Dataset Information

Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study.

ABSTRACT:

Background

Iron deficiency is the most prevalent nutrient deficiency and the most common cause of anaemia worldwide. Because of the increased iron requirements during pregnancy, iron deficiency can lead to maternal anaemia and reduced newborn iron stores. We examined the proportion and risk factors of iron deficiency among pregnant women in a developed Asian country.

Methods

Within a prospective cohort in Singapore, 985 Asian women were assessed for iron status at 26-28 weeks' gestation, with plasma ferritin and soluble transferrin receptor (sTfR) measurements. Iron status was determined according to plasma ferritin concentrations at ≥30 μg/L (iron sufficiency), 15 to < 30 μg/L (modest iron depletion) and < 15 μg/L (severe iron depletion). Multivariable ordinal logistic regression was used to analyze risk factors for modest and severe iron depletion.

Results

The median (25-75th percentile) plasma ferritin concentration was 24.2 (19.9-30.6) μg/L. Overall, 660 (67.0%) and 67 (6.8%) women had modest and severe iron depletion, respectively. Higher plasma sTfR was observed in women with severe iron depletion than among those with iron sufficiency (median 17.6 versus 15.5 nmol/L; p < 0.001). Age < 25 years (odds ratio 2.36; 95% confidence interval 1.15-4.84), Malay (2.05; 1.30-3.24) and Indian (1.98; 1.14-3.44) ethnicities (versus Chinese), university qualification (1.64; 1.13-2.38), multiparity (1.73; 1.23-2.44) and lack of iron-containing supplementation (3.37; 1.25-8.53) were associated with increased odds of modest and severe iron depletion.

Conclusions

Nearly three-quarters of Singaporean women were iron deficient in the early third trimester of pregnancy. These results suggest universal screening and supplementation of at-risk pregnancies may be evaluated as a preventive strategy.

Trial registration

NCT01174875 . Registered 1 July 2010 (retrospectively registered).

SUBMITTER: Loy SL

PROVIDER: S-EPMC6460529 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study.

Loy See Ling SL Lim Li Min LM Chan Shiao-Yng SY Tan Pei Ting PT Chee Yen Lin YL Quah Phaik Ling PL Chan Jerry Kok Yen JKY Tan Kok Hian KH Yap Fabian F Godfrey Keith M KM Shek Lynette Pei-Chi LP Chong Mary Foong-Fong MF Kramer Michael S MS Chong Yap-Seng YS Chi Claudia C

BMC public health 20190411 1

<h4>Background</h4>Iron deficiency is the most prevalent nutrient deficiency and the most common cause of anaemia worldwide. Because of the increased iron requirements during pregnancy, iron deficiency can lead to maternal anaemia and reduced newborn iron stores. We examined the proportion and risk factors of iron deficiency among pregnant women in a developed Asian country.<h4>Methods</h4>Within a prospective cohort in Singapore, 985 Asian women were assessed for iron status at 26-28 weeks' ges ...[more]

PMID: 30975203

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Project description:BackgroundAnaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria.MethodsIn this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA.ResultsIron deficiency was observed among 41% (95%CI: 38 - 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 - 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 - 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 - 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 - 2.82).ConclusionAbout 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.

Project description:BackgroundCOVID-19 may predispose pregnant women to higher risks of severe disease and poorer neonatal outcome. Psychological sequalae of this pandemic may pose a greater conundrum than its clinical aspects. It is currently unknown that how pregnant women cope with this global pandemic and its ramifications. The aims of the study are to understand the attitudes and precaution practices of non-infected pregnant women towards the COVID-19 outbreak in Singapore.MethodsAn online cross-sectional survey of COVID-19 awareness among pregnant women attending antenatal clinics in Singapore was conducted. An internet link was provided to complete an online electronic survey on Google platform using a quick response (QR) code on mobile devices. The online survey consists of 34 questions that were categorized into 4 main sections, namely 1) social demographics 2) attitude on safe distancing measures 3) precaution practices and 4) perceptions of COVID-19. Multiple linear regression analysis was performed to examine women's precaution practices among six independent socio-demographic variables, including age, ethnicity, education, front-line jobs, history of miscarriage and type of antenatal clinic (general, high risk).ResultsA total of 167 survey responses were obtained over 8 weeks from April to June 2020. The majority of women were aged ≤35 years (76%, n = 127), were of Chinese ethnicity (55%, n = 91), attained tertiary education (62%, n = 104) and were not working as frontline staff (70%). Using multiple linear regression models, Malay ethnicity (vs. Chinese, β 0.24; 95% CI 0.04, 0.44) was associated with higher frequency of practicing social distancing. Malay women (β 0.48; 95% CI 0.16, 0.80) and those who worked as frontline staff (β 0.28; 95% CI 0.01, 0.56) sanitized their hands at higher frequencies. Age of ≥36 years (vs. ≤30 years, β 0.24; 95% CI 0.01, 0.46), Malay (vs. Chinese, β 0.27; 95% CI 0.06, 0.48) and Indian ethnicity (vs. Chinese, β 0.41; 95% CI 0.02, 0.80), and attendance at high-risk clinic (vs. general clinic, β 0.20; 95% CI 0.01, 0.39) were associated with higher frequency of staying-at-home.ConclusionSocial demographical factors including age > 36 years old, Malay ethnicity, employment in front line jobs and attendance at high-risk clinics are likely to influence the attitudes and precaution practices among pregnant women towards COVID-19 in Singapore. Knowledge gained from our cross-sectional online survey can better guide clinicians to communicate better with pregnant women. Hence, it is important for clinicians to render appropriate counselling and focused clarification on the effect of COVID-19 among pregnant women for psychological support and mental well being.

Project description:BackgroundMalaria in pregnancy remains a public health problem in sub-Saharan Africa. Identifying risk factors for malaria in pregnancy could assist in developing interventions to reduce the risk of malaria in Burkina Faso and other countries in the region.MethodsTwo cross-sectional surveys were carried out to measure Plasmodium falciparum infection using microscopy in pregnant women in Saponé Health District, central Burkina Faso. Data were collected on individual, household and environmental variables and their association with P. falciparum infection assessed using multivariable analysis.ResultsA total of 356 pregnant women were enrolled in the surveys, 174 during the dry season and 182 during the wet season. The mean number of doses of sulfadoxine-pyrimethamine for Intermittent Preventive Treatment in pregnancy (IPTp-SP) was 0.4 doses during the first trimester, 1.1 doses at the second and 2.3 doses at the third. Overall prevalence of P. falciparum infection by microscopy was 15.7%; 17.8% in the dry season and 13.7% in the wet season. 88.2% of pregnant women reported sleeping under an insecticide-treated net (ITN) on the previous night. The odds of P. falciparum infection was 65% lower in women who reported using an ITN compared to those that did not use an ITN (Odds ratio, OR = 0.35, 95% CI 0.14-0.86, p = 0.02). IPTp-SP was also associated with reduced P. falciparum infection, with each additional dose of IPTp-SP reducing the odds of infection by 44% (OR = 0.56, 95% CI 0.39-0.79, p = 0.001). Literate women had a 2.54 times higher odds of P. falciparum infection compared to illiterate women (95% CI 1.31-4.91, p = 0.006).ConclusionsThe prevalence of P. falciparum infection among pregnant women remains high in Burkina Faso, although use of IPTp-SP and ITNs were found to reduce the odds of infection. Despite this, compliance with IPTp-SP remains far from that recommended by the National Malaria Control Programme and World Health Organization. Behaviour change communication should be strengthened to encourage compliance with protective malaria control tools during pregnancy.

Project description:ObjectivesIron-folic acid non-compliance is a major problem in the study area. Therefore, this study aimed to assess the level of iron-folic acid supplementation compliance and associated factors among pregnant women.MethodsA community-based cross-sectional study design was conducted among pregnant women from 1 to 30 November 2018 in Dangila, Northern Ethiopia. A multi-stage sampling technique was used to select the participants. The data were collected using a structured questionnaire. For data entry and analysis, Epi Info 7 and Statistical Package for Social Science (SPSS) 23.0 were used, respectively. Bivariable and multivariable logistic regression analyses were done. Descriptive statistics like mean and standard deviation, and odds ratios with their respective confidence intervals were calculated. Statistically significant was declared at a p value of less than 0.05. The results were presented using text, tables, and figures.ResultsA total of 589 pregnant women were involved, yielding a response rate of 91.2%. The average age of the participants in the study was 30.90 ± 5.93 years. The average weekly iron-folic acid pill intake was 5.3. The iron-folic acid compliance rate was 76.9% (95% confidence interval: 73.5-80.6). Women who had four or fewer alive children (adjusted odds ratio = 2.68, 95% confidence interval: 1.37-5.23), took less than 30 min to get to the health facility (adjusted odds ratio = 1.90, 95% confidence interval: 1.16-3.10), being a government employee (adjusted odds ratio = 0.16, 95% confidence interval: 0.03-0.81), attended antenatal care conferences (odds ratio = 2,95% confidence interval: 1.16-3.42), and started iron-folic acid tablets in the first trimester (odds ratio = 2.3, 95% confidence interval: 1.39-3.87) were associated with iron-folic acid compliance.ConclusionThe level of iron-folic acid supplementation compliance was low. Attending antenatal care training and starting to take iron-folic acid pills early in the first trimester were both factors associated with iron-folic acid supplementation compliance. Health care and health extension workers should emphasize and monitor the iron pill-taking habits of pregnant women in home-to-home visits.

Dataset Information

Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study.

Background

Methods

Results

Conclusions

Trial registration

Publications

Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study.

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