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      Prevalence of anemia and sociodemographic characteristics among pregnant and non-pregnant women in southwest China: a longitudinal observational study

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          Abstract

          Background

          Globally, the prevalence of anemia among women of reproductive age is about 29.4%, and anemia impacts about 40% of pregnant women and more than 20% of non-pregnant women. We conducted a longitudinal observational study of anemia in pregnant and non-pregnant women, and analyzed the association between the prevalence of anemia and sociodemographic characteristics of women in southwest China.

          Methods

          This study was a longitudinal observational study which involved 640,672 women aged 18–49 years from 129 counties in southwest China. Data were from databases of National Free Preconception Health Examination Project (NFPHEP) and electronic medical records of local hospitals. We adjusted the diagnostic thresholds of anemia for altitude. The prevalence of anemia was expressed in percentages and 95% confidence intervals (95% CI). The association between the prevalence of anemia and sociodemographic characteristics of pregnant and non-pregnant women were analyzed using univariate and multivariate logistic regression method, expressed in crude odds ratio (cOR), adjusted odds ratio (aOR) and 95%CI.

          Results

          Of the 640,672 participants, 121,254 women suffered from anemia, with the prevalence of 18.9% (95%CI: 18.8–19.0%). From 2014 to 2018, the prevalence of anemia declines from 23.0–16.4%.The prevalence was 21.6% in the first trimester, higher than women in non-pregnancy (17.4%) and women in the third trimester (10.5%). Results from the multivariable logistic regression showed that women aged 18–20 (aOR = 1.28) or over 35 years old (aOR = 1.07), being farmers (aOR = 1.42), being ethnic minorities (aOR: 1.19 ~ 1.73), during the first trimester (aOR = 1.32) were more likely to be anemic.

          Conclusions

          Although the anemia prevalence of women of reproductive age has been decreasing in recent years, the prevalence of anemia is still high in pregnant and non-pregnant women in southwest China, especially during the first trimester. Women who were older or younger, being farmers, being ethnic minorities were at high risk of anemia. Anemia in women of reproductive age cannot be neglected.

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          Most cited references34

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          Anemia at older age: etiologies, clinical implications, and management.

          Anemia is quite frequently diagnosed in older individuals and is a key indicator of various reactive and clonal conditions. Many underlying diseases, like myelodysplastic syndrome (MDS), develop preferentially in elderly individuals. The prevalence of anemia at older age is increasing, and this is mainly attributable to more frequently applied diagnostics and demographic changes in our societies. The etiology of anemia at older age is complex and ranges from bone marrow failure syndromes to chronic kidney disease, and from nutritional deficiencies to inflammatory processes including inflammaging in immunosenescence. In a smaller number of cases, no clear-cut etiology is identified. These patients are referred to as unexplained anemia or idiopathic cytopenia of unknown significance. In others, somatic mutations in leukocytes are found, but diagnostic criteria for MDS or other hematologic diseases are not fulfilled, a condition termed clonal cytopenia of undetermined significance. Management of anemias at older age depends on (1) the severity of the anemia, (2) underlying condition(s), and (3) patient-related factors, including comorbidities. Even a mild anemia may substantially affect physical and cognitive capacities and quality of life. An underestimated aspect is that because of age-related changes, organ function such as erythropoietin production in the kidney may become suboptimal. Management and treatment of anemia in older patients often require a multidisciplinary approach and detailed investigations of organ function. In this article, we review current concepts around anemias at older age, with special emphasis on etiologies, clinical implications, and innovative concepts in the management of these patients.
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            Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis

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              The Prevalence of Anemia and Moderate-Severe Anemia in the US Population (NHANES 2003-2012)

              Chi Le (2016)
              Since anemia is associated with poor health outcomes, the prevalence of anemia is a significant public health indicator. Even though anemia is primarily caused by iron deficiency, low oxygen-carrying capacity may result from other conditions such as chronic diseases, which remain a relevant health concern in the United States. However, studies examining current rates of anemia in the total US population and in more specific subgroups are limited. Data from five National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2012 were analyzed to assess two outcomes: anemia and moderate-severe anemia, which were based upon serum hemoglobin levels (Hb) as per World Health Organization (WHO) definitions. Statistical analysis using SAS examined temporal trends and the prevalence of anemia among sexes, age groups, and races/ethnicities. The study estimated that an average of 5.6% of the U.S. population met the criteria for anemia and 1.5% for moderate-severe anemia during this 10-year period. High-risk groups such as pregnant women, elderly persons, women of reproductive age, non-Hispanic blacks, and Hispanics were identified, and relationships between multiple risk factors were examined. Rates of anemia in men increased monotonically with age, while that of women increased bimodally with peaks in age group 40–49 years and 80–85 years. The effect of risk factors was observed to compound. For instance, the prevalence of anemia in black women aged 80–85 years was 35.6%, 6.4 times higher than the population average. Moreover, anemia is a growing problem because of the increased prevalence of anemia (4.0% to 7.1%) and moderate-severe anemia (1.0% to 1.9%), which nearly doubled from 2003–2004 to 2011–2012. Thus, these results augment the current knowledge on anemia prevalence, severity, and distribution among subgroups in the US and raised anemia as an issue that requires urgent public health intervention.
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                Author and article information

                Contributors
                liumin@bjmu.edu.cn
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                14 September 2020
                14 September 2020
                2020
                : 20
                : 535
                Affiliations
                [1 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Epidemiology and Biostatics, School of Public Health, , Peking University, ; No.38, Xueyuan Road, Haidian District, 100191 Beijing, China
                [2 ]GRID grid.507067.3, Yunnan Population and Family Planning Research Institute, ; No.146, Qingnian Road, Wuhua District, Yunnan 650021 Kunming, China
                [3 ]GRID grid.415444.4, The Second Affiliated Hospital of Kunming Medical University, ; No.1168, Chunrong west Road, Chenggong District, Yunnan 650500 Kunming, China
                Article
                3222
                10.1186/s12884-020-03222-1
                7488658
                32928139
                62e65ecd-dd6d-4b60-9780-d8827145bbcc
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 8 January 2020
                : 31 August 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 71874003
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Obstetrics & Gynecology
                anemia,women`s health,prevalence,southwest china
                Obstetrics & Gynecology
                anemia, women`s health, prevalence, southwest china

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