Epidemiological Profile of Pregnant Women with Anemia Admitted at the Maternity Unit of the Health District Hospital of Keita, Tahoua from 2018 to 2020
Issue: 2023 - Volume 23 [Issue 8]
Maman Manzo Lawaly *
University Boubakar Bâ of Tillabéri (UBB-Ti), Tillabéri, Niger Republic.
Institute of Public Health, Niamey, Niger Republic.
Karimou Harouna Boureima
University Boubakar Bâ of Tillabéri (UBB-Ti), Tillabéri, Niger Republic.
Zoubeirou Alzouma Mayaki
University Boubakar Bâ of Tillabéri (UBB-Ti), Tillabéri, Niger Republic.
*Author to whom correspondence should be addressed.
Aims: The objective of this study is to provide data on the epidemiological profile of pregnant women aged 15-45 years with anemia in Keita department, Tahoua regional state of Niger republic.
Methodology: A retrospective cross-sectional study was conducted from January 1st, 2018 to December 31st, 2020, on pregnant women who attended antenatal care at the maternity unit of the health district of Keita. Structured questionnaire was used to retrieve data regarding pregnancy from the medical record files which are archived at the maternity unit and entered into Epi Info version 220.127.116.11 for further analysis.
Results: Of the 1571 registered pregnant women, 310 suffered from anemia, with the prevalence of 19.7%. The prevalence of the severity of anemia was 17.7% mild, 49.0% moderate, and 33.2% severe anemia. The mean age of the pregnant women with anemia was 25.3±6.97 years and most were at third trimester (53.5%). Out of 310 patients, 244(78.7%) were either illiterate or had primary education level. Most of them 262(84.5%) are housewives and only 2(0.7%) visited hospital for antenatal care more than four times. About 249(80.3%) were multigravida. 52(16.8%) deliveries were by cesarean section with a higher recourse to blood transfusion. Major maternal complications were postpartum hemorrhage (28.4%), abortion (31.9%), malaria (15.2%) and maternal deaths (5%). Neonatal outcome was analyzed in terms of stillbirth (9%) and neonatal deaths (7%).
Conclusion: Anemia in pregnancy is a real public health problem in Niger republic and was mild in severity in the study setting of Keita, especially during the third trimester. Pregnant women who were younger, housewives, illiterates, multiparous and multigravida constitute the most vulnerable segments of the population at risk of anemia. Therefore, further strengthening of the existing health care system through awareness and education on early and regular antenatal care visits for a positive pregnancy experience should be reinforced.
Keywords: Anemia, pregnancy, epidemiology, antenatal care.
How to Cite
Ba DM, Ssentongo P, Kjerulff KH, Na M, Liu G, Gao X, Du P. Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study. Curr Dev Nutr. 2019;3(12):nzz120. DOI: 10.1093/cdn/nzz120
Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: A systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16–25.
Kassebaum NJ, Lopez AD, Murray CJL, Lozano R. A comparison of maternal mortality estimates from GBD 2013 and WHO. The Lancet. 2014;384:2209–2210. DOI:https://doi.org/10.1016/S0140-6736(14)62421-1
Ali N, Nur Kalmi Z, Sanusi NS, Ahad A, Mohd Khairuddin NA, Rosman SR, et al. Retrospective review of the prevalence and risk factors of anaemia among antenatal mothers attending health clinics in Alor Gajah, Melaka. Malays Fam Physician. 2022;17(3):137-143. DOI: 10.51866/oa.135
Herzog SA, Leikauf G, Jakse H, Siebenhofer A, Haeusler M, Berghold A. Prevalence of anemia in pregnant women in Styria, Austria-A retrospective analysis of mother-child examinations 2006–2014. PLoS ONE. 2019;14(7):e0219703. DOI:https://doi.org/10.1371/journal.pone.0219703
Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016;387(10021):907–16.
World Health Organization. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia;2008.
GBD 2021 Anaemia Collaborators. Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(9):e713-e734. DOI: 10.1016/S2352-3026(23)00160-6. Epub 2023 Jul 31.
