EFFECTIVENESS OF PROPHYLACTIC IRON AND FOLIC ACID IN PREVENTING MATERNAL ANEMIA AMONG VEGETARIANS-A CASE CONTROL STUDY
INTRODUCTION: Anemia complicating pregnancy poses a considerable danger to pregnant women and the fetal outcomes. Maternal anemia is defined as presence of less than 9gm% of hemoglobin in blood (Van Hove et. al, 2000). There is a significant risk of premature delivery and miscarriage in anemic women. The fetus is also at risk for low birth weight and severe anemia is associated with increased maternal mortalities (Oats J, Abraham S 2005). The two main types of anemia encountered during pregnancy are Iron deficiency anemia and Folate deficiency anemia. As the pregnancy advances there is an increased demand for dietary iron and folic acid. The dietary source of iron and folic acid are not sufficient to meet the demand. The anemia tends to worsen as the pregnancy progresses because of increased demand. The prevalence of maternal anemia is very high among the southern states of India. Among the other causes, a probable reason for this high incidence could be the exclusive vegetarian diet followed by majority of the population residing in the region (Antony A C, 2001). The diet does not include any animal products including milk and milk derivatives.
OBJECTIVE: It is evident that those pregnant women who strictly follow vegetarian diet are at a higher risk for developing anemia (Letsky A E, 2001). In India the regular antenatal care provided at the Maternity Centers run by the state governments includes one time investigation for the presence of anemia at the end of first trimester and the subsequent test is done when the period of gestation reaches full term. Prophylactic iron and folic acid in the form of nutritional supplements are given only to those mothers who are diagnosed to have anemia at the end of first trimester (Yadav R J et. al, 2009). Hence there is a possibility of a failure to provide prophylactic iron and folic acid supplements if anemia is not detected during the latter half of the pregnancy. In contrast to the state government’s maternity centers, beneficiaries of the safe motherhood initiative sponsored by the federal government to all its employees are provided with nutritional supplements irrespective of their hemoglobin status from the beginning of first trimester (Singh S et al, 2009). It is possible to study the role of iron and folic acid supplements in prevention of anemia by comparing those women who receive prophylaxis therapy and those who do not receive any supplements
A comprehensive literature review performed in relation to the effectiveness of prophylactic nutritional supplements for all vegetarian mothers drew inconclusive evidence and the necessity for such prophylactic treatment is not significantly researched. The objective of this research is to establish a relationship between vegetarianism and the incidence of anemia during pregnancy and by this illustrate the need for a universal nutritional supplement provision for all women who are known as exclusive vegetarians.
AIM: To assess whether pregnant women who are vegetarians and have taken prophylactic nutritional supplements irrespective of their anemic status show lesser incidence of maternal anemia than the mothers who do not take supplements during the pregnancy but follow vegetarian diet. This study also aims to compare the hemoglobin levels during the last trimester between the women who have received prophylaxis and those who have not received any supplements.
HYPOTHESIS: All pregnant women who receive Iron and Folic acid prophylaxis irrespective of their Hemoglobin status will have lower incidence of anemia and higher levels of Hemoglobin.
RELEVANCE: This study could stress the need for modification in the antenatal care provided according to the specific needs of people. The assessment would help in conducting additional research on the dosage of nutritional supplements and the...
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