Postnatal iron status of Hong Kong Chinese women in a longitudinal study of maternal nutrition

Objective: To report postnatal iron nutritional status of Hong Kong Chinese women during the first 6 months postpartum. Design and subjects: A longtitudinal study examining postnatal calcium and iron status of Hong Kong Chinese breastfeeding and formula-feeding women wa s conducted during 1998. Postpartum women aged 20-40 y, with no bone or blo od disorders were recruited and interviewed at 0 (baseline), 2, 6 weeks, 3 and 6 months postpartum. Dietary intake was assessed by a 3 day dietary rec ord and cross checked by a 24 h recall. Complete blood count and serum ferr itin level were measured to assess anaemia and iron status. In this report, subjects were divided into an anaemic group (haemoglobin level < 10 g/dl) and a non-anaemic group (haemoglobin level greater than or equal to 10 g/dl ) according to baseline haemoglobin levels. Results: At baseline, 13/47 (27.7%) subjects were anaemic. Two of these 13 anaemic subjects were still anaemic at 3 and 6 months postpartum. Anaemic s ubjects showed significantly (P < 0.01) greater amounts of blood loss and a higher rate of primary postpartum haemorrhage than the non-anaemic subject s. Daily food intake and dietary nutrient intake did not differ significant ly between the two groups. During the first 6 weeks postpartum, subjects in both groups consumed more poultry and egg, and comparable amounts of meat, compared with women in the Hong Kong general population. Iron and vitamin C intakes for the majority of subjects reached 60% of the US Recommended Da ily Allowances. Regression analysis suggested that the rate of change in ha emoglobin level in the first 6 weeks postpartum was positively correlated w ith baseline MCV level and serum ferritin level, but negatively correlated with baseline haemoglobin level. Conclusions: Blood loss at delivery is an important factor for postpartum a naemia. Postnatal recovery of iron status of this group of women appeared t o be more related to physiological factors than to dietary factors. The rol e of diet as well as other physiological changes in postpartum women requir es further investigation. Finding ways to minimise blood loss at delivery c ould be the most practical strategy to reduce the rate of postpartum anaemi a. Sponsorship: CSM was supported by a research studentship from the Research Grants Council, I-long Kong.