Kinyoki D, Osgood-Zimmerman AE, Bhattacharjee NV; Local burden of disease anaemia collaborators; Kassebaum NJ, Hay SI. Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018. Nat Med. 2021;27(10):1761-1782. DOI:10.1038/s41591-021-01498-0. Epub 2021 Oct 12.
PMID: 34642490; PMCID: PMC8516651.
World Health Organization. Fact sheets Anemia; 2023. Available:https://www.who.int/news-room/fact-sheets/detail/anaemia
World Health Organization. The global prevalence of anaemia in 2011. World Health Organization;2015.
National Institute of Statistics. National nutrition survey using SMART methodology, Niger ;2020. Available: http://www.stat-niger.org e-mail : firstname.lastname@example.org
World Health Organization. Guideline: Daily iron and folic acid supplementation in pregnant women. Geneva, World Health Organization;2012.
United Nations System Standing Committee on Nutrition. Progress in nutrition: Sixth report on the world nutrition situation. Geneva, United Nations System Standing Committee on Nutrition Secretariat;2010.
International Anemia Consultative Group. Report of the 2001 International Anemia Consultative Group Symposium. Why is iron important and what to do about it: a new perspective. Washington, DC, INACG Secretariat. 2002:1–50.
Peña-Rosas JP, Viteri FE. Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2009;(4):CD004736.
Ministry of Public Health: Integrated Strategic Plan for Reproductive Health, Maternelle, Néonatale, Infantile, Adolescent et Jeune/ Nutrition (SRMNIAJ/Nut) ;2018-2021.
Ministry of Public Health, Population and Social Affairs. Niger’s investment case for reproductive, maternal, neonatal, child and adolescent health and nutrition (SRMNIA-Nut) ;2022-2026.
Kalaivani K. Prevalence & consequences of anaemia in pregnancy. Indian J Med Res. 2009;130(5):627-33.
Stephen G, Mgongo M, Hussein Hashim T, Katanga J, Stray-Pedersen B, Msuya SE. Anaemia in pregnancy: Prevalence, risk factors, and adverse perinatal outcomes in Northern Tanzania. Anemia. 2018: 1846280. DOI: 10.1155/2018/1846280. PMID: 29854446. PMCID: PMC5954959.
Nwizu EN, Iliyasu Z, Ibrahim SA, Galadanci HS. Socio-demographic and maternal factors in anaemia in pregnancy at booking in Kano, northern Nigeria. Afr J Reprod Health. 2011;15(4):33-41.
Mulugeta M, Zelalem A, Meseret A, Bamlaku E. Prevalence and predictors of maternal anemia during pregnancy in Gondar, Northwest Ethiopia: An institutional based cross-sectional study. Anemia; 2014.
ID 108593. Available:http://dx.doi.org/10.1155/2014/108593
Sukrat B, Sirichotiyakul S. The prevalence and causes of anemia during pregnancy in Maharaj Nakorn Chiang Mai Hospital. J Med Assoc Thai. 2006;89.Suppl 4:S142-6. PMID: 17725151.
Henri E, Valere MK, Lucas EE, Calixte PI, Ngalame CM, Grâce TT, et al. Hematological profile and risk factors of anemia in pregnant women: A Cross sectional descriptive and analytical study in Douala Cameroon. Open Journal of Obstetrics and Gynecology. 2019;9:968-980. Available:https://doi.org/10.4236/ojog.2019.97094
Ali N, Nur Kalmi Z, Sanusi NS, Ahad A, Mohd Khairuddin NA, Rosman SR, et al. Retrospective review of the prevalence and risk factors of anaemia among antenatal mothers attending health clinics in Alor Gajah, Melaka. Malays Fam Physician. 2022;17(3):137-143. DOI: 10.51866/oa.135 PMID: 36606167. PMCID: PMC9809431.
Yu Wu, Hanfeng Ye, Jihong Liu, Qiuyue Ma, Yanling Yuan, Qian Pang, Jue Liu, Cai Kong and Min Liu. Prevalence of anemia and sociodemographic characteristics among pregnant and non-pregnant women in southwest China: a longitudinal observational study. BMC Pregnancy and Childbirth. 2020; 20:535 Available:https://doi.org/10.1186/s12884-020-03222-1
Chola MJ, Mwembo TA, Tamubango KH, Ngwe TJ, Kakoma SZ, Kalenga MKP. Prevalence and associated factors of anemia during pregnancy in Lubumbashi, in the south of Democratic Republic of Congo: Situation in 2020. PAMJ Clinical Medicine. 2021;7(19).
