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      Prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana

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          Abstract

          Background

          Anaemia remains a major cause of morbidity and mortality among women and children worldwide. Because deficiencies in essential micronutrients such as iron, folate and vitamin B12 prior to and during gestation increase a woman’s risk of being anaemic, adequate dietary intake of such nutrients is vital during this important phase in life. However, information on the dietary micronutrient intakes of pregnant women in Ghana, particularly of those resident in rural areas is scanty. Thus, this study aimed to assess anaemia prevalence and dietary micronutrient intakes in pregnant women in urban and rural areas in Ghana.

          Methods

          A comparative cross sectional study design involving 379 pregnant women was used to assess the prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. Anaemia status and mid upper arm circumference (MUAC) were used as proxy for maternal nutritional status. Haemoglobin measurements were used to determine anaemia prevalence and the dietary diversity of the women were determined with a 24-hour dietary recall and a food frequency questionnaire.

          Results

          Overall, anaemia was present in 56.5% of the study population. Anaemia prevalence was higher among rural residents than urban dwellers. Majority of the respondents had inadequate intakes of iron, zinc, folate, calcium and vitamin A. The mean dietary diversity score (DDS) of the study population from the first 24-hour recall was 3.81 ± 0.7. Of the 379 women, 28.8% met the minimum dietary diversity for women (MDD-W). The independent predictors of haemoglobin concentration were, gestational age, maternal age and dietary diversity score. Such that respondents with low DDS were more likely to be anaemic than those with high DDS (OR = 1.795, p = 0.022, 95% CI: 1.086 to 2.967).

          Conclusions

          A large percentage of pregnant women still have insufficient dietary intakes of essential nutrients required to support the nutritional demands during pregnancy. Particularly, pregnant women resident in rural areas require interventions such as nutrition education on the selection and preparation of diversified meals to mitigate the effects of undernutrition.

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          Most cited references18

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Iron deficiency anemia: a common and curable disease.

            L. Miller (2013)
            Iron deficiency anemia arises when the balance of iron intake, iron stores, and the body's loss of iron are insufficient to fully support production of erythrocytes. Iron deficiency anemia rarely causes death, but the impact on human health is significant. In the developed world, this disease is easily identified and treated, but frequently overlooked by physicians. In contrast, it is a health problem that affects major portions of the population in underdeveloped countries. Overall, the prevention and successful treatment for iron deficiency anemia remains woefully insufficient worldwide, especially among underprivileged women and children. Here, clinical and laboratory features of the disease are discussed, and then focus is placed on relevant economic, environmental, infectious, and genetic factors that converge among global populations.
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              Low first-trimester hemoglobin and low birth weight, preterm birth and small for gestational age newborns.

              To examine the relationship between first-trimester hemoglobin (Hb) concentration and risk of low birth weight (LBW), preterm birth and small for gestational age (SGA). Data were obtained from a population-based prenatal care program in China. A total of 88,149 women who delivered during 1995-2000 and had their Hb measured in the first trimester were selected as study subjects. The prevalence of anemia (Hb or =120 g/L. Low first-trimester Hb concentration increases the risk of LBW, preterm birth and SGA.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: Writing – original draft
                Role: ConceptualizationRole: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                24 January 2020
                2020
                : 15
                : 1
                : e0226026
                Affiliations
                [1 ] Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
                [2 ] Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
                [3 ] Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
                [4 ] School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
                [5 ] Department of Nutrition and Dietetics, Universiti Putra, Selangor, Malaysia
                CSIR-Foood Research Institute, GHANA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-0869-5703
                http://orcid.org/0000-0002-5609-8065
                Article
                PONE-D-19-16653
                10.1371/journal.pone.0226026
                6980408
                31978048
                cd8a33e7-9298-4d97-98f1-2f6dd6288380
                © 2020 Ayensu et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 June 2019
                : 19 November 2019
                Page count
                Figures: 0, Tables: 7, Pages: 15
                Funding
                This work was supported by a PhD Fellowship to JA from Organization for Women in Science for the Developing World (OWSD), Swedish International Development Cooperation Agency (SIDA), and The World Academy of Sciences (TWAS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Medicine and Health Sciences
                Hematology
                Anemia
                Biology and Life Sciences
                Nutrition
                Nutrients
                Medicine and Health Sciences
                Nutrition
                Nutrients
                Earth Sciences
                Geography
                Geographic Areas
                Urban Areas
                Biology and Life Sciences
                Nutrition
                Medicine and Health Sciences
                Nutrition
                People and Places
                Geographical Locations
                Africa
                Ghana
                Earth Sciences
                Geography
                Geographic Areas
                Rural Areas
                Biology and Life Sciences
                Nutrition
                Malnutrition
                Medicine and Health Sciences
                Nutrition
                Malnutrition
                Custom metadata
                Data cannot be shared publicly because it contains sensitive identifying information. However, data are available from the Committee on Human Research Publication and Ethics (CHRPE), the ethics board of the School of Medical Sciences of the Kwame Nkrumah University of Science and technology, KNUST and Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana (Email: chrpe.knust.kath@ 123456gmail.com ) for researchers who meet the criteria for access to confidential data.

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