地域医療と健康教育

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Major Risk Factors Predicting Anemia Development during Pregnancy: Unmatched-Case Control Study

Belete Argaw, Ayele Argaw-Denboba*, Biruhalem Taye, Alemayehu Worku and Amare Worku

Background: Anemia in pregnancy is associated with increased rates of maternal and perinatal mortality, premature delivery and other adverse outcomes. Hence, identifying anemia predicting risk factors in high-risk groups such as pregnant women is essential for problem based intervention modalities, particularly for developing countries. The aim of this study was to identify the major risk factors predictive of anemia development during pregnancy in Hawassa and Yirgalem cities located in Sidama Zone, Ethiopia.

Methods: Unmatched case-control study, involving 561 pregnant women who initiated antenatal care follow up during their first trimester, was conducted from February to March 2011. Socio-demographic, hemoglobin level, obstetric and medical data of the study participants were collected using pre-tested well-structured questionnaire and reviewing antenatal care follow up record cards of each pregnant woman. Hemoglobin level <11 g/dl was used to define anemia during pregnancy. Bivariate and multivariate analyses were conducted to find predictors of anemia, P-value <0.05 was considered as statistically significant.

Results: The major predicting risk factors for occurrence of anemia among pregnant women were, lower educational level (AOR=3.3, 95% CI: 1.3-8.0, P=0.007), prolonged menstruation period 6-8 days before the index pregnancy (AOR=3.1, 95% CI: 1.6-5.9., P=0.001), intestinal parasitic infection (AOR=2.9, 95% CI: 1.4-8.1, P=0.000), gastritis with duodenal ulcer bleeding (AOR=3.87, 95% CI: 1.8-8.0, P=0.000) and not taking meat/organ meats (AOR=2.8, 95% CI: 1.3-6.1, P=0.008).

Conclusions: Family illiteracy, intestinal parasitic infection, duration of menstrual bleeding, gastritis with duodenal ulcer bleeding, and inadequate intake of organ meats were identified as strong predicting risk factors of anemia among pregnant women. Therefore, to reduce maternal mortality, the overall anemia prevention strategy in pregnant women should promote community-based health education to low educated families, mass de-worming of intestinal parasites and focused counseling for those women who have prolonged menstruation and peptic ulcer diseases.