Maternal anemia in pregnancy: assessing the effect of routine preventive measures in a malaria-endemic area

Am J Trop Med Hyg. 2013 Feb;88(2):292-300. doi: 10.4269/ajtmh.12-0195. Epub 2013 Jan 7.

Abstract

We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin < 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anemia, Iron-Deficiency / complications
  • Anemia, Iron-Deficiency / epidemiology
  • Anemia, Iron-Deficiency / prevention & control*
  • Antimalarials / therapeutic use
  • Dietary Supplements*
  • Female
  • Folic Acid / administration & dosage*
  • Folic Acid Deficiency / prevention & control
  • Hemoglobins / analysis
  • Humans
  • Iron / administration & dosage*
  • Logistic Models
  • Malaria / complications
  • Malaria / epidemiology*
  • Malnutrition / complications
  • Malnutrition / prevention & control
  • Multivariate Analysis
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Pregnancy Complications, Hematologic / prevention & control*
  • Prevalence
  • Randomized Controlled Trials as Topic
  • Young Adult

Substances

  • Antimalarials
  • Hemoglobins
  • Folic Acid
  • Iron