Prevalence and Factors Associated with Anaemia among Pregnant Women Attending Antenatal Clinic in the Second and Third Trimesters at Pumwani Maternity Hospital, Kenya

Open Journal of Obstetrics and Gynecology

Jan 2016

DOI: 10.4236/OJOG.2016.61003

Citations:85

Influential Citations:8

Observational Studies (Human)

Enhanced Details

Methods

Hospital-based cross-sectional study at Pumwani Maternity Hospital, Nairobi, Kenya (June 8–August 18, 2015); 258 pregnant women in the 2nd and 3rd trimesters attending antenatal care; systematic random sampling; hemoglobin concentration measured with portable HemoCue B-Hb photometer; data analyzed with SPSS; mean age 26.4 years (SD 4.7); age groups 18-24 (40.3%), 25-30 (39.5%), 31+ (20.2%); all Nairobi County residents; mostly married (84.9%), employed (67.4%), Christian (90.3%); HIV status positive in 7.8%.

Intervention

Iron and folic acid supplementation during pregnancy; dosage not reported; started at varying gestational ages, with most beginning at 19-24 weeks.

Results

Anaemia (Hb <11 g/dL) prevalence was 57.0% (95% CI 51.0-63.0); mean Hb 10.32 g/dL (SD 1.72); severity: mild 26.5%, moderate 70.7%, severe 2.7%. Independent predictors of anaemia: age ≥31 years (AOR 2.71; 95% CI 1.25-5.88), government/private employed (AOR 2.94; 95% CI 1.47-5.88), self-employed (AOR 1.91; 95% CI 1.03-3.53), not taking IFAS (AOR 2.04; 95% CI 1.14-3.64), MUAC <23 cm (AOR 2.52; 95% CI 1.36-4.67). Conclusion: Anaemia is a severe public health problem in pregnancy; advanced age, employment, not taking IFAS, and MUAC <23 cm are independently associated with anaemia. Emphasize uptake of iron and folic acid supplementation and nutritional support, especially for older and employed pregnant women.

Limitations

Cross-sectional design cannot establish causality; anaemia types not classified by red blood cell morphology; single-hospital study in Nairobi County limits generalizability.

Abstract

Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population. Globally, 41.8% pregnant women and close to one third of non-pregnant women (30.2%) are anaemic. Anaemia during pregnancy contributes to 20% of all maternal deaths and it increases the risks of foetal, neonatal and overall infant mortality. In Kenya, according to the Ministry of Health, the prevalence of anaemia among pregnant women is 55.1%. Objective: To determine the prevalence and associated factors of anaemia among pregnant women attending antenatal clinic (ANC) at Pumwani Maternity Hospital (PMH). Methodology: A hospital based cross-sectional study design was conducted from 8th June to 18th August, 2015. Systematic random sampling method was used to select 258 pregnant women. Mothers who attended ANC during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer. Data were cleaned, coded and fed into SPSS Version 20.0 for analysis. Descriptive statistics such as frequency, percentage, mean and standard deviation were used to describe selected variables. Pearson’s chi-square test and odds ratio (OR) with corresponding 95% confidence intervals (CI) computed to find association between independent and dependent variables. Multivariate analysis was done to determine factors significantly and independently predicting anaemia during pregnancy. Results: The present study revealed that the prevalence of anaemia among the pregnant women was 57%. Advanced maternal age (>31 years) (AOR = 2.71; 95% CI = 1.25 - 5.88; P = 0.012) more than 18 - 24 years, government/private employed women (AOR = 2.94; 95% CI = 1.47 - 5.88; P = 0.002) and self-employed women (AOR = 1.91; 95% CI = 1.03 - 3.53; P = 0.039) compared to housewives, not taking iron/folic acid supplementation (IFAS) (AOR = 2.04; 95% CI = 1.14 - 3.64; P = 0.016) and mid-upper arm circumference (MUAC) less than 23 cm (AOR = 2.52; 95% CI = 1.36 - 4.67; P = 0.003) were found to be predictors of anaemia. Conclusion: Anaemia among pregnant women is found to be severe public health problem based on the World Health Organization classification of anaemia. Advanced age, employment, not taking IFAS during the current pregnancy and MUAC of less than 23 cm were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are employed and advanced in age. Moreover, they should be educated on the importance of taking iron and folic acid during pregnancy. show less