International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 8 Issue 4, Jul-Aug 2024 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

Prevalence, Magnitude, Contributing

Factors of Anemia among Pregnant Women
B. Gomathi1, Subhasmita Behera2, Valsamma PC3, Soumya Kar4, Amruta B. S5
1
Reader/Associate Professor, College of Nursing, AIIMS, Bhubaneswar, Odisha, India
2
Nursing Tutor, Department of OBG Nursing, SUM Nursing College, SOA (DTU), Bhubaneswar, Odisha, India
3
Nursing Superintendent, Christian Fellowship Hospital, Chhattisgarh, India
4
Nursing Tutor, Department of OBG Nursing, Prativa Devi College of Nursing, Bhubaneswar, Odisha, India
5
Nursing Officer, AIIMS Kalyani, West Bengal, India

ABSTRACT How to cite this paper: B. Gomathi |

Introduction Subhasmita Behera | Valsamma PC |
Anemia during pregnancy is a major cause of morbidity and Soumya Kar | Amruta B. S "Prevalence,
mortality of pregnant women in developing countries and has both Magnitude, Contributing Factors of
Anemia among Pregnant Women"
maternal and fetal consequences.
Published in
Methods International Journal
Quantitative approach with descriptive research design was adopted of Trend in
for the present study. Five hundred (500) pregnant women attending Scientific Research
antenatal OPD of IMS & SUM Hospital, Bhubaneswar, Odisha were and Development
selected purposively. Pregnant women can understand Odia language (ijtsrd), ISSN: 2456-
6470, Volume-8 | IJTSRD68295
and available during data collection period were included in the
Issue-4, August
study. Institutional Ethical Committee (IEC) and administrative 2024, pp.1114-1120, URL:
permission was taken from IMS & SUM Hospital. The tools used to www.ijtsrd.com/papers/ijtsrd68295.pdf
collect the data were as follows: 1. Demographic questionnaire, 2.
Questionnaire to assess the contributing factors of anemia and 3. Copyright © 2024 by author (s) and
Checklist to assess the symptoms of anemia. Data was collected by International Journal of Trend in
interview schedule. The data were analysed by using descriptive and Scientific Research and Development
inferential statistics with SPSS 21 version. Journal. This is an
Open Access article
Results distributed under the
The overall prevalence of anemia among pregnant women was terms of the Creative Commons
41.2%. Nearly half of them had mild anemia (48.6%), followed by Attribution License (CC BY 4.0)
9.6 % had moderate anemia and whereas only 3% had severe anemia. (http://creativecommons.org/licenses/by/4.0)
The magnitude of anemia was associated with age in years
(χ2=2.450, p=0.003), duration of menstrual cycle (χ2=2.707, KEYWORDS: pregnant women,
p=0.004), type of menstrual flow (χ2=3.080, p=0.005), multiparity anemia, prevalence, contributing
(χ2=4.339, p=0.004). factors, magnitude
Conclusion: It is concluded that the prevalence of anemia in
pregnancy was low compared to the finding of other studies and
magnitude of anemia among pregnant women was found to be
anemia is a moderate. Frequent assessment of their physical health
and counselling is more important to prevent anemia rather than
treatment.

INTRODUCTION
Pregnancy is not just a matter of waiting to give birth 65% to 75%.1 Anemia is the second most common
but a joyful and a fulfilling period in a woman’s life. cause of maternal death in India and contributing to
It can also cause ill health or even death. Anemia is about 80% of the maternal deaths caused by anemia
one of the most common nutritional deficiency in South East Asia.2
disorders affecting the pregnant women; the Anaemia is the term that indicates a low red cell
prevalence in developed countries is 14%, in
count and a below normal haemoglobin or
developing countries 51%, and in India, it varies from haematocrit level. A reduction in the concentration of

