Anemia and Associated Factors Among Pregnant Women Attending Antenatal Care Clinic in Wolayita Sodo Town, Southern Ethiopia

Determinant factors of anaemia among pregnant women attending antenatal care clinic in Northwest Ethiopia

Background

Anaemia is a low blood haemoglobin concentration and has been shown to be a public health problem affecting both developing and developed countries. Pregnant women are the most vulnerable groups to anaemia due to several factors, including parasitic infection and feeding habits during their pregnancy. The aim of this study was to assess the prevalence and determinant factors of anemia in pregnant women in Northwest Ethiopia.

Methods

A cross-sectional study was conducted among pregnant women from February, 2017 to June, 2017. The data on determinant factors were collected using a structured questionnaire. The hemoglobin level and intestinal parasites were determined using Hemocue HB 201 and formol ether concentration techniques, respectively. Data was entered and analyzed using SPSS version 23 statistical software. Bivariate and multivariate regressions were computed and odds ratio was determined at 95% confidence interval.

Results

The study consists of 743 participants with a median age of 25 years were included. The prevalence of anemia among pregnant women was 79 (10.6%). The prevalence of mild, moderate and severe anaemia were 78 (99.8%), 1 (0.1%) and 1 (0.1%), respectively. Pregnant women of rural dwellers (AOR = 3.72, CI =1.51-9.18), farmer in occupation (AOR = 3.51, CI = 1.75-7.01), and not educated (AOR = 2.25, CI = 1.13-4.48) were significantly associated with increased risk of anemia.

Conclusion

Anaemia is still a problem amongst pregnant women in the study area though much has been done to increase the hemoglobin level during pregnancy. Health education should be given on factors that aggravate anaemia during pregnancy.

Prevalence of anemia and associated factors among pregnant women in Adigrat General Hospital, Tigrai, northern Ethiopia, 2018

Objectives

Anemia remains a major public health problem in Ethiopia, which causes maternal and fetal severe consequences. In Tigrai, there are limited literatures on prevalence of anemia and associated factors among pregnant women. Thus, a hospital based cross-sectional study was conducted to determine the prevalence and associated factors of anemia in Adigrat General Hospital. Data was analyzed and computed using SPSS version 22. p value = 0.05 at 95% confidence interval was considered statistically significant.

Results

Overall prevalence of Anemia among the pregnant women attending Adigrat General Hospital was 7.9%. About 62.5% and 37.5% of the anemic women were with mild (Hgb: 10.0–10.9 g/d1) and moderate (Hgb: 7–9.9 g/dl) type respectively. Factors like, residing in rural areas increases risk of anemia by 6 times (AOR = 6, 95% CI 1.34, 27.6, p = 0.019), participants having current blood loss (AOR = 3.4, 95% CI 1.16, 10.2, p = 0.026), having history of recent abortion (AOR = 7.9, 95% CI 2.23, 28.1, p = 0.001) and gestational age in the third trimester (AOR = 4.9, 95% CI 1.39, 17.6, p = 0.013) were statistically associated with anemia. Generally, prevalence of anemia is found to be low in the study area. However, it should be given due attention. Therefore, strong endeavor is needed to control anemia among pregnant women by assessing different micronutrient deficiencies for further prevention.

Prevalence of intestinal parasitic infection and its association with anemia among pregnant women in Wondo Genet district, Southern Ethiopia: a cross-sectional study

BACKGROUND

Previous studies reported contradicting findings about the association between intestinal parasitosis and maternal anemia. In this study we aimed to determine the prevalence of intestinal parasitic infection and its association with anemia among pregnant women in Wondo Genet district, Southern Ethiopia.

METHODS

This facility-based cross-sectional study was conducted in June and July 2018. Pregnant women (n = 352) were randomly drawn from five health centers using antenatal care follow-up lists. Trained data collectors administered the questionnaire. Capillary blood was collected and analyzed for hemoglobin using the HemoCue method. Stool sample was collected following standard procedure and analyzed for the presence and types of intestinal parasites using direct microscopy with Formalin-ether concentration technique. Association between intestinal parasitosis and anemia was measured using multivariable binary logistic regression analysis. The outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI).

RESULTS

The overall prevalence of intestinal parasitic infection was 38.7% (95% CI: 33.6-43.8%). One-tenth (9.7%) of the pregnant women were infected with polyparasites. Ascaris lumbricoides was the predominant infection encountered in 24.9% of the women. The other infections identified were: hookworms (11.2%), Giardia lamblia (5.4%), Entamoeba histolytica (3.4%), Trichuris trichiura (2.9%) and Schistosoma mansoni (2.3%). The mean (± standard deviation) hemoglobin concentration was 12.3 (±1.9) g/dl and 31.5% (95% CI: 26.6-36.4%) women were anemic (hemoglobin < 11 g/dl). The prevalence of anemia among women infected with intestinal parasite (55.6%) was substantially higher than the prevalence in their counterparts (16.4%) (p <  0.001). In a multivariable model adjusted for multiple potential confounders including socio-economic status indicators, the odds of anemia were six times increased (AOR = 6.14, 95% CI: 2.04-18.45) among those affected by at least one intestinal parasite.

CONCLUSION

Strengthening the existing water, sanitation and hygiene programs and routine deworming of pregnant mothers may help to reduce the burden of both intestinal parasitic infection and anemia in pregnant women.

Dietary Diversity and Its Association with Anemia among Pregnant Women Attending Public Health Facilities in South Ethiopia

Background

Anemia is a major public health problem among pregnant women in developing countries like Ethiopia. Nutritional deficiency related to anemia is an important contributor to maternal mortality and poor fetal outcomes.

Methods

Institution based cross-sectional study was conducted among pregnant women to assess the prevalence of anemia and its association with dietary diversity in Hossana Town from March 15 to April 30, 2017. Systematic random sampling procedure was employed to select 314 study subjects. Data were collected using an interviewer administered semi-structured questionnaire supplemented with laboratory tests. Multivariable logistic regression was used to determine the independent predictors of anemia.

Results

The prevalence of mild to moderate anemia among pregnant women was 56.6% and 40.8% respectively. The mean dietary diversity and food variety score of study participants were 7 and 22 respectively. Maternal education (AOR=10.5; 95% CI:2.2, 27), occupation of spouse (AOR=9.3; 95% CI:1.6, 53), nutrition education (AOR=2.5; 95% CI:1.5, 6.4) and dietary diversity (AOR=18.6; 95% CI: 4.4, 28) were significantly associated with anemia.

Conclusion

Anemia was found to be a moderate public health problem in Hossana Town. Therefore, there is a need of nutrition education and promotion awareness on healthy diets to prevent anemia among pregnant women.

Adherence to iron with folic acid supplementation and its associated factors among pregnant women attending antenatal care follow up at Debre Tabor General Hospital, Ethiopia, 2017

Introduction

Nutritional anemia is a major public health problem throughout the world, particularly in developing countries. Iron with folic acid supplementation (IFAS) is recommended to mitigate anemia and its resulting complications during pregnancy. There has been limited study on IFAS adherence of pregnant women in the study area. The aim of this study was to assess adherence to IFAS and its associated factors among pregnant women attending antenatal care service in Debre Tabor General Hospital, Ethiopia.

Methods

An institution-based cross-sectional study was conducted from January 9 to April 8, 2017, at Debre Tabor General Hospital. A total of 262 study participants were included and selected by systematic random sampling. The entire interviewed questionnaire was checked and entered into EpiData version 3.1 and then exported to SPSS version 20 for windows for analysis. IFAS adherence status was defined as, if pregnant mothers took 65% or more of the IFAS which is equivalent to taking IFAS at least 4 days a week during the 1-month period preceding the study. Regressions were fitted to identify independent predictors of IFAS adherence. A P-value of less than 0.05 was used to declare statistical significance.

Results

A total of 241 pregnant women were included (92% response rate), of which 107 (44%) were adherent to IFAS. Only 39% received IFAS counseling, and 52% had some knowledge of IFAS. Gravidity (AOR = 2.92 95% CI (1.61, 5.30)), gestational age at first ANC visit (AOR = 3.67, 95% CI (1.94, 6.97)), pregnant women who got advice about IFAS (AOR = 2.04, 95%CI (1.12, 3.75)), current anemia (AOR = 2.22, 95%CI (1.45, 4.29)), and had knowledge about IFAS (AOR = 3.27, 95% CI (1.80, 5.95)) were statistically associated with adherence to IFAS among pregnant women.

Conclusion

Overall, IFAS adherence among pregnant women was low. The associated factors with adherence of IFAS were counseling and knowledge, early ANC attendance, pregnancy history, and current anemia diagnosis. IFAS counseling by health workers was low but, when given, was associated with improved IFAS adherence. Health workers and health extension workers should consistently counsel on IFAS benefits during ANC visit, to improve IFAS adherence during the current and subsequent pregnancies.

Prevalence and risk factors of anemia among pregnant women attending a public-sector hospital in Bangalore, South India

Background:

Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal mortality and low birthweight. According to the National Family Health Survey-4 reports, maternal anemia continues to be a public health problem.

Objective:

To study the prevalence of anemia and its risk factors among pregnant women attending a public-sector hospital.

Materials and Methods:

This study was nested within an ongoing cohort study “ÇASCADE” which is exploring the effect of prenatal exposure to maternal cortisol and psychological distress on infant development in Bangalore. The respondents were enrolled from the antenatal clinic at Jayanagar General Hospital, which is a sub-district hospital. A total of 280 women who fulfilled the eligibility criteria were enrolled.

