Hostname: page-component-77c89778f8-gvh9x Total loading time: 0 Render date: 2024-07-23T15:20:44.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Burden of Anaemia, Hypertension and Diabetes among pregnant women in India

Published online by Cambridge University Press:  09 January 2023

Bal Govind Chauhan Open the ORCID record for Bal Govind Chauhan [Opens in a new window] ,
Praveen K. Chokhandre Open the ORCID record for Praveen K. Chokhandre [Opens in a new window] ,
Baldev Singh Kulaste  and
Vini Sivanandan
Bal Govind Chauhan*
Affiliation:
Assistant Professor, Population Research Centre, Gokhale Institute of Politics and Economics, Pune, Maharashtra, India-411004
Praveen K. Chokhandre
Affiliation:
Assistant Professor, Population Research Centre, JSS Institute of Economic Research, Dharwad, Karnataka 580004
Baldev Singh Kulaste
Affiliation:
Office Superintendent, Population Research Centre, Gokhale Institute of Politics and Economics, Pune, Maharashtra, India-411004
Vini Sivanandan
Affiliation:
Assistant Professor, Population Research Centre, Gokhale Institute of Politics and Economics, Pune, Maharashtra, India-411004
*
*Corresponding author: Bal Govind Chauhan, Assistant Professor, PRC, GIPE, Pune, India-411004. Email: govind.iips@ghmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Non-communicable Diseases such as anaemia, hypertension and diabetes and their treatment may upsurge the risk of childbirth-related complications for both women and their babies. The present study is an attempt to assess the level and determinants of Anaemia, Hypertension and Diabetes among pregnant women using the fourth round of National Family Health Survey-4 (2015-16) data. Bivariate and logistic regression techniques have been used for data analysis. Study findings suggest that the prevalence of anaemia among pregnant women was found to be 25.9%, whereas the corresponding figure for hypertension and diabetes were 4.4% and 2.4%, respectively. Further, substantial socio-economic differentials have been observed in the prevalence of Anaemia, Hypertension and Diabetes among pregnant women. Results of regression analysis suggest that anaemia and hypertension were significantly higher among women in their third trimester [(OR = 2.10; p < 0.001) and (OR = 1.63; p < 0.001)], respectively, compared to women in the first trimester. Similarly, pregnant women in the age group 35-49 were at an elevated risk of hypertension (OR = 2.78; p < 0.001)) and diabetes (OR = 2.50; p < 0.001)) compared to women aged 15-24. Further, the risk of anaemia was found to be significantly lower among pregnant women from the richest quintile (OR = 0.71; p < 0.001) and women with higher educational level (OR = 0.72; p < 0.001) when compared to women from the poorest wealth quintile and women with no formal education respectively. Similarly, pregnant women from the richest quintile (OR = 1.68; p < 0.001) and women from other religion (OR = 1.75; p < 0.001) are significantly more likely to develop diabetes compared to women from the poorest quintile and women from the Hindu religion, respectively. In conclusion, early screening for predicting the risk of gestational anaemia, gestational diabetes, and gestational hypertension is critical in minimizing maternal and reproductive outcomes. The existing guidelines for Screening and Management of Gestational Diabetes, Gestational Hypertension need to be contextualized and modified according to a local need for effective treatment.

