Anemi och järnbrist under graviditet. En beskrivande studie med kvinnor från sydvästra Sverige.
Sammanfattning: Background: Anemia and iron deficiency (ID) is a health problem for pregnant women, throughout the world. Countries in Africa and Asia have the highest rate of these problems. Research has found that in high income countries, women who are multipara or immigrants have anemia more often than others.The midwife in Sweden has an area of expertise of reproductive and neonatal health. There are documents from the government that states the importance of giving equal care with focus on women’s human rights. If health care is unequal there can be negative effects both individually and for the society.The definition of anemia is by the level of Hemoglobin (Hb). Iron deficiency (ID) can be one reason to anemia. Anemia and ID can sometimes give health problems to mother or child during pregnancy or at the delivery. There are national and more local or regional medical guidelines which regulates how the midwife should give care to pregnant women with anemia or ID.Aim: The aim of this study was to investigate the frequency of anemia and iron deficiency among pregnant women in Sweden and the background factors related to anemia and iron deficiency. The second aim was to compare care and treatment of pregnant women with anemia between two different medical guidelines.Method: This study has collected data from 2126 women in a cohort study made in southwest Sweden. Pregnant women were recruited during 2013 and 2014. Their blood samples and medical files where collected together with data from a questionnaire. Quantitative methods using descriptive methods with means and standard deviations where used. Risk factors for anemia and ID where analysed with multifactor logistic regression. Two different medical guidelines where compared with participants as group A and group B.Result: Within the population, in first trimester, 3, 7% had anemia and 15, 8 % showed ID. Background factors as multiparity (OR=2,4) or country of birth Africa (OR=6,1) or Asia (OR=3,7) were related with higher risk for anemia when constant was nulli-para and Northern5Europe, in the beginning of the pregnancy. In second trimester, the factor being born outside Europe was related to higher risk for anemia. Iron supplement was registered among women with a higher probability to anemia in the first and second trimester. In the third trimester was overweight defined by Body Mass Index (BMI) 25-29, 9, one factor that increased the probability for anemia (OR =2,2). Factors related to the probability to get ID, in the first trimester was older than 28 years (OR 0, 5) and multiparity (OR=2, 2) compared with first pregnancy. Compared with women born in Northern Europe the probability to get ID was higher among women born in Asia (OR=1,6) or in Africa (OR=3,5).There were differences between group A and B in background factors and significant difference in Hb in trimester two.Conclusions Pregnant women in this study had anemia and iron deficiency in different frequency according to characteristics. Risk groups had higher probability for anemia and iron deficiency. The probability is higher among women born in Asia or Africa and multipara compared to women from northern Europe expecting their first child. Risk groups for anemia and ID during pregnancy are made clear in this study, they may need extra care during pregnancy.Analysing Ferritin in early pregnancy is positive for early start with iron supplement. Comparison between regional guidelines in group A and B shows that if iron deficiency is discovered late it can be negative for the percentage with anemia in the middle of pregnancy.
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