Impact de l’anémie ferriprive maternelle sur la survie du nouveau-né vulnérable de petite taille : Etude prospective à Kisangani, en République Démocratique du Congo
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La prévention des naissances prématurées, des petits pour l’âge gestationnel (PAG ou SGA en anglais) et du faible poids de naissance (FPN ou LBW) est essentielle à la santé des enfants du monde entier. Les naissances prématurées, les SGA et les LBW sont appelés nouveau-né vulnérable de petite taille ou SVN. Le but de cette étude est de déterminer la survie du SVN né d’une mère avec anémie ferriprive ou IDA et ses facteurs prédictifs. Étude de cohorte prospective, appariée, ouverte et multicentrique portant sur 1 226 nouveau-nés de mères souffrant IDA. Nous avons réalisé une analyse statistique, incluant l’analyse concurrente de risques et le modèle de regression de Cox, pour illustrer les effets cliniques de l’IDA sur les nouveaux-nés et les facteurs de risque. Le risque d'effets cliniques et le taux d'incidence du phénotype PT+SGA+LBW ont augmenté respectivement de plus de 2,21 fois (2,20-2,21) et de 3,86 fois (3,82-3,90). Le risque du phénotype T+SGA+LBW a augmenté de 1,28 fois (1,28-1,29) ou 28 % pour l'IDA modérée, de 2,48 fois (2,47-2,49) pour l'IDA sévère. Ce risque a augmenté de 5,64 fois (5,63-5,66) pour l'insuffisance pondérale de la mère en fin de grossesse. Le risque associé au phénotype PT+AGA+LBW a augmenté de 1,78 (1,75-1,81) ou 78 % et de 5,53 fois (5,47-5,59) chez les naissances vivantes issues de mères à faible poids en début de grossesse et de mères sans supplémentation en fer. L'anémie ferriprive maternelle a un impact grave sur l'état de santé du nouveau-né. Menacés par une incidence plus élevée de mortalité et diverses morbidités à court et à long terme, les VSN issus des mères IDA devrait bénéficier de soins appropriés.
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