THE NUTRITIONAL ANAEMIA AND ITS RELATION BY THE EATING OF CHEESE OR YOGURT AMONG PREGNANT WOMEN IN ELOBIED CITY, WEST OF SUDAN

BACKGROUND: This study was conducted at the Obstetrics and Gynecologcal Hospital in Elobied City North Kordofan State, West of Sudan, in the period from December 2017 to December 2019, to detect the presence of nutritional anaemia among pregnant women, and to study the relation between the presence of anemia and eating the cheese or yogurt with the meal among the pregnant women. METHODS: Systematic random sampling method was used to select 384 pregnant women. Data were collected by questionnaire and a blood samples were taken from all women chosen and analyzed by Mindray Haematology Analyzer to measure the hemoglobin level to detect the presence of anaemia. The data of questionnaire were analyzed by SPSS and the results presented in tables and figures showing the percentages. The Chisquare test (McNemar,s test) was used to find the relation between the presence of anaemia and eating of cheese or yogurt. RESULTS: Most pregnant women (75%) were have anemia. Most pregnant women (61.5% ) were eating cheese or yogurt with the nutritional meal. Conclusion: The study discovered that there is a relation between eating of cheese or yogurt with the meal and the presence of anaemia, where the eating of cheese or yogurt with the meal contributed to the presence anemia with 45.1%. This study recommended the pregnant women to eat cheese or yogurt with separate time of nutritional meal (not with the meal). INTRODUCTION Anaemia, defined as a decreased concentration of blood hemoglobin, is one of the most common nutritional de-ficiency diseases observed globally and affects more than a quarter of the world’s population [1]. Anaemia is a major cause of morbidity and mortality of pregnant women and increases the risks of foetal, neonatal and infant mortality [2] . Anaemia during pre g-nancy contributes to 20% of all maternal deaths [3]. Iron deficiency is the cause of 75% of anaemia cases during pregnancy [4]. According to UNICEF [5] the causes of iron deficiency are: too little iron in the diet, poor absorption of iron by the body, and loss of blood (including from heavy menstrual bleeding). It is also caused by lead poisoning in children. Nutritional 7838(Online) ISSN: 2455 10.36713/epra2016 : DOI Journal SJIF Impact Factor 2021: 8.013| ISI I.F. Value:1.241| EPRA International Journal of Research and Development (IJRD) Volume: 6 | Issue: 5 | May 2021 Peer Reviewed Journal 287 | www.eprajournals. com | https://doi.org/10.36713/epra2016 : DOI Journal | 2021 EPRA IJRD Anaemia develops slowly after the normal stores of iron have been depleted in the body and in the bone marrow. Women, in general, have smaller stores of iron than men and have increased loss through menstruation, placing them at higher risk for nutritional anaemia. High-risk groups include: women of child-bearing age who have blood loss through menstruation; pregnant or lactating women who have an increased requirement for iron; infants, children, and adolescents in rapid growth phases; and people with a poor dietary intake of iron through a diet of little or no meat or eggs for several years. Source of iron: Non-vegetarian dietary sources of iron are red meat, fish, liver, and egg yolks; vegetarian sources include lentils and beans, whole grains and products made from these foods [5]. Forms of iron: There are two forms of iron, haem-iron and non-haem iron. Haem-iron is better absorbed than non-haem iron. Foods rich in haem-iron are liver, meat, poultry and fish . Foods containing non-haem iron are those of vegetable origin, e.g., cereals, green leafy vegetables, legumes, nuts , oilseeds, and dried fruits. The bioavailability of non-haem iron is poor owing to the presence of phytates, oxalates, carbonates , phosphates and dietary fibre which interfere with iron absorption. ( 6) Calcium: As published by Tidehag (7) : Calcium has been shown to inhibit iron absorption in both rats and man. Giving 165 mg Ca as milk, cheese or calcium chloride reduced absorption by 5060% . Calcium inhibits the absorption of both heme and nonheme iron. Sources of calcium: The milk and milk products like yogurt and cheese are the richest sources of calcium. The presence of large quantities of calcium in nutritional meal is conflicted with iron absorption [8] objectives: To detect the presence of nutritional anaemia among pregnant women, and to study the relation between the presence of anemia and the eating of cheese or yogurt with the meal among the pregnant women. METHODOLOGY Study type and design: descriptivecross sectional study. StudyArea : Elobied city, at Obstetrics and Gynecology Hospital which includes the departments ofaccidents, intensive care, laboratory, pharmacy, and referring clinic. Study population : All the pregnant women attending antenatal care clinic (ANC) at Obstetrics and Gynecology Hospital in Elobied city during the study period. Inclusion criteria : Mothers who attended antenatal care clinic (ANC) during the period from 15th August to 15th September, 2019 and who met the choosing criteria (systemic random sample) had chosen. Sampling : a / Samplesize : The sample size was determined according to Le (9) by the following formula: Where: n is sample size. Z is the value of the standard normal variable corresponding to 95% level of significance (z = 1.96). p is the prevalence of VL (p = 0.5) and (q = 1 –p) since no prior information exist. d is a marginal error (d =0.05) Accordingly, a sample of 384 persons will be obtained. b / Sample Technique : The systematic random sample was used. Data Collection Methods and tools : In this study a structured pre-coded and close-ended questionnaire was used to collect data . Some health workers was trained to assist in filling the questionnaire. Blood samples were colected in (2.5ml). DATA ANALYSIS The blood samples were analyzed in the laboratory of the hospital by Mindray Haematology Analyser to measure the level of hemoglobin. The cut-off points for the diagnosis of anaemia was according to the hemoglobin level as mentioned by park (10), where A hemoglobin level of 10 to 11 g/dl has been defined as early anaemia; a level below 10 g/dl as marked anaemia. The data of questionnaire were analyzed by statistical package for social sciences (SPSS) . The results were presented in figures and tables showing the percentages.The relations between some variables and the infection by anaemia were done according to Al Qassas (11) and Le (12) by McNemar,s test ( Chisquare (X2) test) for the correlative percentages in the table (2x2) by the formula: X2 = (B C )2 B + C Where: B and C are cells in the table 2x2 (without the cells of the total) as in the following shape: