Anaemia in pregnancy—a cross-sectional study in Singapore

Abstract

Objective: To determine the prevalence and predictors of anaemia in pregnancy in Singapore. Design: Hospital based case controlled study. Setting: National University Hospital, between January±December 1993. Subjects: All women delivered at the National University Hospital, Singapore in 1993 had their haemoglobin estimated. If it was less than 11 gmadl, blood was taken to establish the cause of anaemia. Data was also collected with regard to their antenatal progress, and factors predisposing to anaemia in pregnancy. Logistic regression, Chi-square test, Fischer's exact test, Mantel±Haenszel test were used to assess the relationships between categorical variables. Results: The prevalence of anaemia at delivery was 15.3%. The most common cause of anaemia in pregnancy was due to iron de®ciency (81.3%). The occurrence of anaemia in pregnancy is related to the socio-economic status of the women. Multiparous women of the lower socio-economic class who tend to book late in pregnancy were found to have the highest risk of anaemia.Multivariate logistic regression analysis revealed iron prophylaxis, haemoglobin level at booking, race and previous history of anaemia in earlier pregnancy as important predictors of anaemia at delivery. The odds of anaemia for a woman not on therapy was about 11 times that of her counterpart on prophylactic iron therapy (95% CI 8.76±14.13). A 55% reduction in odds of anaemia was estimated per 1 gm% increase in haemoglobin level at booking. As compared to Chinese, Malays and Indians who experienced signi®cant increase in odds of anaemia of 95% and 58% respectively. Further, a pregnant woman with a previous history of anaemia is 2.6 times as likely to be anaemic, as compared with one without history of anaemia.Except for a higher incidence of preterm delivery, there was no other statistically increased risk of complications in the antepartum, intrapartum or postpartum periods. There was no difference in the incidence of antepartum haemorrhageaoperative deliveries, postpartum haemorrhage, low birthweight, intrauterine growth retardation and neonatal outcome. Conclusions: The study con®rms that iron de®ciency anaemia is the most common cause of anaemia in pregnancy and is a major health problem in developing and developed countries. Sponsorship: This study was funded by a research grant from the National University of Singapore. Descriptors: anaemia in pregnancy; iron-de®ciency; risk factors

Prevalence of Anemia among Pregnant Women Attending Antenatal Care at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia

“…This result is almost consistent with across sectional study carried out in Gonder (23%) and in the University of Port Harcourt Teaching Hospital, Port Harcourt in Nigeria which had shown a prevalence rate of 23.2% [12,13]. In contrast to this study, a study conducted at Health Promotion Hospital Nakhonsawan, in Thailand showed a prevalence rate of 14.1% [14].This may be due to a difference in socio-economic and educa tional status between the study populations in the two study areas.…”

Postnatal iron status of Hong Kong Chinese women in a longitudinal study of maternal nutrition

“…For nonpregnant and non-lactating women, a haemoglobin cut-off of 12 gadl is used to de®ne anaemia (Cook & Skikne, 1989;Institute of Medicine (US), 1993). Previous studies have used Hb cut-off values of either 10 gadl (Lao et al, 1996), 11 gadl (Singh et al, 1998) or 12 gadl (Kuvibidila et al, 1994). Although it has been suggested that the haemodilution effect of pregnancy is still apparent at 6 ± 8 weeks postpartum (Taylor & Lind, 1979), our ®ndings showed that the mean Hb level of subjects had increased to !…”

Iron status and its association with pregnancy outcome in Korean pregnant women

“…The prevalence of anemia in our study was similar to previous reports conducted in Korea (Lim and Kim, 1998;Yu et al, 1999) and in Asia (Hui et al, 1995). Anemia or iron deficiency during pregnancy is associated with intrauterine growth retardation, premature birth, low birth weight, increased labor time, higher risk of infection, elevated maternal and prenatal mortality, muscle dysfunction and low physical capacity (Murphy et al, 1986;Lu et al, 1991;Scholl and Hediger, 1994;Singh et al, 1998;Zhou et al, 1998;Yip, 2000). Lone et al (2004) reported the association between low maternal Hb level and Apgar score o5 at 1 min, which is an index of health status of newborn babies.…”

“…In Asia, the prevalence of anemia was estimated to be 44% in non-pregnant and 60% in pregnant women (Rush, 2000). At least 50% of the anemia has been attributed to iron deficiency (DeMaeyer and Adiels-Tegman, 1985;Singh et al, 1998). Maternal iron deficiency anemia increases the risk of premature delivery and subsequent low birth weight, and may contribute to low iron status and poor health of infants (Allen, 2000;Scholl and Reilly, 2000;Kaiser and Allen, 2002).…”