Skip to main content
Top
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Assessment of maternal anemia in rural Western China between 2001 and 2005: a two-level logistic regression approach

Authors: Leilei Pei, Lin Ren, Duolao Wang, Hong Yan

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

There are multiple adverse effects of anemia on human function, particularly on women. However, few researches are conducted on women anemia in rural Western China. This study mainly aims to investigate the levels and associated factors of maternal anemia between 2001 and 2005 in this region.

Methods

6172 and 5372 mothers with children under three years old were selected from 8 provinces in 2001 and from 9 provinces in 2005 respectively in Western China by means of a multi-stage probability proportion to size sampling method (PPS). The blood samples were tested and related socio-demographic information was obtained through questionnaires. A two-level logistic regression model was employed to identify the determinants and provincial variations of women anemia in 2001 and 2005.

Results

The results indicated that the crude prevalence of women anemia in 2005 was higher than the rate in 2001(45.7% vs 33.6%). Based on the nationwide census data in 2000, the age-standardized prevalence of women anemia in the study were obtained as 38.0% in 2001 and 50.0% in 2005 respectively. Two-level logistic model analysis showed that compared to the average, women were more likely to be anemic in Guangxi and Qinghai in 2001 as well as in Chongqing and Qinghai in 2005; that women from Minority groups had higher odds of anemia in contrast with Han; that women with higher parity, longer breastfeeding duration and higher socioeconomic level had a lower rate of anemia, while age of women was positively associated with anemia. The positive correlation between women anemia and altitude was also observed.

