Nutritional determinants of anemia, in pregnant women and pregnancy outcomes, in urban Burkina Faso

Abstract

Anemia in pregnancy is responsible for 15 to 20 % of maternal deaths in developing countries. They are often neglected and may pas unobserved; with serious consequences on pregnancy, like maternal deaths, IUGR, preterm birth and LBW. The main causes of anemia during pregnancy in order of decreasing importance are: iron and folate-deficiency, malaria, intestinal parasites and hemoglobinopathies. Diet in Burkina Faso is dominated by cereals comsomption at 80 % of energy needs. However, these vegetable foods are characterized by their low iron content and are frequently involved in iron deficiency observed in pregnant women anemia. Thus, according to the latest DHS (2003) the prevalence of anemia were 54 % and 68 % respectively in women of childbearing age and pregnant women in Burkina Faso. In contrast, very few studies have been conducted on pregnancy anemia, its effects on foetal intrauterine growth and the role of women diet. This study aimed to investigate the general role of diet during pregnancy on the occurrence of anemia and the possible consequences of this anemia on foetus grown, in urban areas.

This was a cross-sectional study conducted on March-June 2005 on a representative sample of 8 maternities in the city of Ouagadougou. Ali births in these maternities wards during the study period were included. Were excluded: women for whom it was not possible 10 have an accurate estimate of the pregnancy term in weeks of amenorrhea, pregnancy < 33 weeks, stillbirths, women referred from another city. The data collected focused on maternal characteristics, prenatal care, nutrition al, dietary intake, haemoglobin rate and the woman household socio-economic data. These data were entered on EPI DATA 3.0 and analyzed using STATA software. The association between variables was tested by Chi square test. BMI after child­ birth has been used to assess the nutritional status of mothers. The LBW has been defined by a newborn baby whose birth weight was below 2.500 g. IUGR was defined by a birth weight below the 10^th percentile curve reference weight for gestational age of Alexander.

In total, 3 344 births were observed in the 8 maternities during the study period. The mean birth weight was 2.914 ± 428 g (range from 810 to 4.650 g), 14.6 % of newborns had LBW, and 24.3 % had IUGR. The mean haemoglobin rate was 11.45 ± 1.51 g /dl, with extremes of 6.5 g /dl and 19.7 g /dl. Thirty eight percent (38.2 %) of women had moderate anemia and 0.1 % had severe anemia. Factors significantly associated with anemia in late pregnancy in univariate analysis were: the household wealth index, women educational attainment, the employment status of the household head. There was no association on the one hand, between the women usual diet and anemia, the other between anemia during late pregnancy and newborn weight This study confirmed the high prevalence of anemia among pregnant women in Burkina Faso. The role of anemia in pregnant women, as an intermediary between nutritional status, food deficient and foetal growth.