Nonterah EA, Adomolga E, Yidana A et al. Descriptive epidemiology of anaemia among pregnant women initiating antenatal care in rural Northern Ghana. Afr J Prm Health Care Fam Med. 2019;11(1).
Nadia O, Kabira T, Ghizlane B, Fatim EJ. Prevalence and social determinants of anemia among pregnant women in the Province of Essaouira, Morocco. Public health. 2018;30(5).
Setty S, Mariem SM, Ahmed Z, Ahmed E, Abderrazzak K, Soad K, Aicha L, Rachid B. Relation Entre Les Facteurs Socio-Économiques Et L’anémie Au Cours De La Grossesse (Nouakchott – Mauritanie). ESJ. 2017;13(36).
ISSN: 1857 – 7881. DOI: 10.19044/esj. 2017.v13n36p93 URL:http://dx.doi.org/10.19044/esj.2017.v13n36p93
Raj PBU, Mangasuli V. Retrospective study on prevalence of anaemia among pregnant women at booking in a health care centre in Yadwad, Dharwad, Karnataka, India. Int J Community Med Public Health. 2016;3:2762-5.
Fitnaningsih EC, Retno M, Dyah AU, Agus G. Retrospective study on anemia prevalence of pregnant women during third trimester pregnancy in Yogyakarta 2019. Int. Journal Health Scie. Tech. 2021;3(2) Available:https://doi.org/10.31101/ijhst.v3i2.2331
Mooi ZJ, Tan JH, Nurul ABCA, Ooi SM, Kavitha N, Nazimah I. Prevalence of iron deficiency anemia in pregnancy and its therapeutic response to treatment: a retrospective audit in a tertiary hospital. Int J Adv Med. 2022;9:1090-5.
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:e61. DOI:10.1017/S146342362100061X. PMID: 34727999. PMCID: PMC8569827.
Huanqing Hu, Aiqun Huang, Qi Yang, Wei Zhao, Yu Ma, Jiangli Di. Prevalence and Risk Factors of Anemia of Pregnant Women — 6 Provinces in China, 2014−2018. China CDC Weekly. 2020;2(14): 225-229. DOI: 10.46234/ccdcw2020.058
Fage SG, Egata G, Dessie Y, Kumsa FA, Mizana BA. Anemia among School Adolescents in Haramaya Town, Eastern Ethiopia: Cross-Sectional Study. Nutr Metab Insights. 2020;13:1178638820953131. DOI: 10.1177/1178638820953131. PMID: 32922031. PMCID: PMC7457681.
Aboussaleh Y, Farsi, M, El Hioui M, Ahami, A. Nutritional transition in Morocco: Coexistence of anemia and obesity among women in North-West Morocco. Antropo. 2009;19, 67-74. Available:www.didac.ehu.es/antropo
Michael AW, Jessica A, Divine E. A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries. Anemia;2023. ID 6406286:11. Availabel:https://doi.org/10.1155/2023/6406286
Lestari S, Fujiati II, Keumalasari D, Daulay M, Martina SJ, Syarifah S. The prevalence of anemia in pregnant women and its associated risk factors in North Sumatera, Indonesia. IOP Conf. Series: Earth and Environmental Science 125. 2018;012195. DOI:10.1088/1755-1315/125/1/012195
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva, Switzerland: World Health Organization;2016.
World Health Organization. Iron deficiency anemia: assessment, prevention and control-a guide for programme managers, WHO, Geneva;2012.
Onyeneho NG, I'Aronu N, Chukwu N, Agbawodikeizu UP, Chalupowski M, Subramanian SV. Factors associated with compliance to recommended micronutrients uptake for prevention of anemia during pregnancy in urban, peri-urban, and rural communities in Southeast Nigeria. J Health Popul Nutr. 2016;35(1):35. DOI: 10.1186/s41043-016-0068-7 PMID: 27806723. PMCID: PMC5090877.
