Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria

Abstract

Anaemia in pregnancy is a major health problem and an important cause of adverse foetomaternal outcomes in developing countries. Iron deficiency is the cause of the overwhelming majority of the cases of anaemia in pregnancy. Iron deficiency anaemia (IDA) has been linked with adverse foetal and maternal outcomes. This study investigated the prevalence of IDA and evaluated its effects on foetomaternal outcomes among parturients in Lagos, Nigeria. This was a cross-sectional study that enrolled 220 women aged 15-49 years with singleton gestation at term, between May 1, 2016, and March 31, 2017. Participants were selected by systematic sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure haemoglobin and serum ferritin concentrations, and the associations between IDA (defined as anaemia and iron deficiency) and pregnancy outcomes were examined. A P-value <0.05 was considered as statistically significant. The prevalence of IDA was 12.3%. Routine antenatal iron supplementation (adjusted odds ratio 0.18, 95% confidence interval 0.07-0.46; P = 0.001) and interpregnancy interval of at least 2 years (adjusted odds ratio 0.20, 95% confidence interval 0.05-0.97; P = 0.021) have significant association with IDA. Iron deficiency anaemia was not significantly associated with adverse perinatal outcomes but there were significant associations with increased risk of blood transfusion (P = 0.001) and maternal infectious morbidities such as puerperal pyrexia (P = 0.041) and wound infection (P = 0.020). IDA is still a fairly common condition among parturients in Lagos and it's mostly associated with maternal peripartum morbidities. Adequate pregnancy spacing through the use of effective contraception and routine antenatal iron supplementations in pregnancy is a recommended preventive measure against IDA and its adverse sequelae. Future studies should adopt the use of transferrin saturation (TSAT) in compliment with serum ferritin assay as a more sensitive marker of iron deficiency.

The Role of Anemia in Term and Preterm Pregnancies: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)

“…In addition, positive association for preterm birth and anemia was evidenced in non-white women, living in the Northeast region, schooling years less than 8, presence of children below 5 years old, onset of prenatal care at second or third trimester and less than six prenatal care visits. These findings are consistent with literature as anemia is associated with poor access to antenatal care and low socio-economic condition [5,17,18]. In our country, non-white skin color and the Northeast region are associated with lower income regions and therefore associated with anemia [25].…”

“…Our results also found association with maternal age and the presence of anemia in preterm deliveries, as it was more frequent in pregnant adolescents. This is in agreement with the Chinese study that found higher prevalence of anemia in women under 20 [17]. In addition, positive association for preterm birth and anemia was evidenced in non-white women, living in the Northeast region, schooling years less than 8, presence of children below 5 years old, onset of prenatal care at second or third trimester and less than six prenatal care visits.…”

“…WHO's national estimates report anemia prevalence of 41.8% [4], higher than our results. Furthermore, our study presented higher prevalence of anemia then reported in a study in Lagos, Nigeria in 2020, that was 20.0% [17], higher than a multicenter Chinese study that found an overall prevalence of anemia of 23.5% [18], higher than a study conducted in Jerusalem with 10.5% of anemia [19] and higher than a large retrospective study in British Columbia that found anemia in 12.8% of its records [20]. The difference in findings throughout studies may represent the population analyzed as having anemia is more prevalent in low-income countries and in regions with poor antenatal care [21].…”

Prevalence and Determinants of Anaemia among Women aged 15-49 in Nepal: A Trend Analysis from Nepal Demographic and Health Surveys from 2006 to 2016

“…Anaemia prevalence is common around the globe but most prevalent in developing countries. Prevalence of anaemia was recorded higher in the South Asian and African continent than in other countries throughout the world (Ajepe et al, 2020).Global estimation indicated that three out of ten (29%) of non-pregnant women and more than one third (38%) were anaemic (Herzog et al, 2019;Kay et al, 2019). It is estimated that nearly half a billion of women from reproductive age are affected by anaemia (Wemakor, 2019).…”

Association between maternal dietary quality and gestational diabetes mellitus based on the Diet Balance Index for Pregnancy

“…During the survey, we were somewhat astonished to note that multiple pregnant women never prefer to consume animal entrails before pregnancy, which may be one of the reasons why the participants had such a severe iron-rich food deficiency during pregnancy. Since iron-rich food deficiency is related to premature, postpartum hemorrhage, and low birth weight, it is indispensable to augment the intake of ironrich foods during pregnancy [29,30]. Besides, soybean and its products, aquatic products, milk and milk products, eggs, and meats are generally considered favorable sources of high-quality protein and minerals, yet more than 60% of participants did not meet the recommended intake.…”