Factors associated with iron deficiency anaemia among pregnant teenagers in Ashanti Region, Ghana: A hospital-based prospective cohort study

Abstract

Background Iron Deficiency Anaemia (IDA) is reportedly high in pregnant adults and the causes well studied. However, among pregnant teenagers, the levels and associated factors of IDA are not fully understood. Methods In a prospective cohort study among Ghanaian pregnant teenagers, aged 13–19 years, IDA prevalence and associated factors were investigated. Sociodemographic data, household hunger scale (HHS), lived poverty index (LPI), FAO’s women’s dietary diversity score (WDDS) and interventions received during antenatal care (ANC) were obtained from 416 pregnant teenagers in Ashanti Region, Ghana. Micronutrient intakes using a repeated 24-hour dietary recall, and mid-upper arm circumference (MUAC) were determined and blood samples analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP). Results Anaemia (Hb cutoff <11.0 g/dL) was 57.1%; deficient systemic supply of iron stores (31.4%), depleted body stores of iron (4.4%), inadequate dietary iron intake (94.5%), and inadequate multiple micronutrient intakes (49.5%), were all notable among study participants. Between-subject effects using Generalized Linear Modelling indicated malaria tablet given at ANC (p = 0.035), MUAC (p = 0.043), ZPP (p<0.001), ZPP/Hb ratio (p<0.001) and depleted body iron stores (DBIS) (p<0.001) to significantly affect Hb levels. Pregnant teenagers with a high ZPP/Hb ratio (OR = 9.7, p<0.001, 95%CI = 6.0–15.8) had increased odds of being anaemic compared to those with normal ZPP/Hb ratio. Participants who were wasted (OR = 1.2, p = 0.543, 95%CI = 0.6–2.3), and those with depleted iron stores (OR = 3.0, p = 0.167, 95%CI = 0.6–14.6) had increased odds of being anaemic. Participants who experienced hunger were close to 3 times more likely (OR = 2.9, p = 0.040, 95%CI = 1.1–7.8) for depleted iron stores, compared to those who did not experience hunger. Also, participants with inadequate multiple micronutrients intakes (OR = 2.6, p = 0.102, 95%CI = 0.8–8.4), and those with low serum levels of ferritin (OR = 3.3, p = 0.291, 95%CI = 0.4–29.2) had increased odds of depleted body iron stores. Conclusions IDA is common among pregnant teenagers and the related factors include malaria tablets given at ANC, maternal hunger, maternal MUAC, a deficient systemic supply of iron, depleted body iron stores, ZPP, and ZPP/Hb ratio. Appropriate interventions are urgently needed to address the causes of IDA among pregnant teenagers.

Beyond hemoglobin: uncovering iron deficiency and iron deficiency anemia using serum ferritin concentration among pregnant women in eastern Ethiopia: a community-based study

“…Our findings are higher than previous studies reported in Singapore [ 5 ], Ghana [ 36 – 38 ], Thailand [ 39 ], and Australia [ 40 ]. However, it is consistent with the findings from Palestine [ 41 ].…”

Multinomial logistic regression analysis of the determinants of anaemia severity among children aged 6-59 months in Ghana: New evidence from the 2019 Malaria Indicator Survey

“…The increased levels of severe, moderate and mild anaemia among children under age ve, as found in this study and other studies in Africa, raise the issue of low blood haemoglobin concentrations in children as a result of iron de ciency in diets, low iron supplement intake and poor feeding practices [2,20,29,[37][38][39]. Other studies also argued that malaria plays an essential role in the aetiology of anaemia coupled with high rates of Plasmodium falciparum parasite infection in the African region increases the risk of anaemia severity, especially among children under age ve [40][41][42][43][44].…”

“…Several studies using nationally representative [15][16][17][18][19][20][21][22][23][24][25] and health facility-based data [26][27][28][29] have examined demographic, social, economic, household, nutritional, environmental, health system and spatial/geographical factors predicting childhood anaemia status.…”

Birth Outcomes of Anemia in Pregnancy in Bolgatanga Regional Hospital

“…Antenatal care (ANC), including the receipt and use of iron-containing supplements, as well as deworming and jungle fever prophylaxis during pregnancy in endemic regions, not only result in better birth results for the mother and her kid yet moreover lead to improvements in wellbeing and food for the woman in later life. Utilizing backslide rot investigation, Annan et al (2021) report the total change in Hb levels seen among pregnant ladies in India. 7% of the women with less HB were attributed to healthcare professionals (joined results introduced for ANC administrations, deworming, and weight checking) during pregnancy (Talukder, Osei, Haselow, Kroeun, Uddin, & Quinn, 2016).…”