Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania.
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.
Young
Sera L
SL
Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA. slyo@ucdavis.edu
Khalfan
Sabra S
SS
Farag
Tamer H
TH
Kavle
Justine A
JA
Ali
Said M
SM
Hajji
Hamad
H
Rasmussen
Kathleen M
KM
Pelto
Gretel H
GH
Tielsch
James M
JM
Stoltzfus
Rebecca J
RJ
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
D006454:Hemoglobins; D019266:Iron, Dietary