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PubMed2006

Use of routine beef carcase Escherichia coli monitoring data to investigate the relationship between hygiene status of incoming stock and processing efficacy.

In Australian export-registered abattoirs microbiological monitoring is carried out within the E. coli and Salmonella Monitoring (ESAM) program. During the calendar year 2003, the ESAM database indicated a national prevalence of Escherichia coli of around 3.0% for steers/heifers and 7.1% for cows/bulls. An investigation was carried out to attempt to elucidate why some establishments had E. coli prevalence markedly higher or markedly lower than the national average. The investigation was based on a questionnaire completed by fifteen export establishments which provided data on livestock, processing, operator training and management. The responses were verified by site visits and then evaluated for their relationship with ESAM data on E. coli in two stages. In stage 1, E. coli prevalence for each abattoir was plotted against each variable recorded by the questionnaire; no single variable was a reasonable predictor for prevalence of E. coli on carcases. In stage 2, variables influencing contamination were grouped under two categories: contamination on incoming livestock (Problem variables) together with the ability of the plant's process to deal with such contamination (Process variables). The analysis prompted two main conclusions. Firstly, plants with a large incoming problem with livestock (long haul, high tag score and proportion of cows/bulls slaughtered) plus "poor" processes had higher than average E. coli prevalence. Secondly, plants with hot water decontamination systems had low E. coli prevalence even when there was a substantial incoming problem with livestock, such as a relatively high proportion of cows/bulls.

Abattoirs↗
PubMed2004

Healthful eating: perceptions, motivations, barriers, and promoters in low-income Minnesota communities.

Self-administered surveys of low-income subjects (n=796)recruited at food programs, grocery stores, and other public places in four Minnesota study communities were designed to examine definitions of healthful food and to identify motivations, barriers, and promoters of healthful eating. Fruits and vegetables were most often given as definitions of healthful eating, regardless of income, race, or sex. Subjects said they eat healthfully primarily for health, weight, and family concerns. Almost half of subjects indicated that time was a barrier to healthful eating, and more than one-third cited money concerns. Half of the top promoters of healthful eating included federal or local food assistance programs. Family was the most common promoter. Identification of perceptions, barriers, and promoters of healthful eating for low-income and minority populations may be useful for tailored intervention planning. Specifically, family-based interventions and food assistance programs may be more successful in promoting healthful eating for selected segments of the population.

Adult↗
PubMed2004

Relationship of child-feeding practices to overweight in low-income Mexican-American preschool-aged children.

OBJECTIVE: The purpose of this research was to examine the relationship of child-feeding practices and other factors to overweight in low-income Mexican-American preschool-aged children. DESIGN: Cross-sectional survey with anthropometric measurements of mothers and target children. Trained bilingual staff interviewed the parents to collect data on child-feeding strategies, food patterns, child's health history, parental acculturation level, food insecurity, and other household characteristics. Subjects and setting Complete data were available from 204 low-income Mexican-American parents residing in California with at least one child aged 3 to 5 years. Outcomes measured Risk of overweight was defined as body mass index (BMI) (measured as weight [in kilograms]/height [in meters](2)) >/=85th percentile and overweight was defined as BMI >/=95th percentile. The Student t test, chi(2) test, and logistic regression were used. RESULTS: Three variables were positively related to risk of overweight: birth weight (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.11 to 4.82), mother's BMI >/=30 (OR, 2.05; 95% CI, 1.11 to 3.79), and juice intake (OR, 2.33; 95% CI, 1.09 to 4.98). Being enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children was negatively related to risk of overweight (OR, 0.40; 95% CI, 0.21 to 0.75). Additional variables related to overweight were monthly income >$1,500 (OR, 2.33; 95% CI, 1.00 to 5.42) and child takes food from the refrigerator between meals (OR, 0.32; 95% CI, 0.13 to 0.76). CONCLUSIONS: The results of this study suggest that biological and socioeconomic factors are more associated with overweight in Mexican-American preschool-aged children than most of the self-reported child-feeding strategies.

Acculturation↗
PubMed2006

Nutrition knowledge is associated with greater weight loss in obese and overweight low-income mothers.

