Wilunda Calistus, Tanaka Shiro, Esamai Fabian, Kawakami Koji
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Department of Child Health and Paediatrics, School of Medicine, Moi University, Eldoret, Kenya.
Matern Child Nutr. 2017 Jul;13(3). doi: 10.1111/mcn.12375. Epub 2016 Oct 7.
It is unclear whether routine prenatal anemia control interventions can reduce anemia risk in young children. This study examines the associations between prenatal iron supplementation and/or deworming and anemia in children aged 6-23 months in sub-Saharan Africa (SSA). We analyzed data from Demographic and Health Surveys conducted between 2003 and 2014 in 25 SSA countries. The surveys collected data on prenatal iron supplementation and deworming and determined children's hemoglobin levels through blood testing. We assessed the associations between prenatal iron supplementation and/or deworming and anemia using multinomial logistic regression. The study included 31,815 mother-child pairs: 25.0%, 41.4%, and 4.8% of children had mild, moderate, and severe anemia, respectively. Compared with children whose mothers did not take iron and deworming drugs prenatally, the risk of moderate/severe anemia was reduced among children whose mothers took only iron supplements for ≥6 months (odds ratio [OR]: 0.58; 95% confidence interval [CI]: 0.45-0.76); only deworming drugs (OR: 0.73; 95% CI: 0.56-0.93); deworming drugs plus iron for <6 months (OR: 0.79; 95% CI: 0.67-0.93); and deworming drugs plus iron for ≥6 months (OR: 0.77; 95% CI: 0.59-0.99). Prenatal use of only iron for <6 months was not associated with moderate/severe anemia. Prenatal iron and/or deworming drugs had no effect on mild anemia. Prenatal anemia control interventions are associated with reduced risk of moderate/severe anemia but not with mild anemia in young children in SSA. Iron supplements should be taken for ≥6 months or with deworming drugs prenatally to reduce moderate/severe anemia risk in children.
常规产前贫血控制干预措施能否降低幼儿贫血风险尚不清楚。本研究调查了撒哈拉以南非洲(SSA)地区产前铁补充剂和/或驱虫与6至23个月儿童贫血之间的关联。我们分析了2003年至2014年在25个SSA国家进行的人口与健康调查的数据。这些调查收集了产前铁补充剂和驱虫的数据,并通过血液检测确定儿童的血红蛋白水平。我们使用多项逻辑回归评估了产前铁补充剂和/或驱虫与贫血之间的关联。该研究纳入了31,815对母婴:分别有25.0%、41.4%和4.8%的儿童患有轻度、中度和重度贫血。与母亲产前未服用铁剂和驱虫药的儿童相比,母亲仅服用铁补充剂≥6个月的儿童中,中度/重度贫血风险降低(优势比[OR]:0.58;95%置信区间[CI]:0.45 - 0.76);仅服用驱虫药(OR:0.73;95% CI:0.56 - 0.93);驱虫药加铁剂服用<6个月(OR:0.79;95% CI:0.67 - 0.93);以及驱虫药加铁剂服用≥6个月(OR:0.77;95% CI:0.59 - 0.99)。产前仅服用铁剂<6个月与中度/重度贫血无关。产前铁剂和/或驱虫药对轻度贫血无影响。在SSA地区,产前贫血控制干预措施与幼儿中度/重度贫血风险降低相关,但与轻度贫血无关。产前应服用铁补充剂≥6个月或与驱虫药一起服用,以降低儿童中度/重度贫血风险。