Keywords

AnaemiaDiabeteshypertensionPregnant womenNFHS-4
Type
Research Article
Information
Journal of Biosocial Science , Volume 55 , Issue 5 , September 2023 , pp. 931 - 946
Copyright
© The Author(s), 2023. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amant, F, Han, SN, Gziri, MM, Vandenbroucke, T, Verheecke, M, & Van Calsteren, K (2015) Management of cancer in pregnancy. Best Practice & Research. Clinical Obstetrics & Gynaecology, 29(5), 741–753. https://doi.org/10.1016/j. bpobgyn.2015.02.006.CrossRefGoogle ScholarPubMed
American College of Obstetricians and Gynecologists (2019) ACOG Practice Bulletin No. 202: Gestational hypertension and preeclampsia. Obstetrics & Gynecology, 133(1), e1. https://doi.org/10.1097/AOG.0000000000003018 Google Scholar
Bláha, V, Yang, ZJ, Meguid, M, Chai, JK, & Zadák, Z (1998) Systemic nicotine administration suppresses food intake via reduced meal sizes in both male and female rats. ACTA MEDICA-HRADEC KRALOVE-, 41, 167–174.Google ScholarPubMed
Chełchowska, M, Ambroszkiewicz, J, Gajewska, J, Jabłońska-Głąb, E, Maciejewski, TM, & Ołtarzewski, M (2016) Hepcidin and iron metabolism in pregnancy: correlation with smoking and birth weight and length. Biological trace element research, 173(1), 14–20.CrossRefGoogle ScholarPubMed
Choudhary, R, Sharma, SM, Kumari, V, & Gautam, D (2016) Awareness, treatment adherence and risk predictors of uncontrolled hypertension at a tertiary care teaching hospital in Western India. Indian heart journal, 68(Suppl 2), S251.CrossRefGoogle Scholar
Chow, CK, Teo, KK, Rangarajan, S, Islam, S, Gupta, R, Avezum, A, … & Yusuf, S (2013) Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. Jama, 310(9), 959–968.10.1001/jama.2013.184182CrossRefGoogle Scholar
Goli, S, Rammohan, A, & Singh, D (2015) The effect of early marriages and early childbearing on women’s nutritional status in India. Maternal and Child Health Journal.10.1007/s10995-015-1700-7CrossRefGoogle ScholarPubMed
Government of India (2014) National Guidelines for Diagnosis & Management of Gestational Diabetes Mellitus. Maternal Health Division, Ministry of Health and Family Welfare, GOI. [cited 10 Aug. 21]. Available from: https://nhm.gov.in/images/pdf/programmes/maternal-health/guidelines/National_Guidelines_for_Diagnosis_&_Management_of_Gestational_Diabetes_Mellitus.pdf Google Scholar
Haider, BA, Olofin, I, Wang, M, Spiegelman, D, Ezzati, M, & Fawzi, WW (2013) Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Bmj, 346.10.1136/bmj.f3443CrossRefGoogle ScholarPubMed
Heslehurst, N, Simpson, H, Ells, LJ, Rankin, J, Wilkinson, J, Lang, R, … & Summerbell, CD (2008) The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obesity reviews, 9(6), 635–683.CrossRefGoogle ScholarPubMed
Hussein, J (2017) Non-communicable diseases during pregnancy in low and middle income countries. Obstetric medicine, 10(1), 26–29.CrossRefGoogle ScholarPubMed
Imamura, F, Micha, R, Khatibzadeh, S, Fahimi, S, Shi, P, Powles, J, … & Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE) (2015) Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment. The lancet global health, 3(3), e132–e142.CrossRefGoogle ScholarPubMed
Iversen, K (2017) Diabetes in pregnancy: A neglected cause of maternal mortality. Maternal Health Task Force. https://www.mhtf.org/2017/05/10/diabetes-inpregnancy-a-neglected-cause-of-maternal-mortality/ Google Scholar
Kalaivani, K (2009) Prevalence & consequences of anaemia in pregnancy. Indian J Med Res, 130(5), 627–33.Google ScholarPubMed
Kocyigit, A, Erel, O, & Gur, S (2001) Effects of tobacco smoking on plasma selenium, zinc, copper and iron concentrations and related antioxidative enzyme activities. Clinical biochemistry, 34(8), 629–633.CrossRefGoogle ScholarPubMed
Koopmann, A, Bez, J, Lemenager, T, Hermann, D, Dinter, C, Reinhard, I, … & Kiefer, F (2015) Effects of cigarette smoking on plasma concentration of the appetite-regulating peptide ghrelin. Annals of Nutrition and Metabolism, 66(2-3), 155–161.CrossRefGoogle ScholarPubMed
Lumbiganon, P, Laopaiboon, M, Intarut, NA, Vogel, JP, Souza, JP, Gülmezoglu, AM, … & WHO Multicountry Survey on Maternal and Newborn Health Research Network (2014) Indirect causes of severe adverse maternal outcomes: a secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health . BJOG: An International Journal of Obstetrics & Gynaecology, 121, 32–39. https://doi.org/10.1111/1471-0528.12647.CrossRefGoogle ScholarPubMed
