Anemia in Ugandan pregnant women: a cross-sectional, systematic review and meta-analysis study.

Anemia Pregnancy Uganda

Journal

Tropical medicine and health
ISSN: 1348-8945
Titre abrégé: Trop Med Health
Pays: Japan
ID NLM: 101215093

Informations de publication

Date de publication:
01 Mar 2021
Historique:
received: 29 10 2020
accepted: 19 02 2021
entrez: 2 3 2021
pubmed: 3 3 2021
medline: 3 3 2021
Statut: epublish

Résumé

Anemia in pregnancy represents a global public health concern due to wide ranging maternal and neonatal adverse outcomes in all peripartum periods. We estimated the prevalence and factors associated with anemia in pregnancy at a national obstetrics and gynecology referral hospital in Uganda and in addition performed a systematic review and meta-analysis of the overall burden of anemia in pregnancy in Uganda. We conducted a cross-sectional study among 263 pregnant women attending the antenatal care clinic of Kawempe National Referral Hospital, Kampala, Uganda, in September 2020. Anemia in pregnancy was defined as a hemoglobin level of < 11.0 g/dl and microcytosis as a mean corpuscular volume (MCV) of < 76 fL. We also performed a systematic review (PROSPERO Registration ID: CRD42020213001) and meta-analysis of studies indexed on MEDLINE, Embase, African Journal Online, ClinicalTrials.gov , ICTRP, and the Cochrane Library of systematic review between 1 January 2000 and 31 September 2020 reporting on the prevalence of anemia in pregnancy in Uganda. The prevalence of anemia was 14.1% (n= 37) (95%CI 10.4-18.8), of whom 21 (56.8%) had microcytic anemia. All cases of anemia occurred in the second or third trimester of pregnancy and none were severe. However, women with anemia had significantly lower MCV (75.1 vs. 80.2 fL, p<0.0001) and anthropometric measurements, such as weight (63.3 vs. 68.9kg; p=0.008), body mass index (25.2 vs. 27.3, p=0.013), hip (98.5 vs. 103.8 cm, p=0.002), and waist (91.1 vs. 95.1 cm, p=0.027) circumferences and mean systolic blood pressure (BP) (118 vs 125 mmHg, p=0.014). Additionally, most had BP within the normal range (59.5% vs. 34.1%, p=0.023). The comparison meta-analysis of pooled data from 17 published studies of anemia in pregnancy in Uganda, which had a total of 14,410 pregnant mothers, revealed a prevalence of 30% (95% CI 23-37). Despite our study having a lower prevalence compared to other studies in Uganda, these findings further confirm that anemia in pregnancy is still of public health significance and is likely to have nutritional causes, requiring targeted interventions. A larger study would be necessary to demonstrate potential use of basic clinical parameters such as weight or blood pressure as screening predictors for anemia in pregnancy.

Sections du résumé

BACKGROUND BACKGROUND
Anemia in pregnancy represents a global public health concern due to wide ranging maternal and neonatal adverse outcomes in all peripartum periods. We estimated the prevalence and factors associated with anemia in pregnancy at a national obstetrics and gynecology referral hospital in Uganda and in addition performed a systematic review and meta-analysis of the overall burden of anemia in pregnancy in Uganda.
METHODS METHODS
We conducted a cross-sectional study among 263 pregnant women attending the antenatal care clinic of Kawempe National Referral Hospital, Kampala, Uganda, in September 2020. Anemia in pregnancy was defined as a hemoglobin level of < 11.0 g/dl and microcytosis as a mean corpuscular volume (MCV) of < 76 fL. We also performed a systematic review (PROSPERO Registration ID: CRD42020213001) and meta-analysis of studies indexed on MEDLINE, Embase, African Journal Online, ClinicalTrials.gov , ICTRP, and the Cochrane Library of systematic review between 1 January 2000 and 31 September 2020 reporting on the prevalence of anemia in pregnancy in Uganda.
RESULTS RESULTS
The prevalence of anemia was 14.1% (n= 37) (95%CI 10.4-18.8), of whom 21 (56.8%) had microcytic anemia. All cases of anemia occurred in the second or third trimester of pregnancy and none were severe. However, women with anemia had significantly lower MCV (75.1 vs. 80.2 fL, p<0.0001) and anthropometric measurements, such as weight (63.3 vs. 68.9kg; p=0.008), body mass index (25.2 vs. 27.3, p=0.013), hip (98.5 vs. 103.8 cm, p=0.002), and waist (91.1 vs. 95.1 cm, p=0.027) circumferences and mean systolic blood pressure (BP) (118 vs 125 mmHg, p=0.014). Additionally, most had BP within the normal range (59.5% vs. 34.1%, p=0.023). The comparison meta-analysis of pooled data from 17 published studies of anemia in pregnancy in Uganda, which had a total of 14,410 pregnant mothers, revealed a prevalence of 30% (95% CI 23-37).
CONCLUSIONS CONCLUSIONS
Despite our study having a lower prevalence compared to other studies in Uganda, these findings further confirm that anemia in pregnancy is still of public health significance and is likely to have nutritional causes, requiring targeted interventions. A larger study would be necessary to demonstrate potential use of basic clinical parameters such as weight or blood pressure as screening predictors for anemia in pregnancy.

Identifiants

pubmed: 33648575
doi: 10.1186/s41182-021-00309-z
pii: 10.1186/s41182-021-00309-z
pmc: PMC7919073
doi:

Types de publication

Journal Article

Langues

eng

Pagination

19

Subventions

Organisme : FIC NIH HHS
ID : D43 TW011401
Pays : United States

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Auteurs

Felix Bongomin (F)

Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda. drbongomin@gmail.com.
Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda. drbongomin@gmail.com.

Ronald Olum (R)

School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Andrew Peter Kyazze (AP)

Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Sandra Ninsiima (S)

Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.

Gloria Nattabi (G)

Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.

Lourita Nakyagaba (L)

School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Winnie Nabakka (W)

Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.

Rebecca Kukunda (R)

Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.

Phillip Ssekamatte (P)

Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.

Davis Kibirige (D)

Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.

Stephen Cose (S)

Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
Directorate of Programs, Mildmay Uganda, Wakiso, Uganda.

Annettee Nakimuli (A)

Department of Obstetrics & Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Joseph Baruch Baluku (JB)

Directorate of Programs, Mildmay Uganda, Wakiso, Uganda.
Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda.

Irene Andia-Biraro (I)

Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
Department of Clinical Research, Faculty of Infectious and Tropical Disease (ITD), London School of Hygiene and Tropical Medicine, London, UK.

Classifications MeSH