title: Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania.
abstract: The etiology of pica, the purposive consumption of non-food substances, is not understood, despite its ubiquity among gravidae. We examined correlates of pica in a representative obstetric population (n = 2,368) on Pemba Island, Zanzibar, Tanzania to examine proposed etiologies. Cross-sectional data were collected on socioeconomic characteristics, food intake, geophagy (earth consumption), amylophagy (raw starch consumption), anthropometry, iron status, parasitic burden, and gastrointestinal morbidities. Amylophagy was reported by 36.3%, geophagy by 5.2%, and any pica by 40.1%. There was a strong additive relationship of geophagy and amylophagy with lower hemoglobin (Hb) concentration and iron deficiency anemia. By multivariate logistic regression, any pica was associated with Hb level (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.72-0.81), nausea (OR = 1.45, 95% CI = 1.20-1.73), and abdominal pain (OR = 1.22, 95% CI = 1.01-1.48). These striking results indicate that the nature of the relationship between pica, pregnancy, gastrointestinal distress, and iron deficiency anemia merits further investigation.
authors.affiliation: Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA. slyo@ucdavis.edu
authors.forename: Sera L
authors.initials: SL
authors.lastname: Young
authors.forename: Sabra S
authors.initials: SS
authors.lastname: Khalfan
authors.forename: Tamer H
authors.initials: TH
authors.lastname: Farag
authors.forename: Justine A
authors.initials: JA
authors.lastname: Kavle
authors.forename: Said M
authors.initials: SM
authors.lastname: Ali
authors.forename: Hamad
authors.initials: H
authors.lastname: Hajji
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Rasmussen
authors.forename: Gretel H
authors.initials: GH
authors.lastname: Pelto
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Stoltzfus
mesh_terms: D000740:Anemia / Q000150:complications* / Q000378:metabolism; D018798:Anemia, Iron-Deficiency / Q000150:complications*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019266:Iron, Dietary; D010842:Pica / Q000097:blood / Q000150:complications* / Q000378:metabolism; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000209:etiology* / Q000503:physiopathology; D013636:Tanzania / Q000453:epidemiology
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary