Abstract

Keywords

۱٫ Introduction

۲٫ Methods

۳٫ Results

۴٫ Discussion

acknowledgements

References

Abstract

Introduction
Tamil Nadu administers intravenous iron sucrose for correcting moderate anaemia among pregnant women (Haemoglobin level 7–۸٫۹ g/dl) based on preliminary studies. We did a cross-sectional study to estimate compliance level and that of factors associated with intravenous iron sucrose treatment for moderate anaemia among pregnant women attending health facilities of Kancheepuram health district, Tamil Nadu, India, 2017.

Methods
We needed five pregnant women of 20–۳۰ weeks from 70 clusters (health subcentres) for the assumptions of 64% compliance, 7% absolute precision, 95% Confidence Interval (CI) and a design effect of two. We collected data on knowledge and experience with iron sucrose treatment and reasons for non-compliance. We abstracted haemoglobin levels and administered doses from records. We computed compliance level (%) with 95% CI and estimated adjusted odds ratio (AOR) for non-compliance through logistic regression analysis.

Results
The median age of 350 women was 24 years (Range = 22 to 26). Compliance level to intravenous iron sucrose was 79% (95% CI: 73 to 84). Non-compliance was more likely among women aged 25–۳۵ years (AOR: 2.1, 95% CI: 1.2 to 3.7), primi (AOR: 2.2’ ۹۵% CI: 1.2 to 3.8) and not received treatment information (AOR: 3.1, 95% CI: 1.1 to 8.8). Major reasons for non-compliance were lack of information about treatment, belief that food was better than injections and that injections could harm the baby.

Conclusions
The compliance to intravenous iron sucrose was insufficient. Providing clear information about intravenous iron sucrose to moderately anaemic pregnant women could increase the compliance to intravenous iron sucrose.

۱٫ Introduction

Anemia is the most common nutritional deficiency disorder of pregnancy. The World Health Organization (WHO) estimated global prevalence of anaemia among pregnant women of 15–۴۵ years as 38% in 2011.1 Prevalence of anaemia among pregnant women in South East Asian region (as defined by WHO Regions) is 49%, which is the highest among all the regions in the world.1 In India, the prevalence of anaemia among pregnant women is 54%, which is the highest prevalence in the South East Asian region.1 Prevalence of anaemia among pregnant women in Tamil Nadu is 44%.2

Anaemia during pregnancy will lead to poor maternal and perinatal outcomes. Anaemic pregnant women have a two-fold increase of preterm deliveries, higher incidences of low birth weight, postpartum haemorrhage and puerperal sepsis.3 The babies born to anaemic women have a higher incidence of intensive care unit (NICU) admissions, hyperbilirubinemia, respiratory distress syndrome, neonatal seizures, birth asphyxia and neonatal sepsis.3 According to the ministry of women and child development under Government of India, 20% of maternal deaths in India are due to anaemia and India contributes to half of the global maternal deaths due to anaemia.4