Results:

The prevalence of anemia was observed to be 33.9%; proportion of mild and moderate anemia was almost similar (48.4 and 49.5%). The mean hemoglobin level of all the participants was 11.33 ± 1.460 g/dl. The mean hemoglobin level concentration was high during early gestation with a slight decrease by 21–24 weeks. Prenatal depression but not anxiety appeared to be a strong predictor of anemia on bivariate as well as multivariate analysis. No association was observed with socio-demographic and obstetric variables.

Conclusion:

The burden of maternal anemia was considerably high in the study population. Although iron-folic acid supplementation is available under the national health program to address this issue, it is important to consider and address other risk factors when designing and implementing target interventions for anemia control in selected populations.

Anemia and its association with coffee consumption and hookworm infection among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia

BACKGROUND

Anemia in pregnancy is a major public health concern worldwide, especially in developing countries. Thus, there is a need of having current information and local data on the prevalence of anemia and associated factors during pregnancy to help inform preventive programmes. The aim of this study was to assess the prevalence of anemia and associated factors among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia.

METHODS

An institution based cross-sectional study was conducted at Debre Markos Referral Hospital in July and August 2016. A total of 234 randomly-selected pregnant women took part in the study. Data on sociodemographic factors, environmental and sanitation factors, reproductive factors, and nutrition related characteristics were collected using a structured questionnaire. Hemoglobin level was determined using hematological analyzer (Cell Dyn 1800) machine. The stool sample was collected to identify intestinal parasitic infections. Statistical analysis was done using logistic regression. The p value of less than 0.05 at 95% confidence interval was considered statistically significant.

RESULTS

The overall prevalence of anemia among pregnant women was 11.5% (95% CI: 8.2%- 14.9%). The result of multivariable analysis revealed that, coffee consumption [AOR = 2.91; 95% CI (1.63, 8.78)], and hookworm infection [AOR = 2.65; 95% CI (1.48, 4.72)] were factors significantly associated with anemia among pregnant women.

CONCLUSION

Anemia is of public health concern among pregnant women in the study area. All pregnant women coming to antenatal clinics should be screened and treated routinely for intestinal parasitic infection. Pregnant women should limit coffee consumption, and avoid drinking coffee with meals.

Anemia among Women Attending Antenatal Care at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia, 2017

BACKGROUND

In Ethiopia, prenatal anemia is a major public health concern affecting both the health of the woman and babies. The World Health Organization recommends to conduct repeated prevalence studies concerning prenatal anemia . However, there is no recent evidence on the magnitude of the prenatal anemia. Therefore, the aim of this study was to determine the prevalence and the associated factors of prenatal anemia among women attending the Antenatal Care Clinic at the University of Gondar Referral Hospital.

METHODS

A facility-based cross-sectional quantitative study was conducted among 362 participants from June 03-July 08, 2017, at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. The systematic random sampling technique was employed. Structured interviewer administered questionnaire was used. Human Immunodeficiency Virus (HIV) screening was conducted. Nutritional status of the participants was assessed. Blood sample was collected by capillary tube . Intestinal parasite was examined by stool wet mount test. HIV serostatus was detected. Anemia was defined as hemoglobin concentration below 11 g/dl. The multivariable logistic regression model was employed to identify associated factors and to control the possible effects of confounders.

RESULT

The prevalence of anemia was 22.2% (95% CI: 18.11, 27.1%). The highest odds of anemia were observed among pregnant women with family size of >five [AOR = 3 (95% CI: 1.03, 8.65)], unprotected water source users, [AOR = 4.09 (95% CI: 1.75, 9.55)], HIV infected [AOR = 2.94(95% CI: 1.37, 6.35)], and multigravida women [AOR = 3.5 (95% CI: 1.35, 9.17)].

CONCLUSION AND RECOMMENDATIONS

The prevalence of anemia among pregnant women attending the University of Gondar Referral Hospital was a moderate public health problem. Unprotected water source, large family size, Human Immunodeficiency Virus infection, and repeated pregnancies were factors that predicted anemia. Thus, prevention of Human Immunodeficiency Virus infection, family planning utilization, and accessing pure water are recommended.

Determinants of Anemia among Pregnant Women Attending Antenatal Clinic in Public Health Facilities at Durame Town: Unmatched Case Control Study

BACKGROUND

Anemia among pregnant women is one of the most common public health problems in developing country. World health organization (WHO) estimate shows nearly half of pregnant women were affected by anemia. High burden of anemia is observed in Africa particularly in Ethiopia. However, the factors that contribute to the occurrence of anemia were not exhaustively studied. Therefore, the aim of this study was to identify determinant factors of anemia among pregnant women in Durame Town, southern Ethiopia.

