Factors associated with early pregnancy anemia in rural Sri Lanka: Does being ‘under care’ iron out socioeconomic disparities?

Abstract

Globally, more than a third of pregnant women are anemic, and progress in its prevention and control is slow. Sri Lanka is a lower-middle-income country with a unique public health infrastructure that provides multiple interventions across the lifecycle for anemia prevention, despite which anemia in pregnancy remains a challenge. Studying the factors associated with maternal anemia in this context would provide unique information on challenges and opportunities encountered as low-and-middle-income countries attempt to control anemia by improving health care coverage. All first-trimester pregnant women registered for antenatal care in the Anuradhapura district between July 2019 to September 2019 were invited to participate in the baseline of a cohort study. Interviewer-administered and self-completed questionnaires were used. Anemia was defined using a full blood count. A hierarchical logistic regression model was built to identify factors associated with anemia. Out of 3127 participants, 451 (14.4%) were anemic. According to the regression model (Chi-square = 139.3, p<0.001, n = 2692), the odds of being anemic increased with the Period of gestation (PoG) (OR = 1.07, 95% CI = 1.01–1.13). While controlling for PoG, age and parity, history of anemia (OR = 3.22, 95%CI = 2.51–4.13), being underweight (OR = 1.64, 95%CI = 1.24–2.18), having the last pregnancy five or more years back (OR = 1.57,95%CI = 1.15–2.15) and having used intrauterine devices for one year or more (OR = 1.63, 95%CI = 1.16–2.30) increased the odds of anemia. Breast feeding during the last year (OR = 0.66, 95%CI = 0.49–0.90) and having used contraceptive injections for one year or more (OR = 0.61,95%CI = 0.45–0.83) reduced the risk of anemia. Proxy indicators of being in frequent contact with the national family health program have a protective effect over the socioeconomic disparities in preventing early pregnancy anemia. Maintaining the continuum of care through the lifecycle, especially through optimizing pre and inter-pregnancy care provision should be the way forward for anemia control.

Factors associated with anaemia among pregnant women in Rwanda: An analysis of the Rwanda Demographic and Health Survey of 2020

“…This may be because coming from wealthier households could also mean that women also access better health services and healthier, su cient food than their counterparts with less income. This agrees with results from several studies conducted in Tanzania, Sri Lanka, Nigeria, Rwanda, Uganda and Ethiopia which found women with low wealth index being more likely to be anaemic [27,[40][41][42][43][44].…”

Dampak Kurangnya Nutrisi Pada Ibu Hamil Terhadap Risiko Stunting Pada Bayi Yang Dilahirkan

“…Penyebab kurangnya gizi selama kehamilan kemungkinan karena beberapa faktor diantaranya mual dan muntah, infeksi kronis atau depresi, penggunaan obat tertentu yang bisa mengganggu penyerapan nutrisi sehingga asupan gizi dan kalori yang tidak memadai. (Amarasinghe et al, 2022) Pemenuhan nutrisi/gizi yang tepat sangat membantu tumbuh kembang janin dalam kandungan.…”

Anemia in Pregnancy: Cause and Effect

“…Ibu hamil yang memiliki IMT yang rendah berhubungan signifikan dengan kejadian anemia selama kehamilan (Millatina et al, 2020). Sedangkan menurut penelitian yang dilakukan di Sri Langka, ibu hamil yang underweight berisiko 1,6 kali lebih besar terkena anemia dibandingkan ibu hamil dengan BMI normal, overweight, atau obesitas (Amarasinghe et al, 2022).…”