Kefyalew AA and Abdulahi MD. Prevalence of Anemia and Associated Factors among Pregnant Women in an Urban Area of Eastern Ethiopia. Anemia;2014. ID 561567:7. Available:http://dx.doi.org/10.1155/2014/561567.
Khalafallah AA, Dennis AE. Iron deficiency anaemia in pregnancy and postpartum: pathophysiology and effect of oral versus intravenous iron therapy. J Pregnancy. 2012:630519.
DOI: 10.1155/2012/630519. Epub 2012 Jun 26. PMID: 22792466. PMCID: PMC3389687.
Enawgaw B, Birhanie M, Terefe B, Asrie F. Prevalence of Anemia and iron deficiency among pregnant women attending antenatal care service at University of Gondar Hospital, Northwest Ethiopia. Clin Lab. 2019;65(4).
DOI: 10.7754/Clin.Lab.2018.180822 PMID: 30969067.
Makhoul Z, Taren D, Duncan B et al., Risk factors associated with anemia, iron deficiency and iron deficiency anemia in rural Nepali pregnant women. Southeast Asian Journal of Tropical Medicine and Public Health. 2012;43(3):735–745.
Adinma JB-D, Ikechebelu JI, Onyejimbe U, Amilo G. Adinma EJTJoO, Gynaecology. Influence of antenatal care on the haematocrit value of pregnant Nigerian Igbo women. Trop J Obstet Gynaecol. 2002;19:68–70.
Banjari I, Kenjerić D, Mandić ML. What is the real public health significance of iron deficiency and iron deficiency anaemia in Croatia? A Population-based observational study on pregnant women at early pregnancy from Eastern Croatia. Cent Eur J Public Health. 2015;23(2):122‑7.
Harvey T, Zkik A, Auges M, Clavel T. Assessment of Iron deficiency and anemia in pregnant women: An observational french study. Womens Health. 2016;12(1):95‑102.
Beucher G, Grossetti E, Simonet T, Leporrier M, Dreyfus M. Iron deficiency anemia and pregnancy. Prevention and treatment. Rev Sage-Femme. 2011;10(4):152‑67.
Marine P. Prevalence of anemia in the first trimester of pregnancy: cross-sectional study in a cohort of 648 women followed in a type 3 maternity ward. Human Medicine And Pathology. 2017 ; dumas-01698323.
Charlotte NT, Eveline NDT, Arlette GN, Théophile NN, Gregory HE, Eugene BP. Prevalence and factors associated with anemia in pregnancy at the Douala General Hospital. Pan African Medical Journal. 2016; 25:133 DOI:10.11604/pamj.2016.25.133.10610.
Elzahrani SS. Prevalence of iron deficiency anemia amongpregnant women attending antenatal clinics at Al-Hada Hospital. Canadian Journal on Medicine. 2012;3(1):10–14.
Dudhe M, Vaishnao LS. Impact of anemia over maternal and fetal outcome in tertiary care centre. Indian J Obstet Gynecol Res. 2022;9(3):369-374.
Adil B and Deka OM. The association of maternal anaemia with adverse maternal and foetal outcomes in Somali women: a prospective study. BMC Women’s Health. 2023;23:193 Available:https://doi.org/10.1186/s12905-023-02382-4
Camara B, Oluwalana C, Miyahara R, Lush A, Kampmann B, Manneh K, et al. Stillbirths, neonatal morbidity, and mortality in health-facility deliveries in Urban Gambia. Front Pediatr. 2021;9:579922. DOI: 10.3389/fped.2021.579922.
PMID: 33659227. PMCID: PMC7917219.
Parks S, Hoffman MK, Goudar SS, Patel A, Saleem S, Ali SA, et al. Maternal anaemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan. BJOG. 2019;126(6):737-743.
DOI: 10.1111/1471-0528.15585. Epub 2019 Jan 24. PMID: 30554474. PMCID: PMC6459713.
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 Netw Open. 2022; 5(2):e2147046. DOI:10.1001/jamanetworkopen.2021.47046. PMID: 35113162. PMCID: PMC8814908.