METHOD

An institutional based unmatched case control study was conducted among 111 cases and 222 controls in Durame Town from 16th February to 8th May 2017 using interviewer administered questionnaires. Controls were pregnant women whose hemoglobin level was 11 g/dl and above at their first antenatal care clinics and cases were pregnant women whose hemoglobin level was less than 11 g/dl. Bivariate and multivariate logistic regression model was used to see the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value were used to identify the significant association.

RESULT

A total of 333 women (111 cases and 222 controls) participated in the study. The major determinant factors were parasitic infection (AOR: 3.67, 95% CI: 1.72-7.86), not taking additional diet during pregnancy (AOR: 2.49, 95% CI: 1.22-5.08), consuming tea/coffee immediately after food (AOR: 3.58, 95% CI: 1.72-7.42), not eating meat (AOR: 2.07, 95% CI: 1.03-4.15), previous heavy menstrual blood flow (AOR: 2.62, 95% CI: 1.18-5.84), and being housewife (AOR: 2.38, 95% CI: 1.02-5.57).

CONCLUSION

Parasitic infection, additional diet during pregnancy, consuming tea/coffee immediately after food, meat consumption, previous heavy menstrual blood flow, and occupational status of women were significant factors associated with anemia among pregnant women. Therefore, anemia prevention strategy should include promotion of counseling on additional diet during pregnancy, preventing parasitic infection, and increasing employment opportunities for women.

Undernutrition and its association with socio-demographic, anemia and intestinal parasitic infection among pregnant women attending antenatal care at the University of Gondar Hospital, Northwest Ethiopia

Background

Under nutrition is a worldwide public health problem affecting the well-being of millions of pregnant women in the developing world. Only limited research has been conducted on the prevalence and determinants of maternal nutritional status in Ethiopia. Particularly, data on the nutritional status of pregnant women are lacking. The aim of this study was to assess the prevalence and determinants of undernutrition among pregnant women attending antenatal care at the University of Gondar Hospital, Northwest Ethiopia.

Methods

An institution based cross-sectional study was conducted in January and February 2016. Randomly selected 409 pregnant women were included in the study. Nutritional status was estimated using mid-upper-arm circumference. Data on potential determinants of undernutrition were gathered using a structured questionnaire. The blood sample was collected to analyze hemoglobin. The stool sample was collected to identify intestinal parasitic infections. Statistical analysis was done using logistic regression. P-value < 0.05 at 95% confidence interval was considered as statistically significant.

Results

The prevalence of undernutrition among pregnant women was 16.2% (95% CI: 12.4-20.1%). Using a logistic regression model, factors significantly associated with the undernutrition were living in rural areas (AOR = 2.26), low educational status [no formal education (AOR = 2.91), primary education (AOR = 2.69)], history of too many births (AOR = 2.55), anemia (AOR = 2.01), and intestinal parasitic infection (AOR = 2.73).

Conclusion

The study findings provide evidence for the public health significance of under nutrition among pregnant women in the study area. The problem must be combated through rural livelihood promotion, socioeconomic empowerment of women, sustained nutrition education and expansion of family-planning services in the area.

Prevalence and risk factors for intestinal parasitic infections in pregnant women residing in three districts of Bogotá, Colombia

BACKGROUND

Intestinal parasitic infections (IPI) lead to significant morbidity and mortality in pediatric and adult populations worldwide. Intestinal parasitism during pregnancy is of interest as it may affect the health of pregnant women and their offspring. This study determined the prevalence of IPI in pregnant women living in substandard conditions in three urban districts of Bogotá, Colombia. Associations between prevalence and sociodemographic factors, housing, and living conditions were also evaluated.

METHODS

In a cross-sectional and community-based study, pregnant women were recruited from three districts of Bogotá. A total of 550 participants answered a questionnaire; 331 of these also provided stool samples, with 233 providing one and 98 providing two stool samples. Questionnaire responses were associated with the presence of intestinal parasites, which was determined using a standard combined microscopy technique including direct wet mount and formol-ether concentration. Results were verified by supplementary examination of 48 stool samples by quantitative polymerase chain reaction (qPCR).

RESULTS

Among pregnant women who lived in selected poor residential areas in Bogotá, the overall prevalence of intestinal parasitism was 41% with 9% polyparasitism. Pathogenic parasites were present in 1.2% of the 331 participants including Giardia lamblia and Ascaris lumbricoides. Higher prevalence was found for parasites with debated pathogenicity, including Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), and Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex was also detected (1.5%). When comparing a subset of stool samples using the combined microscopy technique and qPCR, the latter detected a higher 58.3% overall IPI prevalence. Higher prevalence of infections by any intestinal parasite was found in participants who had never been dewormed (p = 0.01). Higher but not statistically significant associations were found between any parasite and women living with a partner, and intestinal polyparasitism and being from a minority group and not having a water sink.