Majella, MG, Sarveswaran, G, Krishnamoorthy, Y, Sivaranjini, K, Arikrishnan, K, & Kumar, SG (2019) A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India. Journal of education and health promotion, 8.Google Scholar
March of Dimes (2014) Multiple sclerosis and pregnancy. https://www.marchofdimes.org/complications/multiple-sclerosis-and-pregnancy.aspx 8.Google Scholar
McLean, E, Cogswell, M, Egli, I, Wojdyla, D, & De Benoist, B (2009) Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public health nutrition, 12(4), 444–454.CrossRefGoogle ScholarPubMed
Mithal, A, Bansal, B, & Kalra, S (2015) Gestational diabetes in India: Science and society. Indian journal of endocrinology and metabolism, 19(6), 701.CrossRefGoogle ScholarPubMed
Miyata, G, Meguid, MM, Fetissov, SO, Torelli, GF, & Kim, HJ (1999) Nicotine’s effect on hypothalamic neurotransmitters and appetite regulation. Surgery, 126(2), 255–263.10.1016/S0039-6060(99)70163-7CrossRefGoogle ScholarPubMed
Northrop-Clewes, CA, & Thurnham, DI (2007) Monitoring micronutrients in cigarette smokers. Clinica Chimica Acta, 377(1-2), 14–38.CrossRefGoogle ScholarPubMed
Office Registrar General of India (2020) Special bulletin on maternal mortality in India 2016-18. New Delhi: Office of the Registrar General and Census Commissioner of India.Google Scholar
Raja, MW, Baba, TA, Hanga, AJ, Bilquees, S, Rasheed, S, Haq, IU, … & Bashir, A (2014) A study to estimate the prevalence of gestational diabetes mellites in an urban block of Kashmir valley (North India). Int J Med Sci Public Health, 3(2), 191–5.10.5455/ijmsph.2013.211120131CrossRefGoogle Scholar
Rajput, R, Yadav, Y, Nanda, S, & Rajput, M (2013) Prevalence of gestational diabetes mellitus & associated risk factors at a tertiary care hospital in Haryana. The Indian journal of medical research, 137(4), 728.Google Scholar
Ramachandran, A, Snehalatha, C, Latha, E, Manoharan, M, & Vijay, V (1999) Impacts of urbanisation on the lifestyle and on the prevalence of diabetes in native Asian Indian population. Diabetes research and clinical practice, 44(3), 207–213.CrossRefGoogle ScholarPubMed
Ramachandran, A, Snehalatha, C, Latha, E, Vijay, V, & Viswanathan, M (1997) Rising prevalence of NIDDM in an urban population in India. Diabetologia, 40(2), 232–237.CrossRefGoogle Scholar
Say, L, Chou, D, Gemmill, A, Tunçalp, Ö, Moller, AB, Daniels, J, … & Alkema, L (2014) Global causes of maternal death: a WHO systematic analysis. The Lancet global health, 2(6), e323–e333. https://doi.org/10.1016/S2214-109X(14)70227-X.CrossRefGoogle ScholarPubMed
Seshiah, V, Balaji, V, Balaji, MS, Sanjeevi, CB, & Green, A (2004) Gestational diabetes mellitus in India. Japi, 52(9), 707–711.Google ScholarPubMed
Stauder, R, Valent, P, & Theurl, I (2018) Anaemia at older age: etiologies, clinical implications, and management. Blood, The Journal of the American Society of Hematology, 131(5), 505–514.Google ScholarPubMed
Swaminathan, G, Swaminathan, A, & Corsi, DJ (2020) Prevalence of gestational diabetes in India by individual socioeconomic, demographic, and clinical factors. JAMA network open, 3(11), e2025074–e2025074.CrossRefGoogle ScholarPubMed
Vaidya, A, Aryal, UR, & Krettek, A (2013) Cardiovascular health knowledge, attitude and practice/behaviour in an urbanising community of Nepal: a population-based cross-sectional study from Jhaukhel-Duwakot Health Demographic Surveillance Site. BMJ open, 3(10), e002976.CrossRefGoogle Scholar
Wendland, EM, Torloni, MR, Falavigna, M, Trujillo, J, Dode, MA, Campos, MA, … & Schmidt, M I (2012) Gestational diabetes and pregnancy outcomes-a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria. BMC pregnancy and childbirth, 12(1), 1–13.10.1186/1471-2393-12-23CrossRefGoogle ScholarPubMed
World Health Organization (2012) The WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium: ICD-MM. World Health Organization.Google Scholar
World Health Organization (2013) WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. Geneva: World Health Organization; p. 103.Google Scholar
World Health Organization (2014) Serum transferrin receptor levels for the assessment of iron status and iron deficiency in populations (No. WHO/NMH/NHD/EPG/14.6). World Health Organization.Google Scholar
World Health Organization (2019) Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.Google Scholar
Zargar, AH, Sheikh, MI, Bashir, MI, Masoodi, SR, Laway, BA, Wani, AI, Bhat, MH and Dar, FA (2004) Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diabetes research and clinical practice, 66(2), 139–145.10.1016/j.diabres.2004.02.023CrossRefGoogle ScholarPubMed