Conclusions

The study demonstrated that the burden of maternal anemia in rural Western China increased considerably between 2001 and 2005. The Chinese government should conduct integrated interventions on anemia of mothers in this region.
Literature
1.
go back to reference McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B: Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutr. 2009, 12: 444-454. 10.1017/S1368980008002401.CrossRefPubMed McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B: Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutr. 2009, 12: 444-454. 10.1017/S1368980008002401.CrossRefPubMed
2.
go back to reference Warrell D, Cox T, Firth J, Benz E: Oxford textbook of medicine. 2003, Oxford, UK: Oxford University Press Warrell D, Cox T, Firth J, Benz E: Oxford textbook of medicine. 2003, Oxford, UK: Oxford University Press
3.
go back to reference Yip R: Iron deficiency and anemia. Nutrition and health in developing countries. Edited by: Semba RD, Bloem MW. 2001, Totowa, New Jersey: Humana Press, 327-342.CrossRef Yip R: Iron deficiency and anemia. Nutrition and health in developing countries. Edited by: Semba RD, Bloem MW. 2001, Totowa, New Jersey: Humana Press, 327-342.CrossRef
4.
go back to reference Yip R: Iron. Present knowledge in nutrition. Edited by: Bowman BA, Russell . 2001, Washington DC: ILSI Press, 311-328. Eighth Yip R: Iron. Present knowledge in nutrition. Edited by: Bowman BA, Russell . 2001, Washington DC: ILSI Press, 311-328. Eighth
5.
go back to reference Horton S, Ross J: The economics of iron deficiency. Food Policy. 2003, 28: 51-75. 10.1016/S0306-9192(02)00070-2.CrossRef Horton S, Ross J: The economics of iron deficiency. Food Policy. 2003, 28: 51-75. 10.1016/S0306-9192(02)00070-2.CrossRef
6.
go back to reference Chan SM, Nelson EA, Leung SS, Li CY: Postnatal iron status of Hong Kong Chinese women in a longitudinal study of maternal nutrition. Eur J Clin Nutr. 2001, 55: 538-546. 10.1038/sj.ejcn.1601180.CrossRefPubMed Chan SM, Nelson EA, Leung SS, Li CY: Postnatal iron status of Hong Kong Chinese women in a longitudinal study of maternal nutrition. Eur J Clin Nutr. 2001, 55: 538-546. 10.1038/sj.ejcn.1601180.CrossRefPubMed
7.
go back to reference Allen LH: Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr. 2005, 81 (suppl): 1206-1212. Allen LH: Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr. 2005, 81 (suppl): 1206-1212.
8.
go back to reference Walter T: Effect of iron deficiency anemia on cognitive skills in infancy and childhood. Food Nutr Bull. 2003, 24 (suppl): 104-110.CrossRef Walter T: Effect of iron deficiency anemia on cognitive skills in infancy and childhood. Food Nutr Bull. 2003, 24 (suppl): 104-110.CrossRef
9.
go back to reference Schloz BD, Gross R, Schultink W, Sastroamidjojo S: Anemia is associated with reduced productivity of women workers even in less physically-strenuous tasks. Br J Nutr. 1997, 77: 47-57. 10.1017/S0007114500002877.CrossRef Schloz BD, Gross R, Schultink W, Sastroamidjojo S: Anemia is associated with reduced productivity of women workers even in less physically-strenuous tasks. Br J Nutr. 1997, 77: 47-57. 10.1017/S0007114500002877.CrossRef
10.
go back to reference Institute of Medicine: Nutrition during pregnancy. 1990, Washington, D.C: National Academy Press, 272-298. Institute of Medicine: Nutrition during pregnancy. 1990, Washington, D.C: National Academy Press, 272-298.
11.
go back to reference Royston R, Armstrong S: The status of women and maternal mortality. Preventing maternal mortality. Edited by: WHO. 1989, Ginebra: WHO, 75-106. Royston R, Armstrong S: The status of women and maternal mortality. Preventing maternal mortality. Edited by: WHO. 1989, Ginebra: WHO, 75-106.
12.
go back to reference ACC/SCN: What Works? A Review of the Efficacy and Effectiveness of Nutrition Interventions. 2001, Manila, Philippines: the Asian Development Bank ACC/SCN: What Works? A Review of the Efficacy and Effectiveness of Nutrition Interventions. 2001, Manila, Philippines: the Asian Development Bank
13.
go back to reference WHO: Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. 2008, Geneva, Switzerland: World Health Organization WHO: Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. 2008, Geneva, Switzerland: World Health Organization
14.
go back to reference Yin S: The 2002 Women Nutrition and health survey in China. 2008, Beijing: People Health Press, 81-82. in Chinese Yin S: The 2002 Women Nutrition and health survey in China. 2008, Beijing: People Health Press, 81-82. in Chinese
15.
go back to reference Dincer OC, Wang F: Ethnic diversity and economic growth in China. J Econ Policy Reform. 2011, 14: 1-10. 10.1080/17487870.2011.523985.CrossRef Dincer OC, Wang F: Ethnic diversity and economic growth in China. J Econ Policy Reform. 2011, 14: 1-10. 10.1080/17487870.2011.523985.CrossRef
16.
go back to reference Liu XL, Yan H, Wang DL: The evaluation of “safe motherhood” program on maternal care utilization in rural western china: a difference in difference approach. BMC Public Health. 2010, 10: 566-10.1186/1471-2458-10-566.CrossRefPubMedPubMedCentral Liu XL, Yan H, Wang DL: The evaluation of “safe motherhood” program on maternal care utilization in rural western china: a difference in difference approach. BMC Public Health. 2010, 10: 566-10.1186/1471-2458-10-566.CrossRefPubMedPubMedCentral
17.
go back to reference CDC: Recommendation to prevent and control iron deficiency in the United States. Morb Mortal Wkly Rep. 1998, 47: 12-13. CDC: Recommendation to prevent and control iron deficiency in the United States. Morb Mortal Wkly Rep. 1998, 47: 12-13.