CONCLUSIONS

This first study of the prevalence of intestinal parasitism in Bogotá focused on pregnant women living in poverty, found a high prevalence of intestinal parasites of debated pathogenicity, and confirmed a low prevalence of pathogenic intestinal parasites. These results highlight the need for educational interventions to disrupt transmission routes for prevalent parasites.

Prevalence and Factors Associated with Anemia among Pregnant Women Attending Antenatal Clinic at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Background

In pregnancy, anemia is an important factor associated with an increased risk of maternal, fetal, and neonatal mortality, poor pregnancy outcomes, and impaired cognitive development, particularly in developing countries like Ethiopia. This study aimed to assess prevalence and factors associated with anemia among pregnant women attending antenatal clinic at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Method

A cross-sectional health facility based study was conducted on 284 pregnant women to assess prevalence and factors associated with anemia at St. Paul's Hospital Millennium Medical College from June to August 2014. Data on sociodemographic and clinical characteristics of the study participants were collected using a pretested structured questionnaire by interview and review of medical records. About 4 ml of venous blood was collected from each subject for peripheral blood film and complete blood counts (CBC). Binary Logistic regression analysis had been used to check for association between dependent and independent variables. In all cases, P value less than 0.05 was considered statistically significant.

Result

The prevalence of anemia was found to be 11.6% (95 % CI; 7.8%-14.8%). Pregnant women in the second [AOR (95% CI), 6.72 (1.17-38.45), and P=0.03] and third trimester [AOR (95% CI), 8.31 (1.24-55.45), and P=0.029] were more likely to be anemic when compared to pregnant women in their first trimester. Pregnant women who did not receive iron/folic acid supplementation [AOR (95%CI), 4.03(1.49-10.92), and P=0.01] were more likely to be anemic when compared to pregnant women who did take supplementations.

Conclusion

In this study the prevalence of anemia in pregnancy was low compared to the findings of others. Gestational age (trimester) and iron/folic acid supplementation were statistically associated with anemia. Therefore, iron supplementation and health education to create awareness about the importance of early booking for antenatal care are recommended to reduce anemia.

The magnitude of anemia and associated factors among pregnant women attending public institutions of Shire Town, Shire, Tigray, Northern Ethiopia, 2018

Objective

Anemia is a widespread health problem among pregnant women causing maternal/infant morbidity and mortality mainly in low-income countries. Understanding of the magnitude of anemia and related socio-demographic variables in a specific setting would help scale-up preventive and therapeutic measures in a locality. So that this study focuses on the magnitude of anemia and its associated factor among pregnant women attending antenatal care in public hospitals of shire town and using institution based cross-sectional study design on 480 randomly selected study subjects.

Result

The overall prevalence of anemia was 16.3%. Majority of the participants (52%) have mild anemia (10–10.9 gm/dl). Pregnant mothers with human immunodeficiency virus, intestinal parasitic infection and having lower inter-pregnancy gap were significant predictors of anemia. Preventing infection of the mother during pregnancy and making the gap between pregnancies are necessary.

Prevalence of helminthic infections and determinant factors among pregnant women in Mecha district, Northwest Ethiopia: a cross sectional study

Background

Intestinal parasites are the most common infections in developing countries. Prevalence and impacts of these parasites are high in pregnant women. The aims of this study were to determine prevalence of helminthic infection and evaluate the determinant factors during pregnancy.

Methods

A cross-sectional study was conducted in Mecha district from November 2015 to January 2016. The data were collected by interview technique and collecting the stool sample from each pregnant woman. Descriptive statistics and binary logistic regression were used.

Results

A total of 783 pregnant women were included. The prevalence of intestinal parasite among pregnant women was 70.6% [95% CI 67 -74%]. Ascaris lumbricoides (32.7%) was the predominant intestinal parasite species. Intestinal parasitic infection were 2.94 folds higher in the absence of latrine (AOR: 2.94 [95% CI: 1.5–5.8]). Absence of regular hand washing habit increase the odds of infection by 3.33 folds higher (AOR: 3.33 [95% CI: 1.54–7.14]). Not wearing shoe increased the odds of helminthic infection by 6.87 folds higher (AOR: 6.87 [95% CI: 3.67–12.9]). Illiteracy increases the odds of intestinal parasitic infection by 2.32 folds higher (AOR: 2.32 [95% CI: 1.04–5.26]). Ingestion of raw vegetables increases the odds of intestinal parasitic infection by 2.65 folds higher (AOR: 2.65 [95% CI: 3.23–9.9]). The odds of intestinal parasitic infection were higher in rural areas (AOR: 2 [95% CI: 5–10]). Intestinal parasitic infection was higher in women aged less than 21 years (AOR: 6.48 [95% CI: 2.91–14.4]).

Conclusion

The prevalence of helminthic infection is high in this study. Latrine utilization, hand washing habit, eating raw vegetables and bare foot were the major determinant factors for the high prevalence. Therefore, health education and improvements in sanitary infrastructure could achieve long-term and sustainable reductions in helminth prevalence.