OBJECTIVE: To examine if greater nutrition knowledge vs gains in knowledge promote more successful weight loss in low-income, overweight and obese mothers with young children. DESIGN: A convenience sample of mothers and their children were measured for height and weight; mothers completed demographic and nutrition knowledge questionnaires pre- and post-intervention. SUBJECTS/SETTING: Participants (N=141) were recruited from government and public health clinics and elementary schools. Inclusion criteria for mothers were: family income <200% federal poverty level; overweight/obese; and Hispanic, African-American, or white race/ethnicity. INTERVENTION: Eight weekly weight-loss classes emphasizing diet, physical activity, and behavior modification based on Social Cognitive Theory were administered to mothers. MAIN OUTCOME MEASURES: Improvements in maternal nutrition knowledge and weight loss. STATISTICAL ANALYSES PERFORMED: Paired-samples t tests, repeated measures analysis of variance, analysis of covariance, Pearson correlations, and chi(2) statistics. RESULTS: Nutrition knowledge of mothers increased in all areas. Participants with weight loss > or =2.27 kg (responders) had greater knowledge than those who did not; however, the actual net gain was similar for those who lost and did not lose weight. Weight gainers only improved in two areas on the test, whereas weight-loss responders increased knowledge in all six. Responders appeared more cognizant of diet, weight loss, and health information. CONCLUSIONS: Weight-management programs should include a strong component of nutrition education to alleviate knowledge inequalities and promote more effective weight control. In low-income mothers, greater initial knowledge may be more predictive of weight loss than gains in knowledge during an intervention.

Adult↗
PubMed2006

The child health/family income gradient: Evidence from England.

Recent studies using Canadian and US data have documented a positive relationship between family income and child health, with the slope of the gradient being larger for older than younger children [Case, A., Lubotsky, D., Paxson, C., 2002. Economic status and health in childhood: the origins of the gradient. American Economic Review 92, 1308-1334; Currie, J., Stabile, M., 2003. Socioeconomic status and child health: why is the relationship stronger for older children? American Economic Review 93, 1813-1823]. In this paper we explore whether or not these findings hold for England, analysing a sample of over 13,000 children (and their parents) drawn from the Health Survey for England. While we find consistent and robust evidence of a significant family income gradient in child health, using the subjective general health status measure, the slope of the gradient is very small. Moreover, we find no evidence that the slope of the gradient increases with child age. Furthermore, we find no evidence of such a gradient with more objective measures, based on nurse examinations and blood test results. Together these results suggest that family income is not a major determinant of child health in England. Finally, we provide some evidence that nutrition and family lifestyle choices have an important role in determining child health and that child health is highly correlated within the family.

Adolescent↗
PubMed2004

Two positively charged residues of phi29 DNA polymerase, conserved in protein-primed DNA polymerases, are involved in stabilisation of the incoming nucleotide.

In DNA polymerases from families A and B in the closed conformation, several positively charged residues, located in pre-motif B and motif B, have been shown to interact with the phosphate groups of the incoming nucleotide at the polymerisation active site: the invariant Lys of motif B and the nearly invariant Lys of pre-motif B (family B) correspond to a His in family A DNA polymerases. In phi29 DNA polymerase, belonging to the family B DNA polymerases able to start replication by protein-priming, the corresponding residues, Lys383 and Lys371, have been shown to be dNTP-ligands. Since in several DNA polymerases a third residue has been involved in dNTP binding, we have addressed here the question if in the DNA polymerases of the protein-primed subfamily, and especially in phi29 DNA polymerase, there are more than these two residues involved in nucleotide binding. By site-directed mutagenesis in phi29 DNA polymerase the functional role of the remaining two conserved positively charged amino acid residues of pre-motif B and motif B (besides Lys371 and Lys383) has been studied. The results indicate that residue Lys379 of motif B is also involved in dNTP binding, possibly through interaction with the triphosphate moiety of the incoming nucleotide, since the affinity for nucleotides of mutant DNA polymerase K379T was reduced in DNA and TP-primed reactions. On the other hand, we propose that, when the terminal protein (TP) is present at the polymerisation active site, residue Lys366 of pre-motif B is involved in stabilising the incoming nucleotide in an appropriate position for efficient TP-deoxynucleotidylation. Although mutant DNA polymerase K366T showed a wild-type like phenotype in DNA-primed polymerisation in the presence of DNA as template, in TP-primed reactions as initiation and transition it was impaired, especially in the presence of the phi29 DBP, protein p6.

Amino Acid Motifs↗
PubMed2004

A 'give it a go' breast-feeding culture and early cessation among low-income mothers.

