Indian Pediatrics - Editorial

Letters to the Editor

Indian Pediatrics 1999; 36:322-323

Prevalence of Iron Deficinecy Anemia Amongst Pregnant Women in Urban Slum Communities of Delhi

Anemia in pregnant mothers is associated with low birth weight and increased perinatal mortality. Low birth weight is a major factor in subsequent infant morbidity and mortality. A decrease in the prevalence of anemia could lead to lowering of incidence of low birth weight and thereby can reduce infant mortality(1).

We would like to share our findings of a pilot study on magnitude of anemia amongst pregnant mothers of urban slum communities in National Capital Territory (NCT) of Delhi. A hospital based study was conducted amongst one thousand two hundred and twenty two pregnant women attending the antenatal clinic (ANC) organized by Maternal and Child Health Centre (MCH), Rural Health Training Center, Najafgarh New Delhi. The MCH center catered to four urban slum communities in Najafgarh. All pregnant women attending for the first time for ANC checkup from January 1997 to April 1998 were included in the study.

Hemoglobin levels were estimated using HemoCue and Sahli' method(2). Dietary intake of 8% of pregnant women, selected randomly, was collected using the 24 hour dietary recall method. Cooked food consumed by pregnant women was converted into raw equivalents and iron intake was calculated using food composition tables(3).

It was found that 85.4% pregnant women had hemoglobin levels below 11.0 g/dl. The prevalence of mild (Hb level 10-10.9 g/dl)), moderate (Hb level 7.0-9.9 g/dl) and 'severe anemia (Hb level 6.9 g/dl and below) was 30.4%,53.5% and 1.5%, respectively.

The dietary intake assessment revealed that the mean daily intake of iron was 14.56 mg/day, which was 61.7% below the recommended dietary allowance as per the ICMR guidelines (RDA of Iron: 38 mg/day). The mean caloric intake was deficient by 25%, 50% and 75% amongst 0.9%, 18% and 65% of the pregnant women (RDA of calories sedentary worker: 2175 Kcal/day), respectively.

The present findings are similar to an earlier study conducted among pregnant women in urban slum communities of Delhi which reported the prevalence of anemia as 94%(4). Earlier studies conducted by ICMR in 10 states and Union Territory of Delhi has documented a prevalence of anemia as 87% among pregnant women(5). Another multicentric study by ICMR in 1992 conducted in 5 states and Union Territory of Delhi, in pregnant women of second trimester reported a prevalence of anemia as 62%(6). Similarly, the prevalence of anemia among pregnant women in urban Baroda has been reported as 72%(7).

In conclusion anemia continues to be a major public health problem in urban slum communities of Delhi.

                                                   Priyali Pathak,
                                               Monica Tandon,
  Umesh Kapil,
                                                Charan Singh, *
                  Department of Human Nutrition.
All India Institute of Medical Sciences,
Ansari Nagar, New Delhi 110 029, India
and
*Rural Health Training Center
Najafgarh, New Delhi, India.

References

1. Dubey AP. Iron deficiency anemia: Epidemiology, diagnosis and clinical profile. In: Nutrition in Children: Developing Country Concerns. Eds. Sachdev HPS, Choudhury P, Department of Pediatrics, Maulana Azad Medical College, New Delhi, 1994; pp 217-235.

2. Program for Appropriate Technology in Health. Anemia Detection in Health Services. Guideline for program Managers. U.S. Agency for International Development, 1996; pp 37.

3. Gopalan C, Rama Sastri BV, Balasubramanian SC. Nutritive Value of Indian Foods. National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 1996; pp 47-91.

4. Kapil U, Saxena N, Ramachandran S. Iron deficiency anemia in pregnancy. Indian Pediatr 1996; 33: 606-607.

5. Indian Council of Medical Research. Task Force Study. Evaluation of National Nutritional Anemia Prophylaxis Programme. Indian Council of Medical Research, New Delhi, 1989; pp 46-72.

6. Indian Council of Medical Research Task Force Study. Field Supplementation Trial in Pregnant Women with 60 mg, 120 mg and 180 mg of Iron with 500 mg of Folic Acid. Indian Council of Medical Research, New Delhi, 1994; pp 1-28.

7. Seshadri S. A Database on Iron Deficiency Anemia (IDA) in India: Prevalence, Etiology, Consequences and Strategies for Control. Prepared for Task Force on Micronutrient Malnutrition Control. Department of Women and Child Development, Ministry of Human Resource Development, New Delhi, 1996.