Fortification of flours with iron and control of anemia in pregnant women in Teresina, Piaui, Brazil

Objective This study compared the hemoglobin levels and the occurrence of anemia in pregnant women before and after the fortification of flours and characterized the eating habits of pregnant women who currently use the service. Methods This cross-sectional study analyzed the hemoglobin data of pregnant women seen by two public services with greater prenatal demand in the city of Teresina, Piaui. The data were obtained from 854 medical records of the women distributed into two groups: not fortified (427 women who would deliver before June 2004) and fortified (427 women whose last menstruation was after June 2005). Women with a hemoglobin level <11.0g/dL were considered anemic. Food intake was analyzed by a semiquantitative food frequency questionnaire. Results Mean hemoglobin levels increased significantly from 11.7g/dL, SD=1.2, to 12.4g/dL, SD=1.3 (p<0.001) after fortification. The prevalence of anemia decreased from 27.2% in the non-fortified group to 11.5% in the fortified group (p<0,001). Conclusion Anemia improved significantly after fortification of the flours, suggesting that the intervention effectively controlled iron deficiency However, it is not possible to attribute the improved iron levels on this measure alone, even though analysis of their eating habits showed that pregnant women from Teresina (PI) presented unusual food habits, with frequent consumption of natural iron sources and foods that facilitate its absorption, in addition to the fortified foods.