OBJECTIVE: to examine cultural expectations and experiences of breast feeding amongst first time mothers from low-income areas, in order to improve understanding of why many cease breast feeding in the early days of their babies' lives. DESIGN: qualitative interviews were carried out with 16 women, who expressed an intention to breast feed, at 37 weeks in their pregnancy and again at 3-9 weeks postnatally. SETTING: women were interviewed in their own homes in low-income areas of North Tyneside, north-east England. FINDINGS: decisions about breast-feeding cessation were usually made within the first few days as women negotiated the pathways of informal cultures of feeding babies and the availability and quality of formal care. A 'give it a go' breast-feeding culture is identified, where women who intended to breast feed had a strong expectation of difficulties and even failure. Expertise and confidence with bottle feeding were more widespread among family and friends. The many influences on the mothers' decision-making were interconnected and contingent upon each other: if one aspect of breast feeding 'goes wrong', other reasons were often brought into play and the underlying pessimism that was felt antenatally was borne out. CONCLUSIONS: positive experiences of formal support could make a crucial difference in the early days of breast feeding. However non-breast-feeding cultures permeated and found expression in negative discourses. Support needs to take account of the cultural contexts in which mothers make decisions and the fact that breast feeding is affected by a multitude of factors simultaneously. Access to advice at the right time is a key issue for some low-income women.

Adult↗
PubMed2006

Relationship between childhood socio-economic position and mortality risk in adult males of the Korea Labour and Income Panel Study (KLIPS).

OBJECTIVES: Evidence on the relationship between childhood socio-economic position (SEP) and adult mortality risk is mounting, but is sparse in regions outside Europe and North America. The present study aimed to examine this relationship in South Korea. STUDY DESIGN: Prospective cohort study. METHODS: First-round data from the Korea Labour and Income Panel Study were linked to data on mortality. Childhood SEP indicators were father's education, own education, father's occupational class at age 14, own first occupational class after age 15, birth place, and residence at age 14. Adulthood SEP indicators included current occupational class, family income, perceived economic hardships, and current residence. RESULTS: Mortality differentials according to current occupational class, economic hardship and current residence were statistically significant. Mortality risk tended to increase as household income decreased. For all childhood SEP indicators, inverse relationships between childhood SEP and mortality risk were found. These inverse relationships were attenuated but did not disappear with adjustment for each adulthood SEP indicator. However, the statistically significant association between childhood SEP and mortality risk did not persist after full adjustment for four adulthood SEP indicators. CONCLUSIONS: Both early- and later-life markers of SEP were related to an increased risk of death in South Korea. Future studies need to examine the relationship between childhood SEP and cause-specific mortality.

Adolescent↗
PubMed2005

Trends in maternal health/healthcare in low-income countries and the implications on neonatal health.

Maternal health in low-income countries has received increasing attention over the last 15-20 years. Maternal mortality ratios in these countries are mainly still modelled estimates and one cannot discern trends. The introduction of registration systems-giving reliable causes of death-is essential both for monitoring maternal health and fuelling action. Countries with documented success in reducing maternal mortality have used systematic, incremental approaches, often tied to multi-sectoral efforts, including roads, communication links, education, water and sanitation. Improving maternal health requires a reasonably well-functioning health system and this typically requires the reduction of poverty and consistent investment in the health system. Increasingly, policies to improve maternal and newborn health are being implemented, but in the poorest countries the impact is still not discernible. New clinical interventions, such as effective treatment of (pre)eclampsia and post-partum haemorrhage, are often beyond reach of the majority in low-income countries. In summary, progress in maternal health, and the intimately linked perinatal and newborn health, is too slow and requires urgent efforts in poverty reduction and health system strengthening in low-income countries.

Developing Countries↗
PubMed2006

Horizontal equity in health care utilization evidence from three high-income Asian economies.

This paper compares the extent to which the principle of "equal treatment for equal need"(ETEN) is maintained in the health care delivery systems of Hong Kong, South Korea and Taiwan. Deviations in the degree to which health care is distributed according to need are measured by an index of horizontal inequity. Income-related inequality in utilization is split into four major sources: (i) direct effect of income; (ii) need indicators (self-assessed health status, activity limitation, and age and gender interaction terms); (iii) non-need variables (education, work status, private health insurance coverage, employer-provided medical benefits, Medicaid status (low-income medical assistance), geographic region and urban/rural residency and (iv) a residual term. Service types studied include western doctor, licensed traditional medicine practitioner (LTMP), dental and emergency room (ER) visits, as well as inpatient admissions. Violations of the ETEN principle are observed for physician and dental services in Hong Kong . There is pro-rich inequity in western doctor visits. Unusually, this inequity exists for general practitioner but not specialist care. In contrast, South Korea appears to have almost comprehensively maintained ETEN although the better-off have preferential access to higher levels of outpatient care. Taiwan shows intermediate results in that the rich are marginally more likely to use outpatient services, but quantities of western doctor and dental visits are evenly distributed while there is modest pro-rich bias in the number of LTMP episodes. ER visits and inpatient admissions in Taiwan are either proportional or slightly pro-poor. Future work should focus on the evaluation of policy interventions aimed at reducing the observed unequal distributions.

