Iron Deficiency Anemia: A Retrospective Cohort Study

Safarzadeh,

Banihashemi,

Montazeri

et al. 2023

Cureus

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Introduction: Understanding the outcomes of anemia in pregnancy is critical. Since no study has been conducted regarding the maternal and neonatal outcomes of iron-deficiency anemia in Hormozgan province of Iran, this study aims to assess the maternal and neonatal outcomes of iron-deficiency anemia in women who gave birth in Hormozgan province from January 2020 to January 2022. Methods: We retrospectively assessed all singleton pregnant women who gave birth at a tertiary hospital in Bandar Abbas, Hormozgan province, Iran, for two years. We divided all women into iron-deficiency anemic and non-iron-deficiency anemic women. Iron-deficiency anemia was defined as hemoglobin less than 10.5 mg/dl at the time of admission without any other hemoglobinopathy, such as sickle cell anemia or thalassemia. Using electronic patient records, data were extracted from the Iranian Maternal and Neonatal Network (IMaN Net), a valid national system. Since the information of birth under 24 weeks of gestation is not recorded in this system, we excluded all deliveries under 24 weeks of gestation. The outcome measures of the study were demographic factors (age, education, residency place, access to prenatal care, smoking), obstetrical factors (parity, labor induction, fetal presentation, mode of delivery), and maternal and neonatal outcomes (the incidence of preeclampsia, gestational diabetes, placenta abruption, postpartum hemorrhage, maternal need for blood transfusion, maternal need for intensive care unit, preterm birth, low birth weight, intrauterine growth retardation, birth asphyxia, stillbirth, and neonatal intensive care admission). Chi-square tests were used to compare differences between iron-deficiency anemic and non-iron-deficiency anemic women. Logistic regression models were used to assess the effect of iron-deficiency anemia on maternal and neonatal outcomes. The result was presented as odds ratio (OR) or adjusted odds ratio (aOR) after adjusting for covariates and a 95% confidence interval (CI). Results: The incidence of iron-deficiency anemia was 2.97%. Education and residency were among the demographic factors that differed significantly between groups. Iron-deficiency anemia was more frequent in those with higher education and women who lived in rural areas. In terms of obstetrical factors, method of delivery was the only significantly different factor between groups. Iron-deficiency anemic mothers had substantially more instrumental deliveries than non-iron-deficiency anemic mothers (4.3% vs. 0.8%), while the incidence of cesarean section was lower. Based on logistic regression in terms of maternal and neonatal outcomes, iron-deficiency anemic women had a substantially higher risk of the need for maternal blood transfusion (aOR: 6.54, 95%CI: 4.72-8.15), postpartum hemorrhage (aOR: 1.54, 95%CI: 0.71-2.11), preterm birth (aOR: 0.98, 95%CI: 0.45-1.13), low birth weight (aOR: 1.04, 95%CI: 0.78-2.01), intrauterine growth retardation (aOR: 1.30, 95%CI: 0.99-2.10), and neonatal intensive care admi...

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“…Furthermore, a research endeavor sought to assess variances between urban and rural areas concerning adverse outcomes related to pregnancy. The ndings revealed that mothers residing in rural areas faced a greater likelihood of anemia, with an adjusted odds ratio of 2.02 (95% CI: 1.07-2.34), compared to their urban counterparts [31]. However, another study conducted in Ethiopia indicated that there was no variation in the prevalence of anemia between pregnant women residing in rural and urban areas [32].…”

Section: Discussionmentioning

confidence: 95%

Plasmodium falciparum infections and Soil Transmitted helminthes correlates with Anemia in Pregnancy: Cross-Sectional Study in Kwale County, Kenya