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haemoglobin in the blood stream to a level below the risk of maternal and perinatal mortality. The
11gm/dl for pregnant women. Among different types negative health effects for the mother include fatigue,
of anaemia iron deficiency anaemia is the most poor work capacity, impaired immune function,
common nutritional disorder (66-80%), in the world increased risk of cardiac diseases, and mortality.8
as per WHO (2002). 3 Anemia in pregnancy has several maternal health
Women in developing countries are always in a state effects such as preterm deliveries, heart failure,
of precarious iron balance during their reproductive postpartum haemorrhage and even death 9 and for the
years. Their iron stores are not well developed foetuses, the effects include low birth weight, birth
because of poor nutritional intake, recurrent asphyxia and perinatal death 10-12.
infections, menstrual blood loss, and repeated Anemia during pregnancy time is found to be major
pregnancies. Gender discrimination in a country like health problem. It is associated with adverse health
India resulting girls lacking access to a balanced diet, and socio –economic consequence among pregnant
adequate health care and proper education. Thus, the women, particularly severe anemia increases risk of
average Indian woman enters her reproductive years, maternal and perinatal mortality. Hence this study was
and particularly pregnancy, with iron and folate planned to assess prevalence, magnitude and
deficiency.4 contributing factors of anemia among pregnant
Anemia during pregnancy is a public health problem women.
especially in developing countries and is associated Methods and Materials:
with adverse outcomes in pregnancy.5 The prevalence Quantitative approach with descriptive design was
of anemia is highest among pregnant women in Sub-
adopted to assess the Prevalence, Contributing factors
Saharan Africa (SSA) (57%), followed by pregnant and magnitude of anemia among pregnant women.
women in Southeast Asia (48%), and lowest The study was carried out in the Gynaecology OPD
prevalence (24.1%) was found among pregnant of IMS & SUM Hospital, Bhubaneswar, Odisha. Five
women in South America .3. Tanzania Demographic
hundred (500) pregnant women attending antenatal
and Health Surveys reported a slight decrease in the OPD were selected purposively. Pregnant women can
prevalence of anemia among pregnant women from understand Odia language and available during data
58% in 2004/05 to 53% in 2010. 6
collection period were included in the study.
The causes of anemia during pregnancy in developing Institutional Ethical Committee (IEC) and
countries are multifactorial; these include administrative permission was taken from IMS &
micronutrient deficiencies of iron, folate, and SUM Hospital. The tools used to collect the data were
vitamins A and B12 and anemia due to parasitic as follows: 1. Demographic questionnaire, 2.
infections such as malaria and hookworm or chronic Questionnaire to assess the contributing factors of
infections like TB and HIV. Contributions of each of anemia and 3. Checklist to assess the symptoms of
the factors that cause anemia during pregnancy vary anemia. Data was collected by interview schedule.
due to geographical location, dietary practice, and The data analysed using descriptive and inferential
season. 7 statistics with SPSS 21 version.
Anemia during pregnancy is reported to have
negative maternal and child health effect and increase
Results
Table No1. Frequency and percentage distribution of demographic characteristics of pregnant women
N= 500
Sl. No Socio-demographic data Criteria Frequency Percentage (%)
18-24 102 20.4
1. Age 25-31 324 64.8
32-38 74 14.8
Below 18.5 14 2.8
18.5-24.9 304 60.8
2 BMI
25.0-29.9 132 26.4
30.0 and above 50 10
No formal 38 7.6
Primary 143 28.6
3. Education Standard
Secondary 193 38.6
Higher secondary 108 21.6