Asia↗
PubMed2006

Social capital and mental health: a comparative analysis of four low income countries.

Women and the poor are disproportionately affected by common mental disorders (CMD), and women in low income countries are particularly at risk. Social capital may explain some of the geographical variation in CMD, but the association between social capital and CMD in low income countries has rarely been studied. This paper aims to explore the relationship between individual and ecological measures of social capital and maternal CMD in four low income countries. Cross-sectional data from the Young Lives (YL) study with information across 234 communities in Peru, Ethiopia, Vietnam and Andhra Pradesh (India) were used. The mental health of mothers of one-year-old children (n=6909), and the individual cognitive and structural social capital of all respondents was assessed. Ecological social capital was calculated by aggregating individual responses to the community level. Multi-level modelling was used to explore the association between individual and ecological (community level) social capital and maternal CMD in each of the four countries, adjusting for a wide range of individual and community level confounders. The analysis shows that individual cognitive social capital is associated with reduced odds of CMD across all four countries. The results for structural social capital are more mixed and culturally specific, with some aspects associated with increased odds of CMD. This suggests that structural social capital has context-specific effects and cognitive social capital more universal effects on maternal CMD.

Adolescent↗
PubMed2004

Measuring adherence to mammography screening recommendations among low-income women.

OBJECTIVES: (1) To describe the accuracy of self-report and administrative claims for measuring mammography adherence among low-income women; (2) to determine whether the accuracy of self-report differed between telephone interview and mailed questionnaire; and (3) to explore whether the method of measuring adherence affected associations between mammography adherence and participant sociodemographic characteristics. DESIGN: Retrospective cohort study of women receiving care from a Philadelphia Medicaid Managed Care Organization (MCO). PARTICIPANTS: Three hundred and ninety-nine low-income women eligible for screening mammography of whom 64% were African American, 14% Caucasian, 13% Hispanic, and 8% Asian American. MEASURES: Self-reported use of mammography screening, administrative mammography claims data, and dates of mammograms from radiology facility records. The "gold standard" categorized women as having undergone screening if they had either a billing claim or facility record for a mammogram in the past 12 months. MAIN RESULTS: Two hundred and eighty-three of the 399 women reported having had a mammogram in the past 12 months. The sensitivity of self-report was 0.93, specificity was 0.54, positive predictive value was 0.70, and negative predictive value was 0.86. One hundred and seventy-nine of the 399 women had a claim for a mammogram in the past 12 months. The sensitivity of claims data was 0.83 with a negative predictive value of 0.84. The sensitivity of self-report was higher with telephone data collection (0.98) than with mailed data collection (0.82), while the specificity was higher with mail (0.64) than telephone (0.50). African American race was associated with adherence to screening recommendations when mammography use was measured by self-report (RR 1.31, P = 0.002) but not when it was measured by claims or facility validation (RR 1.03, P = 0.56, and RR 1.12, P = 0.15, respectively). CONCLUSIONS: Accurate measurement of adherence to mammography screening among low-income women is difficult. Self-report substantially overestimates adherence (particularly when collected through telephone interviews), while also misclassifying some women who underwent screening as not having been screened (particularly when collected through mailed questionnaires). In contrast, administrative claims data substantially underestimates adherence. Inaccurate measurement of mammography adherence can lead to a biased understanding of the factors associated with adherence.

Aged↗
PubMed2004

The role of trust in use of preventive services among low-income African-American women.