Does body mass index early in pregnancy influence the risk of maternal anaemia? An observational study in Indonesian and Ghanaian women

Background

Anaemia is common among pregnant women, especially in low- and middle-income countries (LMICs). While body mass index (BMI) relates to many risk factors for anaemia in pregnancy, little is known about the direct relation with anaemia itself. This is particularly relevant in Southeast Asia and Sub-Saharan Africa where the prevalence of anaemia in pregnancy and the associated adverse outcomes is among the highest worldwide. This study aimed to assess the association between early pregnancy BMI and anaemia at first antenatal care visit in Indonesian and Ghanaian women. In addition, the associations between early pregnancy anaemia and adverse birth outcomes was assessed.

Methods

Prospective cohort studies of women in early pregnancy were conducted in Jakarta, Indonesia (n = 433) and in Accra, Ghana (n = 946), between 2012 and 2014. Linear regression analysis was used to assess relations between early pregnancy BMI and pregnancy haemoglobin levels at booking. Logistic regression analyses were used to assess associations between early pregnancy anaemia as defined by the World Health Organization (WHO) criteria and a composite of adverse birth outcomes including stillbirth, low birth weight and preterm birth.

Results

Indonesian women had lower BMI than Ghanaian women (23.0 vs 25.4 kg/m², p < 0.001) and higher mean haemoglobin levels (12.4 vs 11.1 g/dL, p < 0.001), corresponding to anaemia prevalence of 10 and 44%, respectively. Higher early pregnancy BMI was associated with higher haemoglobin levels in Indonesian (0.054 g/dL/kg/m², 95% CI 0.03 to 0.08, p < 0.001) and Ghanaian women (0.044 g/dL/kg/m², 0.02 to 0.07, p < 0.001). Accordingly, risk for anaemia decreased with higher early pregnancy BMI for Indonesians (adjusted OR 0.88, 0.81 to 0.97, p = 0.01) and Ghanaians (adjusted OR 0.95, 0.92 to 0.98, p < 0.001). No association between anaemia and the composite of adverse birth outcomes was observed.

Conclusion

Higher BMI in early pregnancy is associated with higher haemoglobin levels at antenatal booking and with a reduced risk of anaemia in Indonesian and Ghanaian women.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5704-2) contains supplementary material, which is available to authorized users.

Anaemia in Pregnancy: Prevalence, Risk Factors, and Adverse Perinatal Outcomes in Northern Tanzania

Background and Objective

Anaemia in pregnancy is a public health problem in developing countries. This study aimed to determine the prevalence, risk factors, and adverse perinatal outcomes of anaemia among pregnant women in Moshi Municipal, Northern Tanzania.

Methods

This was a follow-up study conducted from October 2013 to June 2015. A total of 539 pregnant women were enrolled in this study. Interviews were conducted followed by determination of haemoglobin level. Women were followed up at delivery and at 7 days and 28 days after delivery.

Results

A total of 529 women were included in this analysis. Their mean age was 25.8 (SD 5.73). The prevalence of anaemia was 18.0% and 2% had severe anaemia. The clinic of recruitment and low education level of the women were the factors that were independently associated with anaemia during pregnancy. At delivery, there were 10 stillbirths, 16 low birth weight (LBW) newborns, and 2 preterm birth cases. No association was found between anaemia and LBW, preterm birth, or stillbirths.

Conclusion

Anaemia in pregnancy was a mild public health problem in the study setting of Northern Tanzania.

Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

Background

Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia.

Methods

Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration <11 g/dl was classified as anaemic. Stool examinations were also done. Structured questionnaire was used as a tool to collect sociodemographic characteristics, individual dietary diversity and level of household food security data. Multivariate logistic regression model was employed to determine the effect of explanatory variables like level of education, level of household food security, dietary diversity, trimester of pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia.

Results

The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11–3.69), trimester second (AOR = 3.09, 95%CI: 1.41–6.79) and third (AOR = 3.68, 95% CI: 1.67–8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03–3.07) and six and above (AOR = 2.59, 95%CI: 1.37–4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02–2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37–7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34–5.39).

Conclusion

Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors.

Profile of red blood cell morphologies and causes of anaemia among pregnant women at first clinic visit in the mount Cameroon area: a prospective cross sectional study

OBJECTIVE

Anaemia is a serious problem in pregnancy in malaria-endemic countries. This study investigated red cell morphologies and possible causes of anaemia among pregnant women at first clinic visit. Venous blood samples from consented women were used to determine haemoglobin (Hb) levels, mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) using an automated haematology analyzer. Malaria parasitaemia was diagnosed by microscopy. Definitions were as follows: anaemia (Hb < 11.0 g/dl), microcytosis (MCV < 78 fl), macrocytosis (MCV > 101 fl), hypochromasia (MCH < 27 pg), microcytic hypochromia or normocytic hypochromia with anaemia [iron deficiency anaemia (IDA)], normocytic normochromia with anaemia in the absence of malaria parasitaemia (physiological anaemia of pregnancy).

RESULTS

Of the 279 pregnant women enrolled, 57% had anaemia. Malaria parasitaemia was associated with 23.3% of anaemic cases while 76.7% were non-malaria related. The distribution of red cell alterations was as follows: hypochromasia (32.6%), microcytosis (14.7%) and macrocytosis (1.1%). The co-occurrence of malaria parasitaemia, iron deficiency and anaemia was seen in 23.3% of the women, iron deficiency anaemia only occurred in 35.9% while physiological anaemia of pregnancy was 40.9%. Iron deficiency and physiological anaemia of pregnancy contribute to a greater proportion of anaemia in the study area.

Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia

INTRODUCTION

Anemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia.

METHODS

This unmatched case-control study involved 264 (88 = cases and 176 = controls) pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval.

RESULTS

A total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26-8.48), number of pregnancies (AOR = 2.46, 95% CI: 1.14-5.29), iron folate supplementation (AOR = 3.29, 95% CI: 1.27-8.49), dietary diversification score (AOR = 3.23, 95% CI: 1.19-8.71) and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10-5.10). The variable 'blood loss during pregnancy' (AOR = 6.63 95% CI: 2.96-14.86) was identified as a strong predictor of the outcome variable, severe anemia.

CONCLUSION

This study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of pregnant women for state of anemia during their visits to health facilities, as well as de-worming for intestinal parasites infection are needed.

Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis

Background

Anemia during pregnancy is one of the most common indirect obstetric cause of maternal mortality in developing countries. It is responsible for poor maternal and fetal outcomes. A limited number of studies were conducted on anemia during pregnancy in Ethiopia, and they present inconsistent findings. Therefore, this review was undertaken to summarize the findings conducted in several parts of the country and present the national level of anemia among pregnant women in Ethiopia.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, and African Journals Online. Search terms used were; anemia, pregnancy related anemia and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled Meta logistic regression was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence interval (CI).

Results

Twenty studies were included in the meta-analysis with a total of 10, 281 pregnant women. The pooled prevalence of anemia among pregnant women in Ethiopia was 31.66% (95% CI (26.20, 37.11)). Based on the pooled prevalence of the subgroup analysis result, the lowest prevalence of anemia among pregnant women was observed in Amhara region, 15.89% (95% CI (8.82, 22.96)) and the highest prevalence was in Somali region, 56.80% (95% CI (52.76, 60.84)). Primigravid (RR: 0.61 (95% CI: 0.53, 0.71)) and urban women (RR: 0.73 (95% CI: 0.60, 0.88)) were less likely to develop anemia. On the other hand, mothers with short pregnancy interval (RR: 2.14 (95% CI: 1.67, 2.74)) and malaria infection during pregnancy (RR: 1.94 (95% CI: 1.33, 2.82)) had higher risk to develop anemia.

Conclusions

Almost one-third of pregnant women in Ethiopia were anemic. Statistically significant association was observed between anemia during pregnancy and residence, gravidity, pregnancy interval, and malaria infection during pregnancy. Regions with higher anemia prevalence among pregnant women should be given due emphasis. The concerned body should intervene on the identified factors to reduce the high prevalence of anemia among pregnant women.

Electronic supplementary material

The online version of this article (10.1186/s12878-017-0090-z) contains supplementary material, which is available to authorized users.

Predictors of anemia in pregnant women residing in rural areas of the Oromiya region of Ethiopia

Background

Anemia in pregnancy is associated with higher risk of low birth weight and both maternal and perinatal mortality. While previous studies in Ethiopia have examined factors associated with anemia, which factors are the most important determinants of anemia in this population remain unclear. The objective of this study was to examine the association between anemia status in pregnant women with different health, behavioral, and socioeconomic factors in Oromiya province of Ethiopia.

Methods

This study used pregnancy enrollment data from a longitudinal birth cohort study conducted in Ethiopia. Survey data on maternal and household characteristics were collected at enrollment and maternal hemoglobin levels were measured. The analysis includes 4600 pregnant women. Logistic regression models were used to identify factors associated with maternal anemia in pregnancy.

Results

Controlling for geographic location and religion, low maternal MUAC and previous pregnancies were associated with increased odds of anemia, with odds ratios of 1.30 (p < 0.001, CI 1.12-1.51), and 1.50 (p = 0.002, CI 1.16-1.95), respectively. For each additional point on the handwashing score scale, the odds of being anemic were reduced by 12% (p < 0.001, CI 0.82-0.94). Numerate women compared to non-numerate women had 30% lower odds (p < 0.001, CI 0.57-0.85).