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Housewife 324 64.8
4. Occupation
Working 176 35.2
Urban 318 63.6
5. Residence
Rural 182 36.4
Joint family 248 49.6
5. Type of family Nuclear family 250 50
Extended family 2 0.4
5,000-20,000 137 27.4
6. Family Income 21,000-50,000 347 69.4
>50,000 16 3.2
Table No 1 shows that the demographic characteristics of pregnant women indicate that the highest percentage
(64.8%) were aged between 25-31 years. Less than one percentage (0.6%) had severe anemia (Hb < 7g/dl), while
41.2% had normal Hb levels. The majority of women (60.8%) had a BMI of 18.5-24.9, and 38.6% had a
secondary level of education. Additionally, 63.6% of women were from urban areas, and 64.8% were
housewives. The largest religious group was Hindu (89%), and 50% of the women were from nuclear families.
In terms of family income, the highest percentage (69.4%) had a family income between 30,000-50,000.
Table No 2: Prevalence of anemia among pregnant women.
N=500
Sl No. Characteristics Frequency Percentage (%)
1 Anemic 206 41.2
2 Normal Hb 294 58.8
Table No 2 shows that among 500 pregnant women, 206 (41.2%) were anemic according on their hemoglobin
test result (Hb) test.
Table 3: Magnitude of anemia among pregnant women.
N=500
Sl No. Magnitude of Anemia Hemoglobin values Frequency Percentage (%)
1 Mild 9 -10.9 g/dl 243 48.6
2 Moderate 7 - 8.9 g/dl 48 9.6
3 Severe <7g/dl 3 0.6
Table No 3 shows the Magnitude of anemia among pregnant women. Nearly half of the pregnant women
(48.6%) had mild anemia (Hb level: 9-10.9 g/dl), 9.6% had moderate anemia (Hb level: 7-8.9 g/dl), and the
remaining 0.6% were diagnosed with severe anemia (Hb level: <7 g/dl).
Table No 4. Contributing factors of anemia among women with anemia
N=500
Sl. No Contributing Factors Criteria Frequency Percentage (%)
A Obstetrical factor
1 2 2
1. Gravida 2 371 74.2
>2 117 23.4
Primi 98 19.6
2. Parity
Multi 402 80.4
If multi para (Mode of Normal vaginal delivery 83 84.7
2a.
delivery Ceasrean section 15 15.3
Any complication during Yes 41 8.2
3.
previous birth of the child No 459 91.8
B. Menstrual factor
21 days (polymenorrhea) 16 3.2
Interval of menstrual
4. 22- 35 days (normal) 461 92.2
cycle per month
More than 35 days (Oligomenorrhea) 23 4.6
Scanty 35 7
5 Type of menstrual flow Normal 450 90
Heavy 15 3

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C. Nutritional Factor
Non –vegetarian 250 50
6. Type of diet
Vegetarian 250 50
Never 35 7
Weekly 250 50
7. Vegetable Intake
Daily 150 30
Occasionally 65 13
Never 20 4
Weekly 452 90.4
8. Fruits Intake
Daily 14 2.8
Occasionally 14 2.8
Never 5 1
Weekly 134 26.8
9. Dry Fruits
Daily 33 6.6
Occasionally 328 65.6
Never 5 1
Weekly 134 26.8
10. Egg
Daily 33 6.6
Occasionally 328 65.6
Never 5 1
Weekly 134 26.8
11. Fish
Daily 33 6.6
Occasionally 328 65.6
Never 5 1
Weekly 134 26.8
12. Red meat
Daily 33 6.6
Occasionally 328 65.6
Never 5 1
Weekly 134 26.8
13. Milk
Daily 33 6.6
Occasionally 328 65.6
Never 5 1
Weekly 134 26.8
14. Pulses
Daily 33 6.6
Occasionally 328 65.6
D. Medication factor
Bleeding piles 71 14.2
Gastritis 68 13.6
14. H/O Medical Disease Diabetes mellitus 24 4.8
Hook worm infestation 4 0.8
Other 333 66.8
Iron and folic acid 491 98.2
15. H/O Taking Medication Calcium 468 93.6
Deworming medication 7 1.4
Table No 4 shows the contributing factors of anemia among pregnant mothers shows that 74.2% were
multigravida, while 80.4% were multipara. Among multiparous mothers, 84.7% had a normal vaginal delivery,
and during delivery, 91.8% of women experienced no complications.
Regarding menstrual factors, the duration of the menstrual cycle showed that the majority (92.2%) of women
had a normal duration of menstrual flow. In terms of the type of menstrual flow, the majority (90%) had a
normal flow, followed by 7% who had light menstrual flow, and 3% who had heavy menstrual flow.
Among the nutritional factors, equal 50% of women were vegetarian & 50% were non-vegetarian. In terms of
specific dietary intake, 50% of women consumed vegetables less than once a day. Additionally, 90.4% of
women consumed fruits weekly, 65.6% consumed dry fruits daily, 87.2% consumed pulses daily, 35.2%

