Biochemical Evaluation Of Pregnant Women Practicing Geophagia With Special Reference To Iron Nutritional Status In The King Sabata Dalindyebo Municipality

- Abiodun Adams

Title
Biochemical Evaluation Of Pregnant Women Practicing Geophagia With Special Reference To Iron Nutritional Status In The King Sabata Dalindyebo Municipality
Creator
Abiodun Adams
Date
2014
Identifier
http://hdl.handle.net/11260/2878
Identifier
vital:42970
Identifier
Geophagia, pregnant women, iron nutritional status, iron-deficiency anaemia.
Description
Abstract Introduction There is no information on iron deficiency anaemia and ferritin-related oxidative stress as a potential result of geophagia during pregnancy in the King Sabatha Dalyindyebo Municipality, South Africa. Aim The aim of the study was to assess the magnitude of geophagia (soil eating) associated with biochemical and haematological indices of iron nutritional status of pregnant women. Materials and Methods A cross sectional study was carried out among 210 (response rate=95.5% of 220 eligible) pregnant women living in the Mthatha areas of the King Sabata Dalyindebo Municipality attending 3 selected clinics during 2012. Data (socio-demographic, geophagia, haematological indices, serum iron and transferrin saturation) were analyzed using univariate analysis (mean, proportions, percentiles, Odd Ratio and 95%CI, ANOVA and chi-square) and multivariate analysis (Odd Ratio and 95% CI and logistic regression model) was performed. P-Value <0.05 was significant. Results In all cases, 98.6% (n=207) and 100% (n=210) defined by serum iron ≤ 30µmol/l and <40µmol/l, presented with iron deficiency, respectively. However, iron deficiency, defined by serum ferritin <12µg/l and by transferrin saturation <16%, was present in 25.7% (n=54) and 61.9% (n=130) of all cases, respectively. Iron-deficiency anaemia was present in 51.4% (n=108) and 18.6% (n=39) using WHO haemoglobin and serum iron cut-offs and WHO haemoglobin and serum ferritin cut-offs, respectively. However,ii 37.1% (n=78/210) had an iron deficiency, defined by serum iron <10 µmol/l and 30.5% (n=64/210) defined by transferrin saturation <10%. In geophagics, 98.7% (n=76) had iron-deficiency anaemia (using serum iron cut-offs) whereas only 24.1% (n=32) of non geophagics presented with iron deficiency anaemia. However, using serum ferritin cut-offs, geophagics had iron deficiency anaemia estimated at 69.2% (n=27/59) but non geophagics had iron deficiency anaemia estimated at 30.8% (n=12/39). The optimal cut-offs of serum iron <10 µmol/l and transferrin saturation <10% are the best discriminants of iron deficiency as defined by serum ferritin <12 µg/l. Ferritin-related oxidative stress was present among 24.8% in the study population (the highest quartile of serum ferritin being >30.01 µg/l). The most important factors associated with iron deficiency anaemia in all pregnant women were geophagic behaviour (OR=2.1 95% CI 1.1-4.2; P=0.029), MCHC decreases (<30.5 0R=16.6 95%CI 6.8-40.2; P=0.006) and MCHC decreases (30.5-31.5 OR=2.9 95%CI 1.4-6.1; P=0.006). In all pregnant women, serum iron <14 (OR=6.2 95%CI 1.2-31.7; P=0.030), platelets <228 (OR=3.9 95%CI 1.6-10.8; P=0.008), age ≥28years (OR=4.2 95%CI 1.7-10.4; P=0.002), transferrin saturation ≥18% (OR=51.3 95%CI 8.9-295.2; P=<0.0001), were identified as the most significant independent determinants of ferritin-related oxidative stress. However, increase in age, depletion in iron, decrease in platelet count but increase in transferrin saturation were the significant independent determinants of ferritin-related oxidative stress among geophagic pregnant women (Y=0.282 x Age – 1.007 x iron – 0.023 platelet +0.946 transferrin saturation). In non-geophagic pregnant women, only a decrease in iron and an increase in transferrin saturation were the significant characteristics of ferritin-related oxidative stress (Y=-3.21-0.309 x iron + 0.379 transferrin saturation). Conclusioniii Geophagia induces a high level of anaemia, iron deficiency anaemia and ferritin-related oxidative stress. The most independent determinants of iron deficiency anaemia in all pregnant women were geophagic behaviour and MCHC decrease. Independent and important determinants of ferritin-related oxidative stress in all pregnant women were severe categories of decreased iron and platelets with higher levels of age ≥28 years, transferrin saturation (≥18%)
Format
Pdf
Contributor
G. GEORGE
Publisher
Walter Sisulu University
Language
English
Rights
Walter Sisulu University
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