Nyamu,

Kaplich,

Odhiambo

et al. 2024

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Background Prevalence of Anemia in Pregnancy (AiP) in Kenya ranges from 40.6–69.1%. We estimated the prevalence of AiP and correlated Plasmodium falciparum infections and Soil transmitted Helminthes (STHs) infections among the predictors AiP among pregnant women attending antenatal care (ANC) visits. Methods We performed a cross-sectional study among pregnant women attending ANC at Msambweni Hospital, between January and March 2024. Data was collected and analyzed in Epi Info 7. Descriptive statistics were calculated and we compared pregnant women with AiP with those without the condition. Crude Odds Ratios (COR) and 95% confidence intervals (CI) were calculated to identify factors associated with AiP. Results A total of 396 pregnant women were included in the study. The mean age was 27.4 years ± 6.5 years. Proportion of anemia was reported in 201 (50.76%) participants, and the mean Hb was 10.87 mg/dl (± 1.46 mg/dl); 108 (53.73%). The malaria positivity rate among them was 13.38% (53/396), and for STHs was 24/396 (6.06%) (95% CI; 4.11–8.86). Pregnant women with Plasmodium falciparum infections were 2.5 times more likely to experience anemia compared to those without malaria parasites (COR; 2.5, 95% CI: 1.35–4.71). Pregnant women residing in rural areas were 4.1 times more likely to have anemia than those living in urban areas (COR; 4.1, 95% CI: 2.64–6.39). Furthermore, pregnant women with STH infections were 1.7 times more likely to experience anemia compared to those without STH infections (COR; 1.7, 95% CI: 0.71–3.90). Conclusion The prevalence of anemia among pregnant women attending Msambweni County Referral Hospital remains high, associated with Plasmodium falciparum infections, STH infections, and women residing rural areas. Tailored interventions measures should be put in place to reverse the trend.

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“…Furthermore, a research endeavor sought to assess variances between urban and rural areas concerning adverse outcomes related to pregnancy. The ndings revealed that mothers residing in rural areas faced a greater likelihood of anemia, with an adjusted odds ratio of 2.02 (95% CI: 1.07-2.34), compared to their urban counterparts [32]. However, another study conducted in Ethiopia indicated that there was no variation in the prevalence of anemia between pregnant women residing in rural and urban areas [33].…”

Section: Discussionmentioning

confidence: 95%

Plasmodium falciparum infections and Soil Transmitted Helminthes correlates with Anemia in Pregnancy: Cross-Sectional Study in Kwale County

Nyamu,

Kaplich,

Odhiambo

et al. 2024

Preprint

0

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Background Prevalence of Anemia in Pregnancy (AiP) in Kenya ranges from 40.6–69.1%. We estimated the prevalence of AiP and correlated Plasmodium falciparum infections and Soil transmitted Helminthes (STHs) infections among the predictors AiP among pregnant women attending antenatal care (ANC) visits. Methods We performed a cross-sectional study among pregnant women attending ANC at Msambweni Hospital, between January and March 2024. Data was collected and analyzed in Epi Info 7. Descriptive statistics were calculated and we compared pregnant women with AiP with those without the condition. Crude Odds Ratios (COR) and 95% confidence intervals (CI) were calculated to identify factors associated with AiP. Results A total of 396 pregnant women were included in the study. The mean age was 27.4 years ± 6.5 years. Proportion of anemia was reported in 201 (50.76%) participants, and the mean Hb was 10.87 mg/dl (± 1.46 mg/dl); 108 (53.73%). The malaria positivity rate among them was 13.38% (53/396), and for STHs was 24/396 (6.06%) (95% CI; 4.11–8.86). Pregnant women with Plasmodium falciparum infections were 2.5 times more likely to experience anemia compared to those without malaria parasites (COR; 2.5, 95% CI: 1.35–4.71). Pregnant women residing in rural areas were 4.1 times more likely to have anemia than those living in urban areas (COR; 4.1, 95% CI: 2.64–6.39). Furthermore, pregnant women with STH infections were 1.7 times more likely to experience anemia compared to those without STH infections (COR; 1.7, 95% CI: 0.71–3.90). Conclusion The prevalence of anemia among pregnant women attending Msambweni County Referral Hospital remains high, associated with Plasmodium falciparum infections, STH infections, and women residing rural areas. Tailored interventions measures should be put in place to reverse the trend.

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Urban-rural differences in the pregnancy-related adverse outcome

Cited by 9 publications

References 16 publications

Maternal and Neonatal Outcomes of Iron Deficiency Anemia: A Retrospective Cohort Study

Maternal and Neonatal Outcomes of Iron Deficiency Anemia: A Retrospective Cohort Study

Plasmodium falciparum infections and Soil Transmitted helminthes correlates with Anemia in Pregnancy: Cross-Sectional Study in Kwale County, Kenya

Plasmodium falciparum infections and Soil Transmitted Helminthes correlates with Anemia in Pregnancy: Cross-Sectional Study in Kwale County

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