Anemia in Brazilian pregnant women before and after flour fortification with iron
OBJECTIVE: To compare prevalence of anemia and hemoglobin (Hb) levels in Brazilian pregnant women before and after flour fortification with iron. METHODS: A repeated cross-sectional panel study of public health care centers of municipalities in the five Brazilian regions was conducted. Retrospective...
| Autor principal: | Fujimori, Elizabeth |
|---|---|
| Outros Autores: | Sato, Ana Paula Sayuri, Szarfarc, Sophia Cornbluth, Veiga, Glória Valéria da, Oliveira, Valterlinda Alves de, Colli, Célia, Moreira-Araújo, Regilda Saraiva dos Reis, Arruda, Ilma Kruze Grande de, Uchimura, Taqueco Teruya, Brunken, Gisela Soares, Yuyama, Lucia Kiyoko Ozaki, Muniz, Pascoal Torres, Priore, Sílvia Eloíza, Tsunechiro, Maria Alice, Frazão, Andréa das Graças Ferreira, Passoni, Cynthia R Matos Silva, Araújo, Claudia Regina Marchiori Antunes |
| Grau: | Artigo |
| Idioma: | English |
| Publicado em: |
Revista de Saúde Pública
2020
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| Assuntos: | |
| Acesso em linha: |
https://repositorio.inpa.gov.br/handle/1/16163 |
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oai:repositorio:1-16163 |
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oai:repositorio:1-16163 Anemia in Brazilian pregnant women before and after flour fortification with iron Fujimori, Elizabeth Sato, Ana Paula Sayuri Szarfarc, Sophia Cornbluth Veiga, Glória Valéria da Oliveira, Valterlinda Alves de Colli, Célia Moreira-Araújo, Regilda Saraiva dos Reis Arruda, Ilma Kruze Grande de Uchimura, Taqueco Teruya Brunken, Gisela Soares Yuyama, Lucia Kiyoko Ozaki Muniz, Pascoal Torres Priore, Sílvia Eloíza Tsunechiro, Maria Alice Frazão, Andréa das Graças Ferreira Passoni, Cynthia R Matos Silva Araújo, Claudia Regina Marchiori Antunes Hemoglobin A Brasil Demography Diet Supplementation Diet Therapy Epidemiology Female Flour Gestational Age Health Care Delivery Human Iron Deficiency Anemia Iron Intake Pregnancy Pregnancy Complication Prenatal Care Statistics Anemia, Iron-deficiency Brasil Delivery Of Health Care Demography Epidemiologic Methods Female Flour Food, Fortified Gestational Age Hemoglobin A Humans Iron, Dietary Pregnancy Pregnancy Complications, Hematologic Prenatal Care OBJECTIVE: To compare prevalence of anemia and hemoglobin (Hb) levels in Brazilian pregnant women before and after flour fortification with iron. METHODS: A repeated cross-sectional panel study of public health care centers of municipalities in the five Brazilian regions was conducted. Retrospective data were obtained from 12,119 medical records of pregnant women distributed in two groups: before fortification (delivery prior to June 2004) and after fortification (date of last period after June 2005). Anemia was defined as Hb<11.0 g/dl. Hb levels according to gestational age were assessed using two references from the literature. Statistical analysis was carried out using chi-squared tests, Student's t tests, and logistic regression, with a significance level of 5%. RESULTS: In the total sample, prevalence of anemia fell from 25% to 20% after fortification (p<0.001). However, important regional differences were evident: while significant reductions were seen in the Northeast (37% to 29%) and North (32% to 25%) regions, where pre-fortification prevalence was high, smaller reductions were seen in the Southeast (18% to 15%) and South (7% to 6%) regions, where prevalence was low. Hb levels according to gestational age were slightly higher in the first months of pregnancy and lower after the third or fourth months, depending on the reference used. Logistic regression analysis showed that group, geographic region, marital status, trimester of pregnancy, initial nutritional status, and prior pregnancy were associated with anemia (p<0.05). CONCLUSIONS: Prevalence of anemia decreased after fortification, but remains high in the North and Northeast regions. Although fortification may have played a role in this favorable outcome, the contribution of other public policies implemented during the studied period should also be considered. 2020-05-25T19:10:50Z 2020-05-25T19:10:50Z 2011 Artigo https://repositorio.inpa.gov.br/handle/1/16163 10.1590/S0034-89102011005000078 en Volume 45, Número 6, Pags. 1027-1035 Attribution-NonCommercial-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nc-nd/3.0/br/ application/pdf Revista de Saúde Pública |
| institution |
Instituto Nacional de Pesquisas da Amazônia - Repositório Institucional |
| collection |
INPA-RI |
| language |
English |
| topic |
Hemoglobin A Brasil Demography Diet Supplementation Diet Therapy Epidemiology Female Flour Gestational Age Health Care Delivery Human Iron Deficiency Anemia Iron Intake Pregnancy Pregnancy Complication Prenatal Care Statistics Anemia, Iron-deficiency Brasil Delivery Of Health Care Demography Epidemiologic Methods Female Flour Food, Fortified Gestational Age Hemoglobin A Humans Iron, Dietary Pregnancy Pregnancy Complications, Hematologic Prenatal Care |