BACKGROUND: This study explored factors that predict higher trust in primary care providers, and examined the role of patient trust on the use of preventive services for low-income African-American women. METHODS: We conducted a cross-sectional, population-based telephone survey of 961 African-American women over age 40 in Washington, DC. Two dimensions of trust were examined: overall trust in one's regular primary care provider, and trust that the regular provider had no financial conflict of interest. Self-reported use of mammography, Pap tests, clinical breast exams, colorectal cancer screening, blood pressure, height and weight measurement, diet counseling, and depression screening, as delivered by one's primary care provider, were assessed. An index summarizing overall use of these interventions was the main outcome variable. RESULTS: More than two-thirds of respondents reported high trust in their physician. Older respondents (>65) were more trusting of their physicians overall than were younger respondents (P < 0.01). Primary care characteristics (continuity of care, accessibility of the practice, coordination of specialty care by one's regular provider) were more strongly associated with having high trust than were sociodemographic, health status, and insurance characteristics. Higher trust was significantly associated with greater use of recommended preventive services (OR: 2.3, 95% CI: 1.3, 4.0), controlling for the effects of insurance status, primary care, and patient characteristics. CONCLUSIONS: Trust is associated with use of recommended preventive services in low-income African-American women. Stronger patient-provider relationships, with high levels of trust, may indirectly lead to better health through adherence to recommended preventive services for low income African-American women.

Black or African American↗
PubMed2003

A video lesson series is effective in changing the dietary intakes and food-related behaviors of low-income homemakers.

OBJECTIVE: To examine the relative cost-effectiveness of a self-administered video series in delivering nutrition education to low-income homemakers. DESIGN: A quasi-experimental design was used, with subjects randomly assigned to traditional lessons (Traditional Group) or video lessons (Video Group). SUBJECTS/SETTING: 108 subjects were recruited, with 93 nonpregnant, low-income, female homemakers completing the study (response rate = 86%). Subjects had recently enrolled in the Expanded Food and Nutrition Education Program, or the Food Stamp Nutrition Education Program, and had a videocassette recorder and telephone. INTERVENTION: Both groups received 12 lessons from the Eating Right Is Basic Series, 3rd edition, with the Traditional Group being taught in face-to-face sessions and the Video Group receiving self-administered, video-lesson packets. OUTCOME MEASURES: Dietary intake and food behaviors were assessed at pre and post intervention with 24-hour recalls and a 14-item checklist. STATISTICAL ANALYSES: Chi(2) and t tests were used to compare the groups on demographics and pre-intervention dietary factors. Multiple analysis of variance was used for comparisons of change from pre to post intervention. RESULTS: Significant improvements were observed in both groups for fruits, calcium, and vitamins A and C. The Video Group improved on fiber intake (P<or=.005). The groups did not differ on dietary or behavior change (P=.2357). Duplication and implementation costs of the video series totaled 4,820 dollars, or 36% of the traditional lesson cost of 13,463 dollars. APPLICATIONS: Both methods achieved similar improvements in diet and behaviors, but the video method was less expensive. The video series seems to be a cost-effective method for delivering nutrition education to low-income homemakers.

Adolescent↗
PubMed1995

Sources of energy and six nutrients in diets of low-income Hispanic-American women and their children: quantitative data from HHANES, 1982-1984.

OBJECTIVE: Identification of important food sources of energy, protein, fat, vitamin A, vitamin C, calcium, and iron for low-income Hispanic women and their children. DESIGN: A subset of 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES), a sample representing 76% of the Hispanic-origin population, provides the most comprehensive examination of Hispanic food habits in the United States. SUBJECTS/SAMPLES: The sample, which approximates the population of the Special Supplemental Food Program for Women, Infants, and Children (WIC), included 1,046 17- to 34-year-old women with household income less than 185% of poverty level and their 1- to 5-year-old children (n = 1,063). MAIN OUTCOME MEASURES: Tables show the percentage that each food contributes to total intake of energy and six nutrients for women and for children and percentage of persons who reported consuming each food during a 24-hour period. RESULTS: Cultural foods contributed less to the energy and nutrient intake of the population than expected, with few exceptions, notably beans, rice, tortillas, and salsa. Major sources of energy and nutrients were similar to those seen for blacks and whites in the second National Health and Nutrition Examination Survey (1976-1980). APPLICATIONS: The data presented should be useful to researchers designing dietary assessment instruments and to nutrition educators designing or adapting educational materials. The data may be of particular interest to WIC staff who work with low-income Hispanic populations.

Adolescent↗
PubMed1999

Defined, in-home, prenatal nutrition intervention for low-income women.