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consumed eggs daily, 9.2% consumed fish daily, 10.6% consumed red meat daily, and 58.2% consumed milk
daily.
Among medical factors, 62.6% of women had a medical condition during pregnancy, while 37.4% had no
disease condition. Additionally, 85.8% of women had no bleeding piles, 4.8% had diabetes mellitus during
pregnancy. Furthermore, 0.85% had hookworm infestation during pregnancy.
In terms of medication history, the majority of women (98.2%) were taking iron and folic acid, while 93.6%
were taking calcium tablets. Additionally, 1.4% taking deworming medication.
Table 5–Distribution of sign and symptoms of anemia among pregnant women.
N=500
SL. No Sign and Symptoms Frequency Percentage (%)
1. Skin pallor 150 30
2. Dizziness 53 10.6
3. Shortness of breath 1 0.2
4. Fatigue 253 50.6
5. Leg cramp 17 3.4
6. Irregular heart rate 17 3.4
7. Insomnia 80 16
8. Sore mouth 1 0.2
Table 5 outlines the signs and symptoms of anemia among women. The highest percentage (50.6%) reported
experiencing fatigue, followed by 30% with skin pallor, 10.6% with dizziness, and 0.2% with shortness of
breath. Additionally, 3.4% reported leg cramps, 3.4% had an increased heart rate, 84% experienced sleep
disorders, and 0.2% had a sore mouth.
Association between level of hemoglobin with remaining 0.6% were diagnosed with severe anemia
factors contributing to anemia. (Hb level: <7 g/dl).
Chi-square test was used to analyse the association Argaw D, et.al (2020) the overall prevalence of
between demographic characteristics and factors anemia among pregnant women attending antenatal
contributing to anemia. Results revels that there was care was found to be 28.7% (95% CI: 24.1–33.5). Out
significant association between level of hemoglobin of which 19.57% had mild anemia, 8.58% had
and age in years (χ2= 2.450, p= 0.003), duration of moderate anemia, and 0.55% had severe anemia1.
cycle (χ2=4.655, p = 0.002), type of flow (χ2= 2.707, Abdallah F, et.al (2022) 243 (48.6%) had mild
p = 0.004), multiparity (χ2=4.339, p=0.004).
anemia (Hb level: 9-10.9 g/dl), Overall prevalence of
Discussion: anaemia in pregnant women was 25.5%. Out of 107
In present study highest percentage (64.8%) of the pregnant women diagnosed with anaemia and, sixty-
study participant were aged between 25-31 age group, six had mild anaemia16.
highest percentage (63.6%) of women were from Abriha A, et.al (2014) The overall prevalence rate of
urban area, Highest percentage (64.8%) women were anemia with hemoglobin level < 11 g/dl was 19.3%
house wife. (CI:19.1, 19.5). In terms of severity, mild anemia was
Suzon Ahmed, et.al (2019) found that Majority 144 13.7%, moderate anemia was 4.4% and severe anemia
(37.5%) of the study participants were found 21 - 25 was 1.6% 17. Mathewos B, et.al (2014) The
age group. More than half of the participants 200 prevalence found in this study is comparable with
(52.1%) lived in urban area and rest 184 (47.9%) studies done in Southeast Ethiopia (27.9%) 18. Argaw
pregnant women were in rural area5. Sinha A,,et.al D et.al (2020)Overall prevalence of anemia was
(2021) The most common age group in our study was 28.7%, of which (19.6%) had mild anemia3. Neeraj
20-30 years (54.5%)13. Abriha A,et.al (2014) The Rai et.al ( 2016 ) they stated that maximum 44.7%
mean age of the respondents was 25.7 years with 1.05 were suffering from mild anaemia19. Raga A.
years , 178(62.21%) of them were urban residents14. Elzahaf et.al (2016) they stated that maximum 44.5%
In present study the prevalence of anemia among were suffering from mild anemia20.
pregnant women was (41.2%) and (48.6%) of women In this study highest percentage of women (80.4%)
were having mild anaemia (Hb level :9-10.9g/dl), 206 were multiipara. Yesuf NN, et.al (2021) stated that
(41.2%) had normal hemoglobin levels, 243 (48.6%) (45.8%) of them were multiparous anemia were 2.43
had mild anemia (Hb level: 9-10.9 g/dl), 48 (9.6%) times higher among multiparous pregnant mothers as
had moderate anemia (Hb level: 7-8.9 g/dl), and the compared to primigravida mothers. Multiple factors

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
including multiparty and living in rural areas were [3] Argaw D, Hussen Kabthymer R, Birhane M.
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