18.
go back to reference CDC: Altitude hemoglobin curve and CDC anemia criteria which uses the altitude adjustment Atlanta. 1995, Centers for Disease Control and Prevention CDC: Altitude hemoglobin curve and CDC anemia criteria which uses the altitude adjustment Atlanta. 1995, Centers for Disease Control and Prevention
19.
go back to reference Dirren H, Logman MH, Barclay DV, Freire WB: Altitude correction for hemoglobin. Eur J Clin Nutr. 1994, 48: 625-632.PubMed Dirren H, Logman MH, Barclay DV, Freire WB: Altitude correction for hemoglobin. Eur J Clin Nutr. 1994, 48: 625-632.PubMed
20.
go back to reference Dallman PR, Siimes MA, Stekel A: Iron deficiency in infancy and childhood. Am J Clin Nutr. 1980, 33: 86-118.PubMed Dallman PR, Siimes MA, Stekel A: Iron deficiency in infancy and childhood. Am J Clin Nutr. 1980, 33: 86-118.PubMed
21.
go back to reference Xing Y, Yan H, Dang SN, Bianba ZM, Zhou XY, Wang DL: Hemoglobin levels and anemia evaluation during pregnancy in the highlands of Tibet: a Hospital-based study. BMC Public Health. 2009, 9: 336-10.1186/1471-2458-9-336.CrossRefPubMedPubMedCentral Xing Y, Yan H, Dang SN, Bianba ZM, Zhou XY, Wang DL: Hemoglobin levels and anemia evaluation during pregnancy in the highlands of Tibet: a Hospital-based study. BMC Public Health. 2009, 9: 336-10.1186/1471-2458-9-336.CrossRefPubMedPubMedCentral
22.
go back to reference Deon F, Pritchett LH: Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of india. Demography. 2001, 38: 115-132. Deon F, Pritchett LH: Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of india. Demography. 2001, 38: 115-132.
23.
go back to reference Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV: Anaemia in low-income and middle-income countries. Lancet. 2011, 378: 2123-2135. 10.1016/S0140-6736(10)62304-5.CrossRefPubMed Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV: Anaemia in low-income and middle-income countries. Lancet. 2011, 378: 2123-2135. 10.1016/S0140-6736(10)62304-5.CrossRefPubMed
24.
go back to reference Ghada ZA, Magdi NA, Soha ES: Prevalence of anemia in Egypt (Al-Gharbia governorate). Egypt J Hosp Med. 2007, 28: 295-305. Ghada ZA, Magdi NA, Soha ES: Prevalence of anemia in Egypt (Al-Gharbia governorate). Egypt J Hosp Med. 2007, 28: 295-305.
25.
go back to reference Agarwal KN, Agarwal DK, Sharma A, Sharma K, Prasad K, Kalita MC, Khetarpaul N, Kapoor AC, Vijayalekshmi L, Govilla AK, Panda SM, Kumariet P: Prevalence of anaemia in pregnant & lactating women in India. Indian J Med Res. 2006, 124: 173-184.PubMed Agarwal KN, Agarwal DK, Sharma A, Sharma K, Prasad K, Kalita MC, Khetarpaul N, Kapoor AC, Vijayalekshmi L, Govilla AK, Panda SM, Kumariet P: Prevalence of anaemia in pregnant & lactating women in India. Indian J Med Res. 2006, 124: 173-184.PubMed
26.
go back to reference Lindsay HA: Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr. 2005, 81 (suppl): 1206-1212. Lindsay HA: Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr. 2005, 81 (suppl): 1206-1212.
27.
go back to reference Takimoto H, Yoshiike N, Katagiri A, Ishida H, Abe S: Nutritional status of pregnant and lactating women in Japan: a comparison with non-pregnant/non-lactating controls in the national nutrition survey. J Obstet Gynaecol Res. 2003, 29: 96-103. 10.1046/j.1341-8076.2002.00078.x.CrossRefPubMed Takimoto H, Yoshiike N, Katagiri A, Ishida H, Abe S: Nutritional status of pregnant and lactating women in Japan: a comparison with non-pregnant/non-lactating controls in the national nutrition survey. J Obstet Gynaecol Res. 2003, 29: 96-103. 10.1046/j.1341-8076.2002.00078.x.CrossRefPubMed
28.
go back to reference Hyder SM, Persson LA, Chowdhury AMR, EkstroÈm EC: Anaemia among non-pregnant women in rural Bangladesh. Public Health Nutr. 2000, 4: 79-83. Hyder SM, Persson LA, Chowdhury AMR, EkstroÈm EC: Anaemia among non-pregnant women in rural Bangladesh. Public Health Nutr. 2000, 4: 79-83.
29.
go back to reference Rush D: Nutrition and maternal mortality in the developing world. 1998, Boston: Tufts University Rush D: Nutrition and maternal mortality in the developing world. 1998, Boston: Tufts University
30.
go back to reference Bentley ME, Griffiths PL: The burden of anemia among women in India. Eur J Clin Nutr. 2003, 57: 52-60. 10.1038/sj.ejcn.1601504.CrossRefPubMed Bentley ME, Griffiths PL: The burden of anemia among women in India. Eur J Clin Nutr. 2003, 57: 52-60. 10.1038/sj.ejcn.1601504.CrossRefPubMed
31.
go back to reference Lisa MB, Kelley SS, David SF, Anna MS, Mary EC: High prevalence of postpartum anemia among low-income women in the United States. Am J Obstet Gynecol. 2001, 185: 438-448. 10.1067/mob.2001.115996.CrossRef Lisa MB, Kelley SS, David SF, Anna MS, Mary EC: High prevalence of postpartum anemia among low-income women in the United States. Am J Obstet Gynecol. 2001, 185: 438-448. 10.1067/mob.2001.115996.CrossRef
32.
go back to reference Kalkwarf HJ, Harrast SD: Effects of calcium supplementation and lactation on iron status. Am J Clin Nutr. 1998, 67: 1244-1249.PubMed Kalkwarf HJ, Harrast SD: Effects of calcium supplementation and lactation on iron status. Am J Clin Nutr. 1998, 67: 1244-1249.PubMed
Metadata
Title
Assessment of maternal anemia in rural Western China between 2001 and 2005: a two-level logistic regression approach
Authors
Leilei Pei
Lin Ren
Duolao Wang
Hong Yan
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-366

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue