Anaemia in Booked and Unbooked Pregnant Women at Term in a Lower Middle Income Country: A Hospital Based Study
DOI:
https://doi.org/10.21649/akemu.v31i4.5974Keywords:
Anaemia, pregnancy, low income population, third world country, third pregnancy trimester, parity, multigravidity, Family Planning ServicesAbstract
Background: Anaemia is a severe public health problem affecting both developed and developing countries. It is most commonly associated with poverty, poor nutritional status and lack of family planning and antenatal care services especially in the third world countries.
Objectives: To investigate the burden of anaemia in pregnant women at term presenting to Central Park Teaching Hospital and to evaluate the association of severity of anaemia with booking status and parity.
Methods: This is a cross sectional study in which purposive convenience sampling technique was used for data collection of the anaemic women at term (gestation age ≥ 37 weeks). Hemoglobin level, degree of anaemia, booking status and parity status of the study population were obtained from patient records. SPSS version 27 was used. Pearson’s Chi-square test was used to check the association between variables. The p-value of ≤ 0.05 being considered statistically significant.
Results: The frequency of anaemia at term was found to be 49.6% in our study. Anaemia was more common among multigravida (59.4%) and in booked patients (65.3%) with statistically significant differences. More patients with severe anaemia (71.4%) concluded their pregnancy on C-section as compared to patients with mild (54.8%) or moderate (71.0%) anaemia however, this difference was statistically insignificant.
Conclusion: Anemia remains a significant health problem among pregnant women at term in this lower middle–income setting. Higher frequency was observed among multigravida women and those who were booked, indicating that routine antenatal care alone may not be sufficient to prevent anemia.
References
1. Tan J, He G, Qi Y, Yang H, Xiong Y, Liu C, et al. Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey. BMC pregnancy and childbirth. 2020; 20(1):1-2. doi: 10.1186/s12884-020-03359
2. Ikeanyi E, Ibrahim A. Does antenatal care attendance prevent anemia in pregnancy at term? Niger J of Clin Pract. 2015;18(3):323. doi: 10.4103/1119-3077.151730
3. Shah RK, Deep JP, Rahman Z, Shah P, Nayak N, Gupta RS. Prevalence of Anaemia Among Pregnant Women in Third Trimester and Its Effect on Pregnancy Outcome at Tertiary Level Teaching Hospital, Birgunj. Medphoenix. 2020; 5(1):54-63. doi:10.3126/medphoenix.v5i1.31417
4. Sapre SA, Raithatha NS, Bhattacharjee RS.Severe anemia in late pregnancy: a retrospective study at a tertiary care rural medical college in Gujarat. India. Int J Reprod Contracept Obstet Gynecol. 2018; 7(3):1112-5. doi: 10.18203/2320-1770.ijrcog20180903
5. WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.1) [Available from:http://www.who.int/vmnis/indicators/haemoglobin. pdf, accessed on February 24, 2025].
6. Shi H, Chen L, Wang Y, Sun M, Guo Y, Ma S, et al. Severity of anemia during pregnancy and adverse maternal and fetal outcomes. JAMA network open. 2022; 5(2): 2147046. doi: 10.1001/jamanetworkopen.2021.47046.
7. Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron deficiency anemia in pregnancy: Novel approaches for an old problem. Oman Med J. 2020; 35(5):166. doi: 10.5001/omj.2020.108.
8. Savaliya K, Sharma N, Surani R, Dhakar V, Gupta A. Multigravida Women With Moderate to Severe Anaemia in Third Trimester: Fetomaternal Outcomes. Cureus. 2021; 13(12):20493. doi: 10.7759/cureus.20493.
9. Mahar B, Shah T, Shaikh K, Shaikh SN, Uqaili AA, Memon KN, et al. Uncovering the hidden health burden: a systematic review and meta-analysis of iron deficiency anemia among adolescents, and pregnant women in Pakistan. J Health Popul Nutr. 2024; 43(1):149. doi: 10.1186/s41043-024-00643-y.
