Koomesh
Journal of Semnan University of Medical Sciences
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Outlines
Is Iron Supplementation In Health Centers Until the End of the Breastfeeding Period Necessary?
Abstract
Background: Iron deficiency (ID) and anemia are significant health problems affecting women after childbirth in developing and developed countries. These conditions can negatively impact a woman's quality of life, both bodily and psychological. Current guidelines in Iran, as outlined in the Ministry of Health's comprehensive nutrition guide for pregnant and lactating mothers, recommend iron supplementation for lactating women for only three months postpartum.
Objectives: This research seeks to determine if extending this supplementation program offered at health centers to two years after delivery (the entire breastfeeding period) would be beneficial.
Methods: This cross-sectional study was conducted on 177 women, 3 to 24 months after delivery, who had been referred to one of the health centers, clinics, or offices of Semnan, Iran for postpartum care from 2021 to 2022. Complete blood count (CBC) and serum ferritin levels were measured for all participants. Hemoglobin less than 12 g/dL was defined as anemia, ferritin less than 20 µg/L as ID, and both hemoglobin less than 12 g/dL and serum ferritin less than 20 µg/L were defined as iron deficiency anemia (IDA). Test results and individual characteristics of the women were collected through a questionnaire.
Results: Anemia affected 23.2% of the women, while 14.7% experienced iron deficiency (ID), and 7.9% suffered from iron deficiency anemia (IDA). The duration of breastfeeding (OR = 1.09, 95% CI: 1.01 - 1.18, P = 0.040) and regular/irregular intake of iron supplements during pregnancy (OR = 10.46, 95% CI: 3.44 - 31.84, P < 0.001) were significantly associated with ID. Additionally, gravidity (OR = 1.64, 95% CI: 1.01 - 2.67, P = 0.049), and regular/irregular intake of iron supplements during pregnancy (OR = 5.26, 95% CI: 1.40 - 19.76, P = 0.014) showed significant relationships with IDA.
Conclusions: The results indicate a notable prevalence of anemia, ID, and IDA during the breastfeeding phase in Semnan. Given that both ID and IDA are preventable conditions, it's crucial to focus on vulnerable groups, including women with higher parity, extended breastfeeding duration, and irregular iron intake during pregnancy. Consequently, providing targeted support and receiving adequate iron supplementation until the end of the breastfeeding period, can help mitigate the risk of ID and IDA, along with their associated complications.
References
- 1.Jameson JL, Fausi AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine. New York: McGraw-Hill; 2018. p. 683-90.
- 2.Butwick AJ, McDonnell N. Antepartum and postpartum anemia: a narrative review. Int J Obstet Anesth. 2021;47:102985. [PubMed ID:33893005]. https://doi.org/10.1016/j.ijoa.2021.102985.
- 3.Mirza FG, Abdul-Kadir R, Breymann C, Fraser IS, Taher A. Impact and management of iron deficiency and iron deficiency anemia in women's health. Expert Rev Hematol. 2018;11(9):727-36. [PubMed ID:30019973]. https://doi.org/10.1080/17474086.2018.1502081.
- 4.Bodnar LM, Cogswell ME, Scanlon KS. Low income postpartum women are at risk of iron deficiency. J Nutr. 2002;132(8):2298-302. [PubMed ID:12163678]. https://doi.org/10.1093/jn/132.8.2298.
- 5.World Health Organization. Guideline: Iron supplementation in postpartum women. 2016. Available from: https://iris.who.int/bitstream/handle/10665/249242/9789241549585-eng.pdf?sequence=1&isAllowed=y.
- 6.Abdolahi Z, Dorosti AR, Falah H, Bakhshandeh M, Torabi P, Rahmani K, et al. [Comprehensive nutrition guide for pregnant and lactating mothers]. 2nd ed. Qom: Andesheh Mandegar; 2014. p. 67-9.
- 7.Henjum S, Manger M, Skeie E, Ulak M, Thorne-Lyman AL, Chandyo R, et al. Iron deficiency is uncommon among lactating women in urban Nepal, despite a high risk of inadequate dietary iron intake. Br J Nutr. 2014;112(1):132-41. [PubMed ID:24708993]. https://doi.org/10.1017/S0007114514000592.
- 8.Rakesh P, Gopichandran V, Jamkhandi D, Manjunath K, George K, Prasad J. Determinants of postpartum anemia among women from a rural population in southern India. Int J Womens Health. 2014;6:395-400. [PubMed ID:24748821]. [PubMed Central ID:3990363]. https://doi.org/10.2147/IJWH.S58355.
- 9.Rahbar N, Ghorbani R. [Prevalence of anemia, iron deficiency and iron deficiency anemia three months after delivery in the Iranian women]. Koomesh. 2015;16(4):574-80. Persian.
- 10.Khademi Z, Shahi A, Farshid Far GR, Zare S, Vaziri F. [Prevalence of iron deficiency anemia in pregnant women referred to shariati hospital in Bandar Abbas, Iran]. Hormozgan Med J. 2004;8(1):27-31. Persian.
- 11.Zewdu D, Tantu T, Ali R, Demissie H, Baboker P, Daniel Z, et al. Prevalence and predictors of postpartum anemia after caesarean delivery in Ethiopia: A retrospective analysis of risk factors. Midwifery. 2023;123:103707. [PubMed ID:37187101]. https://doi.org/10.1016/j.midw.2023.103707.
- 12.Davidson EM, Scoullar MJL, Peach E, Morgan CJ, Melepia P, Opi DH, et al. Quantifying differences in iron deficiency-attributable anemia during pregnancy and postpartum. Cell Rep Med. 2023;4(7):101097. [PubMed ID:37413986]. [PubMed Central ID:10394161]. https://doi.org/10.1016/j.xcrm.2023.101097.
- 13.Bodnar LM, Cogswell ME, McDonald T. Have we forgotten the significance of postpartum iron deficiency? Am J Obstet Gynecol. 2005;193(1):36-44. [PubMed ID:16021056]. https://doi.org/10.1016/j.ajog.2004.12.009.
- 14.Jalali M, Siassi F, Ghiasvand R, Jarollahi N, Gheibi F, Fatehi F, et al. [Iron Deficiency Anemia in Pregnant Women in Eslamshahr]. J Kerman Univ Med Sci. 2005;12(2):271-7. Persian.
- 15.Mahmoudi G, Nick Pour B, Khazaee-Pool M, Majlessi F. [The Study of Anemia Prevalence and Some Related Factors among Pregnant Women in Health Centers of Mazanderan in 2015]. Payavard Salamat. 2017;11(3):266-75. Persian.
- 16.Rahbar N, Ghorbani R, Rezaei Ahvanoei F. [Prevalence of iron deficiency anemia and its complications in pregnant women referred to medical-health centers in Semnan]. Iran J Obstet Gynecol Infertil. 2014;17(128):12-7. Persian. https://doi.org/10.22038/ijogi.2014.3694.
- 17.Khanal V, Adhikari M, Karkee R. Low compliance with iron-folate supplementation among postpartum mothers of Nepal: an analysis of Nepal Demographic and Health Survey 2011. J Community Health. 2014;39(3):606-13. [PubMed ID:24322600]. https://doi.org/10.1007/s10900-013-9806-6.
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© 2024, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
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