Prevalence and factors associated with anaemia among pregnant women attending antenatal clinic in the second and third trimesters at Pumwani maternity hospital, Nairobi

Abstract

Background: It is estimated that 41.8% of pregnant women worldwide are anaemic. In Africa 57.1% of pregnant women are anaemic. In Kenya the prevalence of anaemia among pregnant women was 55.1% which is a severe public health problem based on the World Health Organization classification of anaemia. Anaemia is a major cause of morbidity and mortality of pregnant women and increases the risks of foetal, neonatal and overall infant morbidity and mortality. Objectives: The broad objective was to assess the prevalence and determinants of anaemia among pregnant women in the second and third trimesters of pregnancy attending antenatal clinic at Pumwani Maternity Hospital, Nairobi. Methodology: A cross-sectional study was conducted from 8th June to 18th August, 2015, on 258 pregnant women who attended antenatal clinic at Pumwani Maternity Hospital in Nairobi. Systematic sampling method was used to select the study participants. The data was collected using pre-tested semi-structured questionnaire through interviews and an assessment of anthropometric and haemoglobin measurements. Descriptive analysis using means, frequency and proportions was computed. Chi-square test (p<0.05) and odds ratio with corresponding 95% confidence interval was used to determine the association between independent and dependent variables. Multivariable logistic regression analysis was performed to determine the independent factors associated with anaemia in these pregnant women. Results: The findings of the study revealed that the prevalence of anaemia among the pregnant women was 57%. Of these, 2.7% were severely anaemic, 70.7% were moderately anaemic and 26.5% were mildly anaemic. Multivariable logistic regression analysis revealed that advanced maternal age (31yrs and above) [AOR=2.71; P=0.012], government or private employed [AOR=2.94; P=0.002] and self-employed [AOR=1.91; P=0.039], not taking iron and folic acid supplementation during the current pregnancy [AOR=2.04; P=0.016] and having mid upper arm circumference of less than 23cm [AOR=2.52; P=0.003] were factors independently associated with anaemia. Conclusion: The prevalence of anaemia among pregnant women at Pumwani Maternity Hospital was 57% which is a severe public health problem. The study revealed that anaemia during pregnancy is caused by many factors, including late pregnancy, lack of formal employment and xvi economic autonomy, poor nutritional status and not taking iron and folic acid supplementation during pregnancy. All these factors lead to poor health condition during pregnancy thus by the time such mothers attend for ante natal clinic, they are already in anaemic state. Recommendations: Reproductive advice and education should be given to all reproductive age women to create awareness about the risk of developing anaemia with late pregnancy. Employed pregnant women should be given enough maternity leave before and after delivery from their employers. There is a need for interventions such as mass media campaigns, outreach education, life skill programmes to educate women on the importance of early ante natal clinic booking and compliance with the use of prescribed medications, consumption of more diversified extra meal and iron-rich foods during pregnancy than usual.