Conclusion

Controlling for woreda and religion, low maternal MUAC, and previous pregnancy increased odds of anemia while numeracy and better handwashing practices significantly reduced the odds of anemia in pregnancy. Further investigation is needed to determine the cause of anemia in pregnant women in Oromiya and to determine the effects of maternal anemia on birth outcomes.

Trimester Pattern of Change and Reference Ranges of Hematological Profile Among Sudanese Women with Normal Pregnancy

Trimester specific reference ranges of hematological indices were described in several populations; however, comparable reports among Sudanese women with normal pregnancy are lacking. To evaluate trimester pattern of change and reference ranges of hematological profile among Sudanese women with normal pregnancy, we followed 143 women with singleton gestation since early pregnancy until the third trimester in Saad Abu-Alela Hospital, Khartoum, Sudan, during the period of January-December 2015. Obstetrics and medical history was gathered using questionnaire and hematological profile was investigated using hemo-analyser. The first, second and third trimester mean (SD) [5^th-95^th centile] of hematological profile were as follow: RBC counts 4.30 (0.36) [3.69-4.93], 4.35 (0.36) [3.69-4.93], 4.08 (0.44) [3.44-4.78] ×10⁶/mm³; hemoglobin concentration 10.81 (1.22) [8.92-12.74], 10.62 (0.93) [9.00-12.10], 10.83 (1.13) [8.82-12.60] g/dL; hematocrit 35.38 (3.52) [30.12-40.30], 34.43 (2.51) [30.58-38.23], 35.17 (3.18) 29.66-40.04] %; WBC counts 7.69 (1.96) [4.36-11.20], 8.45 (1.97) [5.48-12.13], 8.36 (2.11) [5.00-11.96] ×10³/mm³; platelet counts 278.02 (66.93) [182.6-418.0], 251.96 (64.17) [163.8-381.8], 238.36 (57.10) [150.4-346.2] ×10³/mm³. The present study is the first to establish trimester specific, reference range for hematological profile among Sudanese women with normal pregnancy. The trimester reference range of RBC, WBC and platelets and other hematological indices are mostly parallel to international records.

Anemia in pregnancy and its associated factors among primary care clients in Sagamu, Southwest, Nigeria: A facility-based study

Introduction

In Nigeria, anemia in pregnancy is one of the leading causes of poor pregnancy outcomes. This study, therefore, determined the prevalence of anemia and its associated factors, among pregnant primary care clients in Sagamu, Nigeria.

Materials and Methods

A cross-sectional descriptive study was carried out among 400 pregnant, primary care clients in Sagamu, selected through multi-stage sampling. Data were collected with the aid of an interviewer-administered, semi-structured questionnaire, a stadiometer, measuring tape, and a hemoglobinometer. Data were analyzed using SPSS version 17.00. Relevant descriptive and inferential statistics were calculated. Participation was fully voluntary.

Results

The mean age of respondents was 25.4 ± 4.2 years. Most respondents (51.8%) were traders. About a third (32.5%) of respondents were anemic; of these, 72.1% were mildly anemic, while 27.1% were moderately anemic. Anemia was associated with household food security (P = 0.044) and level of food insecurity (P = 0.001) but not with age, occupation, educational status, household size, number of previous pregnancies, body mass index, mid-upper arm circumference, snacking, vegetable intake, and food avoidance (P > 0.05).

Conclusion

Anemia in pregnancy is still high among respondents and associated with household food insecurity. Interventions targeted at improving household food security, dietary intake, and socioeconomic conditions will significantly reduce the prevalence and severity of anemia in pregnancy.

Prevalence, Severity, and Determinant Factors of Anemia among Pregnant Women in South Sudanese Refugees, Pugnido, Western Ethiopia

Background. Anemia is one of the major health problems among refugee pregnant women in the world. Anemia among pregnant women is multifactorial and results in detrimental consequences on the mothers and infants. The aim of this study was to determine the prevalence, severity, and determinants of anemia among pregnant women in South Sudanese refugees, Pugnido western, Ethiopia. Methods. A facility-based cross-sectional study was conducted in Pugnido Administration Refugee and Returnee Affairs Health Center from April 15 to June 30, 2015. Demographic and related data were collected using questionnaire based interview. Complete blood count was done using CELL-DYN 1800 (Abbott USA). Blood smear and fecal specimen were examined for hemoparasite and intestinal parasite, respectively. Bivariate and multivariate logistic regression analyses were done using SPSS-Version 20.0. Results. The overall prevalence of anemia was 36.1%, from whom 2.3% had severe anemia. Being in third trimester, eating meat at most once a week, drinking tea immediately after meal at least once a day, having mid-upper arm circumference below 21 centimeters, and intestinal parasitic infection were identified as independent factors of anemia. Conclusion. More than one-third of pregnant women had anemia in this study. Intervention based strategies on identified determinant factors will be very important to combat anemia among the group.