10. Konje ET, Ngaila BV, Kihunrwa A, Mugassa S, Basinda N, Dewey D. High Prevalence of Anemia and Poor Compliance with Preventive Strategies among Pregnant Women in Mwanza City, Northwest Tanzania: A Hospital-Based Cross-Sectional Study. Nutrients. 2022; 14(18):3850. doi: https://doi.org/10.3390/nu14183850
11. Setia S, Maheshwari B. To study maternal complications in booked and unbooked cases. Int J of Clin Obstet and Gynaecol. 2020; 4(4):89-93. DOI: 10.33545/gynae.2020.v4.i4b.629
12. Saadia A, Bhalli SN, Alavi N, Qayyum HT, Alvi SJUD. Anemia in pre-school children-Does time change anything? Biomedica. 2018; 34(3): 163-7.
13. Shah T, Warsi J, Laghari Z. Anemia and its association with parity. Professional Med J. 2020; 27(5):968-72. doi: 10.29309/TPMJ/2020.27.05.3959
14. Ullah A, Sohaib M, Saeed F, Iqbal S. Prevalence of anemia and associated risk factors among pregnant women in Lahore, Pakistan. Women Health. 2019; 59(6):660-71. doi: 10.1080/03630242.2018.1544966.
15. Costa EA, Ayres Silva JDP. Global profile of anemia during pregnancy versus country income overview: 19 years estimative (2000–2019). Ann Hematol. 2023; 102(8):2025-31. doi: doi:10.1007/s00277-023-05279-2
16. Sudha R, Madenor S. Retrospective study on prevalence of severe anemia in pregnant women and its outcome. Int J Reprod Contracept Obstet Gynecol. 2023; 12(4):955-8. doi: 10.18203/2320-1770.ijrcog20230793s
17. Kumari S, Garg N, Kumar A, Guru PKI, Ansari S, Anwar S, et al. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: A cross sectional study from Jharkhand, India. One Health. 2019; 8(1):100098. doi: 10.1016/j.onehlt.2019.100098.
18. Sabina Azhar B, Islam MS, Karim MR. Prevalence of anemia and associated risk factors among pregnant women attending antenatal care in Bangladesh: a cross-sectional study. Prim Health Care Res Dev. 2021; 22(1):61. doi: 10.1017/S146342362100061X. 10.
19. Habib A, Kureishy S, Soofi S, Hussain I, Rizvi A, Ahmed I et al. Prevalence and Risk Factors for Iron Deficiency Anemia among Children under Five and Women of Reproductive Age in Pakistan: Findings from the Pakistan National Nutrition Survey 2018. Nutrients. 2023;15(15):3361. doi: 10.3390/nu15153361.
20. Khan FH, Khalid AA, Alkwai HM, Alshammari RF, Alenazi F, Alshammari KF, et al. The Effect of High Parity on the Occurrence of Anaemia in Pregnant Women . J Coll Physicians Surg Pak. 2023; 33(12):1400-4. doi:10.29271/jcpsp.2023.12.1400
21. Khan N, Khattak S IV. Frequency of Maternal Anemia in Patients Presenting With Preterm Premature Rupture of Membranes. Cureus. 2024;16(1):52973. doi: 10.7759/cureus.52973.
22. Amel Ivan E, A M. Evaluation of anaemia in booked antenatal mothers during the last trimester. J Clin Diagn Res. 2013; 7(11):2487-90. doi: 10.7860/JCDR/2013/6370.3586.
23. Shell-Duncan B, McDade T. Cultural and Environmental Barriers to Adequate Iron Intake among Northern Kenyan Schoolchildren. Food and Nutrition Bulletin. 2005; 26(1):39-48. doi:10.1177/156482650502600105
24. Adam I, Salih Y, Hamdan HZ. Association of Maternal Anemia and Cesarean Delivery: A Systematic Review and Meta-Analysis. J Clin Med. 2023; 12(2):490. doi: 10.3390/jcm12020490.
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