529 - Iron Folic Acid Supplementation as a Predictor of Anemia in Pregnant Women in Rural India

Poster Number: 529

Brandon Tomlin, University of Utah School of Medicine, Salt Lake City, UT, United States; Pranav Brahmbhatt, Shakti Krupa Charitable Trust, Sathod, Gujarat, India; Bernhard Fassl, Northeast Ohio Medical University, Salt Lake City, UT, United States; James Thomas, University of Utah School of Medicine, Salt Lake City, UT, United States; Allison Judkins, University of Utah School of Medicine, Salt Lake City, UT, United States

Background: Perinatal anemia is a massive global public health burden with an estimated global prevalence of approximately 40%. Severe anemia increases the risk of maternal mortality and can adversely effect fetal development. Adequate correction of anemia is essential for a healthy pregnancy and infant, but universal screening and monitoring is not the care standard in most LMICs. In lieu of universal screening and treatment, providing access to Iron Folic Acid (IFA) tabs is considered an effective and cost-efficient intervention to prevent and treat anemia of pregnancy. However, despite widespread availability of IFA tabs, anemia prevalence continues to be high and the presence of IFA programs may falsely reassure clinicians that patients taking them have adequate hemoglobin

Objective: The objective of this study is to evaluate the efficacy of using Iron Folic Acid as a predictor of adequate hemoglobin levels in pregnant women.

Design/Methods: The study took place at Mota Fofalia Community Health Center (MF-CHC) in Gujarat, India operated by a public-private partnership. The University of Utah operates an academic global health program in collaboration with MF-CHC and assists the health center in sustainable capacity building in maternal-child health. As part of a community-based antenatal care (ANC) program, we recruited a cohort of pregnant women from the surrounding community to complete a standardized nutrition and health survey and participate in scheduled prenatal visits according to WHO and Indian ANC guidelines which include measurement of vital signs and ANC guideline-based interventions . At each ANC visit, a blood hemoglobin level was drawn and each participant was asked if they are currently taking IFA or Albendozole, an antiparisitic.

Results: A total of 501 women were included in the study. 448 (89%) report taking IFA and 53 (11%) report not taking IFA. The average hemoglobin for those taking IFA was 10.11 g/dL (IQR 9.3-11.1) with an average gestational age at screening of 23.0 weeks while the average of those not taking was 10.41 g/dL (IQR 9.8-11.6) (p=.28) with an average gestational age of 10.9 weeks. In the group taking IFA tablets, 97% were also taking Albendozole while only 21% of mothers not taking IFA tablets were taking Albendozole.Conclusion(s): In areas with a high prevalence of anemia, patient compliance with standard IFA antenatal therapy is not a an adequate indicator of intervention. While it appears many mothers begin taking IFA as they become pregnant, the presence of readily available IFA therapy to the community is not sufficient in addressing perinatal anemia.
Brandon Tomlin CVBrandon Tomlin CV.pdf