By Prof. A.K. Susheela | Fluorosis Foundation of India
Project Update: Controlled anemia in pregnant mothers and improved birth weight of babies by withdrawing fluoride intake and improving diet
Funds: Provided by donors under Global Giving, USA
Hospitals where the projects were carried out (1) Deen Dayal Upadhaya Hospital in West Delhi, India (DDU) (2) Sri Lal Bahadur Sastri Hospital, East Delhi, India (LBS)
In both the hospitals, the pregnant women who attend the Antenatal Clinics are from the lower strata of the socio-economic ladder.
In DDU, 2055 pregnant women were scanned
Exclusion criteria: The selection of pregnant women were based on all those, who do not suffer from Diabetes, Tuberculosis, HIV AIDS, Bleeding during pregnancy and High Blood Pressure.
Inclusion criteria: Pregnant women who are anemic with hemolgobin ranging from 11.0 to 5.0 g/dl. Besides urinary fluoride is on the higher side (beyond normal range) i.e. beyond 1.0 mg/L.
The conditions applied for Exclusion and Inclusion were the same in both the hospitals.
Sample Group women were introduced to 2 Interventions.
Intervention I: They were withdrawn from consuming any item containing fluoride, which included drinking water, food and food products and also advised to use toothpaste which has the least fluoride (In India every paste has fluoride – whether fluoridated or not, as fluoride arises as an impurity from raw material used for the manufacture of the paste).
Intervention II: The pregnant women, were provided very effective counselling for improving the nutritive value of diet (by consuming dairy products, fruits and vegetables rich in calcium, iron, folic acid, vitamin C, E and other antioxidants).
A little pictorial booklet in Hindi language showing items that they should consume were provided.
Simple recipes to make soups, salads and sauces with vegetables and fruits were discussed. Also advised to consume less of deep fried food and to reduce the quantity of oil and spices in cooking. Their concepts were changed and encouraged to consume a nutritive diet.
Monitoring: Every visit to Antenatal clinic until delivery, the women were tested for hemoglobin and urinary fluoride. They were able to observe the changes in Hemoglobin due to lowering the urine fluoride content..
The Control Group women were not introduced to interventions I & II, but they were also monitored until delivery
In DDU our 1st series (2004 – 2007) • The urinary fluoride reduced form 6.25 mg/L to 0.25 mg/L prior to delivery. • When urinary fluoride reduced, hemoglobin enhanced from 5.7 g/dl to 13.3 g/dl prior to delivery. • In 80% of the pregnant women, anemia was rectified through the Interventions introduced, and babies born were of normal birth weight ranging from 2.5 to 3.89 kg. • The low birth eight babies (<2.5 kg) were reduced to 20% as opposed to the control group. In LBS – our 2nd series (2007 – 2009) • In LBS we screened 874 pregnant women • Interventions I & II were introduced • Hemoglobin and urinary fluoride tested in pregnant women from the 1st to the last visit prior to delivery • In our series, the sample group women attended Antenatal Clinics from a minimum of 3 to a maximum of 7 visits and were able to avail of the benefit of counselling and consultations. • Urinary fluoride reduced from 4.76 mg/L to 0.30 mg/L prior to delivery. • Hemoglobin enhanced from 7.2 g/dl to 14.1 g/dl prior to delivery • In 92.5% of the pregnant women, anemia was corrected through interventions and babies born with normal birth weight ranging from 2.5 kg to 3.7 kg. • The low birth weight babies < 2.5 kg were reduced to 7.5 % as opposed to the Control group [where the normal birth weight babies were 68.6 % and low birth weight babies were 31.4 % with one pre-term still birth] • In both the series the funds were utilized for cost of (1) testing fluoride in drinking water, (2) testing of fluoride in urine and (3) testing of hemolgobin and for counselling and (4) personnel employed to conduct the programme. • The Foundation wish to record our deep appreciation for the generous donations made by the donors and the funds have made meaningful life for so many families and their little kids. The withdrawal of fluoride enabled the families to have babies without major deformities viz. mental retardation, dwarfs, bow-leg, knock-knee and deaf mutism. • If we have the email id of the donors, we would much like to thank them individually.
By Prof. A.K. Susheela | Project leader
By Prof. A.K. Susheela | Project Leader
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