OBJECTIVES: The purpose of this project was to develop a detailed, in-home, prenatal nutrition intervention protocol for low-income women and to assess the effectiveness of the intervention in improving their dietary intake. A secondary objective was to identify predictors of infant birth weight. DESIGN: A defined protocol was developed and nutritionists followed it to conduct in-home nutrition sessions that included nutrition assessment, education, counseling, and goal setting for low-income women during their pregnancies. A pre/post design was used to assess the effects of the nutrition program on dietary intake. A control group was used in evaluating the effect of the nutrition intervention on birth weight. SUBJECTS/SETTING: Forty low-income pregnant women selected randomly by the county health department nursing staff completed the nutrition intervention. Twenty-six women were also selected to serve as a control group. INTERVENTION: For women in the intervention group, in-home visits were conducted weekly for 4 weeks, followed by 2 monthly visits. The purpose of the in-home visits was to use the defined protocol, which included monitoring weight gain and providing individualized dietary intake assessment and nutrition education and counseling. MAIN OUTCOME MEASURES: The primary outcome measures were change in dietary intake from preintervention to postintervention, mothers' weight at time of delivery, and infant birth weight. STATISTICAL ANALYSIS PERFORMED: Paired t tests were used to compare the women's mean daily energy and nutrient intakes before and after the nutrition intervention. Correlation analysis identified relationships between infant birth weight and independent variables, and multiple stepwise regression analysis was used to identify variables that contributed to the variation in infant birth weight. Mean birth weight was compared in the intervention and control groups by means of a t test. A chi 2 test was used for categoric variables. RESULTS: Comparison of dietary intakes before and after the intervention revealed significant increases in total energy (2,269 to 2,431 kcal, P < .05), folate (345 to 412 micrograms, P < .01), vitamin B-6 (2.1 to 2.5 mg, P < .01), iron (17.5 to 21.2 mg, P < .01), zinc (13.6 to 14.7 mg, P < .01), and calcium (1,175 mg to 1,299 mg, P < .01) and significant (P < .01) increases in daily servings from the vegetable group (1.5 +/- 1.0 to 2.2 +/- 1.1 serving per day) and breads/grains groups (3.4 +/- 1.4 to 4.1 +/- 1.5 servings per day). There was no significant difference in mean birth weight between the intervention and control groups. Sixty-five percent of the variation in infant birth weight was accounted for by mother's weight at time of delivery, pre-pregnancy body mass index, number of visits by the nutritionist, and change in energy intake from preintervention to postintervention. APPLICATIONS: This defined, in-home, prenatal nutrition intervention protocol can be used by providers of prenatal nutrition services to document outcomes of prenatal nutrition care in high-risk women. Use of a defined protocol will facilitate collection of meaningful outcomes data by service providers.

Adolescent↗
PubMedDate not supplied

Women's health and low-income housing.

The inequities in health care and housing access experienced by low-income women in the United States are a continuing concern. This article addresses the interrelationships between housing and health as experienced by low-income clients so that health care practitioners can begin to build active and effective health-promoting partnerships with clients, their families, and their communities. A case study is presented that describes the actual experience of a woman living in a low-income housing development and its effect on her health and access to health care. The importance of the role of midwives in addressing the health care and advocacy needs of women in substandard housing is highlighted.

Female↗
PubMedDate not supplied

Iron stores in low-income pregnant Mexican women at term.

BACKGROUND: Iron stores can be depleted during pregnancy. Serum ferritin is the most useful non-invasive test to assess iron stores in women of reproductive age. Iron status of pregnant Mexican women at term from a low-income group was investigated through serum ferritin determinations. METHODS: Hemoglobin and serum ferritin were measured in 201 low-income urban women with at-term pregnancy receiving attention at a public university hospital. Hemoglobin cut-off value was 110.0 g/L. Depending on their serum ferritin concentration, women were divided into three groups: group I, iron deficiency, serum ferritin <12 microg/L; group II, borderline iron stores, serum ferritin >or=12 microg/L and <30 microg/L, and group III, normal iron stores, serum ferritin >or=30 microg/L. RESULTS: Mean SF value in the entire group was 7.0 +/- 6.4 microg/L, with a mean Hb of 110.1 +/- 15.8 g/L. One hundred seventy-two women (85.6%) had empty iron stores. Ninety-two women (46%) in the entire group had iron deficiency anemia, as did 79 (46%) of the 172 iron-deficient women. During their pregnancy, 165 women (82%) did not ingest any supplemental iron and 131 (65%) did not receive any prenatal care. CONCLUSIONS: We documented a high prevalence of iron deficiency and iron deficiency anemia, together with practically no prenatal care utilization and no supplemental iron ingestion in this low-income group. A serum ferritin concentration >or=12 microg/L was always accompanied by a normal hemoglobin concentration. These data suggest that prenatal care and iron supplementation may be considered as major determinants of maternal iron stores to prevent iron deficiency anemia.

Adolescent↗