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Association of different doses of iron and folic acid supplementation during pregnancy on postpartum anemia, low birthweight and survival of the offspring: findings from three large-scale cross-sectional surveys, India.
Authors: Modugu HR, Chandran SA, and Pradhan MR
Source: Journal of Family Welfare, 61(2):74-88
Topic(s): Anemia
Birth weight
Iron supplements
Maternal health
Women's health
Country: Asia
Published: DEC 2015
Abstract: Despite government efforts, prevalence of anaemia in all age groups is higher in India as compared to other developing countries, and five large cross-sectional surveys have suggested, 70 percent each of preschool children, pregnant women, adolescent girls, and 56 percent of ever married women were anaemic. Low dietary intake, poor iron (less than 20 mg/day) and folic acid intake (less than 70 mg/day); poor bioavailabilityof iron (3-4% only) in phytate and fibre-rich Indian diet; and chronic blood loss due to infectionsuch as malaria and hookworm infestations - were some of the responsible reasons for high anaemia in India. Hence, there is an urgent need for better understanding of how consumption of different doses of daily IFA supplementation during pregnancy is associated with postpartum haemoglobin/anaemia, incidence of LBW and survival of the offspring, as these findings could provide evidence to educate pregnant women for consuming realistic number of IFA for improved maternal and newborn outcomes, thus, leading to strengthening IFA supplementation efforts. We hypothesized that there is a dose-response relationship between IFA consumption during pregnancy on postpartum Rb/anaemia, LBW and neonatal mortality - even after controlling for sociodemographic factors. To test the hypothesis, we have analyzed data from three large cross-sectional surveys in India. Our main aim is to pool the data from these studies to determine whether higher doses of IFA consumption during pregnancy leads to: improved Hb levels of post-partum women; decrease in prevalence of severe/moderate anaemia; decrease in prevalence of overall anaemia; and decrease in incidence of LBW and neonatal mortality of the offspring - or not? We also aim to understand the influence of only IFA supplementation, only food supplementation, and both IFA and food supplementations to pregnant women on the stated outcomes.