| spellingShingle |
Hemoglobin A Brasil Demography Diet Supplementation Diet Therapy Epidemiology Female Flour Gestational Age Health Care Delivery Human Iron Deficiency Anemia Iron Intake Pregnancy Pregnancy Complication Prenatal Care Statistics Anemia, Iron-deficiency Brasil Delivery Of Health Care Demography Epidemiologic Methods Female Flour Food, Fortified Gestational Age Hemoglobin A Humans Iron, Dietary Pregnancy Pregnancy Complications, Hematologic Prenatal Care Fujimori, Elizabeth Anemia in Brazilian pregnant women before and after flour fortification with iron |
| topic_facet |
Hemoglobin A Brasil Demography Diet Supplementation Diet Therapy Epidemiology Female Flour Gestational Age Health Care Delivery Human Iron Deficiency Anemia Iron Intake Pregnancy Pregnancy Complication Prenatal Care Statistics Anemia, Iron-deficiency Brasil Delivery Of Health Care Demography Epidemiologic Methods Female Flour Food, Fortified Gestational Age Hemoglobin A Humans Iron, Dietary Pregnancy Pregnancy Complications, Hematologic Prenatal Care |
| description |
OBJECTIVE: To compare prevalence of anemia and hemoglobin (Hb) levels in Brazilian pregnant women before and after flour fortification with iron. METHODS: A repeated cross-sectional panel study of public health care centers of municipalities in the five Brazilian regions was conducted. Retrospective data were obtained from 12,119 medical records of pregnant women distributed in two groups: before fortification (delivery prior to June 2004) and after fortification (date of last period after June 2005). Anemia was defined as Hb<11.0 g/dl. Hb levels according to gestational age were assessed using two references from the literature. Statistical analysis was carried out using chi-squared tests, Student's t tests, and logistic regression, with a significance level of 5%. RESULTS: In the total sample, prevalence of anemia fell from 25% to 20% after fortification (p<0.001). However, important regional differences were evident: while significant reductions were seen in the Northeast (37% to 29%) and North (32% to 25%) regions, where pre-fortification prevalence was high, smaller reductions were seen in the Southeast (18% to 15%) and South (7% to 6%) regions, where prevalence was low. Hb levels according to gestational age were slightly higher in the first months of pregnancy and lower after the third or fourth months, depending on the reference used. Logistic regression analysis showed that group, geographic region, marital status, trimester of pregnancy, initial nutritional status, and prior pregnancy were associated with anemia (p<0.05). CONCLUSIONS: Prevalence of anemia decreased after fortification, but remains high in the North and Northeast regions. Although fortification may have played a role in this favorable outcome, the contribution of other public policies implemented during the studied period should also be considered. |
| format |
Artigo |
| author |
Fujimori, Elizabeth |
| author2 |
Sato, Ana Paula Sayuri Szarfarc, Sophia Cornbluth Veiga, Glória Valéria da Oliveira, Valterlinda Alves de Colli, Célia Moreira-Araújo, Regilda Saraiva dos Reis Arruda, Ilma Kruze Grande de Uchimura, Taqueco Teruya Brunken, Gisela Soares Yuyama, Lucia Kiyoko Ozaki Muniz, Pascoal Torres Priore, Sílvia Eloíza Tsunechiro, Maria Alice Frazão, Andréa das Graças Ferreira Passoni, Cynthia R Matos Silva Araújo, Claudia Regina Marchiori Antunes |
| author2Str |
Sato, Ana Paula Sayuri Szarfarc, Sophia Cornbluth Veiga, Glória Valéria da Oliveira, Valterlinda Alves de Colli, Célia Moreira-Araújo, Regilda Saraiva dos Reis Arruda, Ilma Kruze Grande de Uchimura, Taqueco Teruya Brunken, Gisela Soares Yuyama, Lucia Kiyoko Ozaki Muniz, Pascoal Torres Priore, Sílvia Eloíza Tsunechiro, Maria Alice Frazão, Andréa das Graças Ferreira Passoni, Cynthia R Matos Silva Araújo, Claudia Regina Marchiori Antunes |
| title |
Anemia in Brazilian pregnant women before and after flour fortification with iron |
| title_short |
Anemia in Brazilian pregnant women before and after flour fortification with iron |
| title_full |
Anemia in Brazilian pregnant women before and after flour fortification with iron |
| title_fullStr |
Anemia in Brazilian pregnant women before and after flour fortification with iron |
| title_full_unstemmed |
Anemia in Brazilian pregnant women before and after flour fortification with iron |
| title_sort |
anemia in brazilian pregnant women before and after flour fortification with iron |
| publisher |
Revista de Saúde Pública |
| publishDate |
2020 |
| url |
https://repositorio.inpa.gov.br/handle/1/16163 |
| _version_ |
1787144890304430080 |
| score |
11.674684 |