Determinantes nutricionais e sóciodemográfico relacionados à anemia em gestantes indígenasrurais mexicanas
Palavras-chave:
Anemia, Estado nutricional, Gravidez, Povos indígenasResumo
Objetivo
Identificar indicadores nutricionais relacionados à anemia considerando o contexto sociodemográfico de gestantes
indígenas-rurais mexicanas.
Métodos
Foram coletados dados de 156 gestantes indígenas-rurais. Foi aplicado um questionário sociodemográfico e foram obtidos indicadores nutricionais: Women’s Dietary Diversity Score (WDDS), índice de massa corporal (IMC) prégestacional, ganho de peso para a idade gestacional, concentrações de hemoglobina e níveis séricos de ferritina, ferro, zinco, vitamina C, vitamina B12 e folato eritrocitário. Utilizou-se análise estatística para identificar variáveis relacionadas à presença de anemia, criando modelo de regressão logística binária com correlações significativas.
Resultados
24% das participantes apresentavam anemia e baixas reservas de ferro, 32,1% baixas concentrações de vitamina C. Além disso, 37,8% experimentaram perda ou ganho de peso insuficiente. As adolescentes apresentaram menor IMC pré-gestacional (22,2±2,8 vs. 24,9±4,4; p=0,000) e menor WDDS em comparação às mulheres adultas (35,8 vs. 21,8; p=0,020). As grávidas que moravam mais longe da sede municipal apresentaram menor WDDS (r=-0,213; p=0,028). Em adultas, ser dona de casa (OR=6,06 [IC 95%=1,35-27,28]; p=0,019), apresentar perda ou ganho de peso insuficiente (OR=5,34 [IC 95%=1,56-18,26]; p= 0,008), baixas concentrações de ferritina (OR=13,12 [IC 95%=3,48-48,34]; p=0,000) e baixos níveis de vitamina C (OR=6,01 [IC 95%=1,36-16,00]; p=0,014), foram contribuintes (Nagelkerke r2=0,470) à anemia.
Conclusão
Ao desenvolver estratégias para a prevenção da anemia em mulheres grávidas, é necessário considerar seus contextos sociais, econômicos e geográficos. Além disso, devem ser estabelecidas políticas públicas para garantir a implementação adequada da suplementação multivitamínica e, neste tipo de população marginal, iniciá-la desde o início da menstruação.
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