Concentração de hemoglobina em gestantes atendidas em serviços de saúde do Sul do Brasil antes e após a ingestão de ferro em alimentos fortificados

Abstract

An iron-deficient diet has been regarded as the main cause of anemia. While this deficiency is more prevalent among expectant mothers and children, anyone who eats a similar diet is a potential victim of this malnutrition. To that end, the Wheat and Corn Flour Fortification Program was yet another strategy employed to reduce the rates of iron-deficiency anemia, especially among the most vulnerable sectors of the population: children and expectant mothers. The objective of this study was to verify the hemoglobin concentration among expectant mothers assisted at public basic health care services in the city of Maringá (Brazil), before and after the fortification of wheat and corn flours with iron and folic acid. The research was set up as crosssectional, quantitative and descriptive-analytical. The non-fortified group was made up of women who had given birth prior to June 2004, when the flour fortification program was implemented nationwide; whereas the fortified group was composed of expectant mothers whose last menstrual period took place after June 2005, the program's 1-year anniversary. 403 expectant mothers were selected for each group, for a total of 806 women. Data analysis was carried out through linear regression, chi-square test, Student's t-test and analysis of variance (ANOVA). The study's results showed a decrease in the prevalence of anemia, as well as statistically significant increases in hemoglobin concentration and hematocrit averages after fortification. The studied variables did not influence the average hemoglobin value during the second and third quarters of the fortified group. There was, however, a statistically significant interference from the flours on the hemoglobin value when associated with gestational age, with better results in the third quarter as compared to the others. It was concluded that flour fortification with iron and folic acid was an effective strategy for the reduction in the prevalence of anemia and in the increase of hemoglobin rates for the studied population, although other non-studied variable could have contributed as well.