Prevalance Of Anemia In pregnancy

Prevalence of anemia during pregnancy: Results of laboratory data analysis from a Primary Health center of Goa

Abstract:

Introduction: Globally anemia affects 1.62 billion people which correspond to 24.8% of the population. It is more prevalent in pregnant women and young children. ^[1]

Objective: Study was conducted to know the status of anemia in the antenatal cases registered at the Primary health Center.

Methods:  Anaemia was diagnosed by estimating the haemoglobin concentration in the blood with the use of the indirect cyanmethemoglobin method, data generated at laboratory was collected and analyzed.

Results: During study period 649 Antenatal cases laboratory data were available, of this 37.6% were mild anemic, 7.4% having moderate anemia, overall prevalence of anemia was 45.10%% in Antenatal cases.

Conclusion: Present study aims at only to find prevalence of anemia among antenatal cases, which was 45.10% slightly higher than NFHS III data, which was 36.9% among pregnant women. ^[2] Further detail assessment of the various factors involved in anemia need to be study among antenatal women.

Key words: Anemia, antenatal cases, pregnancy.

Introduction: Anemia is a global public health problem affecting about 1.62 billion people which corresponds to 24.8% of the population, from both developing and developed countries with major consequences for human health as well as social and economic development. It is more prevalent in pregnant women; over 80% of the countries have a moderate or severe public health problem.^[1]  In the low socio-economic groups 50-60 per cent of women are anemic in the last trimester of pregnancy. Anemia is associated with high incidence of premature births, postpartum haemorrhage, puerperal sepsis and thromboembolic phenomena. ^[3]

Objectives: To study the prevalence of anemia in antenatal cases.

Methodology:  This study was conducted at Sankhalim Primary Health Center of the North Goa. The area under primary health center mostly comprise of rural areas, catering approximately 40,000 populations with more than 70% population belongs to low and middle socio-economic class. Primary Health Center is the nearest government health facility available to this people. Average 64 new antenatal cases (ANC) are registered per month to this PHC. All the Antenatal cases were provided with iron and folic acid supplementation from 13^th week onward.

During their first visit, hemoglobin estimation is done by only laboratory technician by cyanmethemoglobin method. Data which was generated in the laboratory was compiled and analyzed for the prevalence of anemia.

Data was collected for the period of 10 months from January 2010 to October 2010 and analyze for prevalence.

Anemia in pregnant women is defined as hemoglobin level below 11gm%.^[4] and further classified as mild ( 9-10.9 gm%), moderate (7-8.9 gm%) and severe anemia (less than 7 gm%).

Results and Discussions

During study period 649 Antenatal cases data were available at the Primary health Center of which, 88.9% Antenatal cases were Hindu and 10.9% Muslim. Of the 649 Antenatal cases, 86.5% Antenatal cases belongs to 20 to 30 years of age group and only 2.0% was less than 20years of age. Mean hemoglobin was 10.7gm% (SD of 1.37gm %) and mean age was 25.5 years (SD of 4.5yrs)

Total prevalence of anemia among ANC was 45.10%, with mild anemia in 37.6% cases and 7.4% had moderate anemia. In age group of 20-25 years, 45.5% of the 358 Antenatal cases were anemic and 47.3% were having anemia in the age group 26-30years.Anemia in less than 20 years were 53.9% of 13 Antenatal cases (P 0.778).

As per Family Welfare statistics of India 2009, for North Goa, anemia among ever married women aged 15-49 yrs were 38.9% (NFHS III) and 36.4% (NFHS II).Pregnant women age 15-49 who are anaemic are 36.9% NFHS III ( urban-43.3% and rural-26.1%), NFHS II-35%.^[2]   Total 577 Hindu Antenatal cases registered at PHC, of which 44.7% were anemic and 33% of the 71 Muslim Antenatal cases were anemic.(P 0.925)

Prevalence of anemia in Valencia study was 34.44%, and of which 1.8% had severe anemia. ^[5]  Similarly in Tanzania study 23 % of pregnant women had Hemoglobin less than 11gm%. ^[6]

G.S. Toteja et al study shows that the prevalence of anaemia among the 6,923 pregnant women from the 16 districts was 84.9% and overall prevalence of moderate and mild anaemia in pregnant women was 60.1% and 11.8% respectively. ^[7]   Prevalence of anaemia in this study was more than NFHS III.

Present study had only assessed the prevalence of anaemia in antenatal cases at a point of time, further follow up and pregnancy outcome with impact on newborn require to be studied. 

 Age wise distribution of anemia in Antenatal cases

              

                   

References

1.   Worldwide prevalence of anemia 1993-2005, WHO Global Database on Anemia. Edited by Bruno de Benoist, Erin McLean, Ines Egli and Mary Cogswell.

2.   Family welfare statistics in India 2009; Ministry of Health and Family Welfare, Government of India.

3.   K. Park. Preventive Medicine in Obstetrics Paediatrics and Geriatrics. Park’s Textbook of Preventive and Social medicine, 17^th edition. Jabalpur, M/s Banarsidas Bhanot Publishers, 2002; 363.

4.   Iron Deficiency Anaemia, Assessment Prevention and Control, A guide for Programme managers; WHO/NHD 01.3.

5.   Arturo Marti-carvajal, Guiomar Peña-Martí, Gabriela Comunian, Sergio Muñoz et al Prevalence of anemia during pregnancy : Results of Valencia (Venezuela) anemia during pregnancy study. ALAN 2002; v.52n.1Caracas mar.

6.    S.G Hinderaker, B. E. Olsen, Per Bergsjo, Rolv T Lie, Peter Gasheka and Gunnar Kvale. Anaemia in pregnancy in the highlands of Tanzania. Acta Obstet Gynecol Scand 2001; 80: 18–26.

7.   G. S. Toteja, Padam Singh, B. S. Dhillon, B. N. Saxena, F. U. Ahmed, Lt. R. P. Singh et al. Prevalence of anemia in pregnant women and adolescent girls in 16 districts of India. Food and Nutrition Bulletin 2006; vol.27:311-15.