Postpartum anemia is a neglected public health issue in China: a cross-sectional study

Anemia impairs the health and wellbeing of women and increases the risk of maternal and neonatal adverse outcomes. The objectives of this study are to determine the prevalence of postpartum anemia among urban lactating women; investigate the predictors of anemia and explore the potential health effects on lactating performance.

Multi-stage sampling methods were used to recruit 495 lactating women from 3 cities of China. Blood and breast milk samples were collected to analyze hemoglobin levels and iron content, respectively. The intakes and sources of iron-rich food and nutrients were investigated based on Food Frequency Questionnaire and 24 h dietary recall.

The overall prevalence of postpartum anemia was 32.7%; no cases of severe anemia were encountered. Women who living in Guangzhou had a significant higher anemia prevalence. Regards to dietary intake, the amount of iron intake was generally good with a high proportion of heme iron. The animal sources ratio was 23.0%. Total iron intake and the sources of iron were not associated with anemia. Vitamin C intake was significantly higher in non-anemic women (Median (25th, 75 th) was (72.6 (38.4, 130.0) mg/d)) than anemic women (54.7 (30.7, 111.3) mg/d). Other nutrient enhancers were not associated with anemia. There were no significant differences in the iron content of breast milk between women with and without anemia (r=0.047, p=0.302).

Postpartum anemia is common in urban Chinese women. A combination of interventions, including managing antenatal anemia and correcting inappropriate dietary habits will help to prevent postpartum anemia.