A Study to Assess the Prevalence of Maternal Anemia and Factors Associated with Anemia among Pregnant Women in Trichy District, Tamilnadu, India.

 

Mrs. Therese P1, Dr. Mrs. S. Revathi2

1Principal, Keerrai Thamilselvan College of Nursing, Pudukkottai, Tamilnadu.

2Principal (Former), College of Nursing, JIPMER, Puducherry.

*Corresponding Author Email: petertherese77@gmail.com

 

ABSTRACT:

Title:  A study to assess the prevalence of maternal anemia and factors associated with anemia among pregnant women in Trichy district, Tamilnadu, India.

Objectives: To assess and associate the prevalence of maternal anemia and factors associated with anemia among pregnant women.

Method: A descriptive cross sectional study design was used..One hundred and sixty five pregnant women were selected by convenient sampling technique. Permission was obtained from the head’s of department, at Trichy District.  Hemoglobin estimation was done by sahli’s method to the pregnant women who attended antenatal clinic between 12-20 weeks of gestation. Demographic proforma was used for data collection.

Results: The data were organized, tabulated, and analyzed by using descriptive (Percentage, Mean) and inferential statistics (chi-square). The results of the study shows that, majority of the subjects 89.09% were in the age group of 20-30 years, 41.21% of them had high school education,  59.39 % of them were primi women, and  50.90% of them had weight as 41- 50 kg. Regarding prevalence of maternal anemia, 62.42% of them had mild anemia, 37.57% of them had moderate anemia and none of them had severe anemia as well as no anemia. There were significant association of maternal anemia with age, education, parity, and weight of women.

Conclusion: Anemia is more in the age group of 20-30 years. Health education plays a major role in adapting positive health behavior against the factors which influences anemia and its effects during pregnancy. Nurses have a great opportunity to counsel the pregnant women to prevent from anemia by advising them to consume green leafy vegetables daily in their diet along with vitamin ‘C’ rich food as preventive approach.

 

KEYWORDS: Prevalence, Maternal Anemia, factors, associated with anemia, pregnant women.

 

INTRODUCTION:

Anemia has been a very important nutritional disorder in the world. India has a big chunk of population suffering from anemia. India has reported high prevalence of anemia in pregnancy. It was estimated that 87% of the Indian pregnant women are anemic. This figure is the highest among the neighboring South East Asian countries.1

 

The extent to which maternal anemia affects maternal and neonatal health is still uncertain. It has long been recognized that anemia is a major public health problem especially among poorer segments of the population in developing countries such as India, Pakistan and Bangladesh (World Health Organization1992). Anemia that complicates pregnancy threatens the life of both the mother and the fetus.2

 

The incidence of anemia ranges between 20 and 30% in the middle income groups, it is much higher in the lower income groups-60% (urban women) and 70%. rural women).3 Anemia is the commonest problem in pregnancy in developing countries. It is defined by WHO as hemoglobin level less than 11gms% in pregnancy. It is divided in to three degrees mild degree (9.0-10.9gm %) moderate degree (7.0- 8.9gm %) and severe degree (<7.0gm %). It carries a lot of threats to the mother as well as baby.4

 

NEED FOR THE STUDY:

Anemia is a condition in which the hemoglobin level is below normal and insufficient to meet physiologic needs. The World Health Organization (WHO) estimates anemia as a major public health problem with almost 2 billion people having anemia below normal values. India continues to be one of the countries with very high prevalence. National Family Health Survey (NFHS-3) reveals the prevalence of any anemia to be 55.3%.5 According to WHO, in developing countries the prevalence of anemia among pregnant women averages 56%, ranging between 35 to 100% among different regions of the world. Various studies from different regions of the country (India) have reported the prevalence of anemia to be between 33 and 100%. In India, anemia is the second most common cause of maternal deaths, accounting for 20% of total maternal deaths. Prevalence was found to be more in the age group of 41-45, among women with parity index more than 4 and among women with birth interval less than 2 years between two births. The significant association between parity index and prevalence of anemia calls for measures to limit the number of births by improving the family planning services in rural areas.6 The prevalence of anemia was higher in pregnant women who were farmers and with less education, higher gravidity or parity.7 Thus, the study was conducted to assess the prevalence of maternal anemia and factors associated with anemia among pregnant women.

 

STATEMENT OF THE PROBLEM:

A study to assess the prevalence of maternal anemia and factors associated with anemia among pregnant women in Trichy district, Tamilnadu, India.

 

OBJECTIVES:

·        To assess the prevalence of maternal anemia and factors associated with anemia among pregnant women.

·        To associate the prevalence of maternal  anemia and factors associated with anemia among pregnant women.

 

MATERIALS AND METHODS:

A quantitative non experimental approach was used. A descriptive –cross sectional study design was used for this study. The study was conducted in Primary Health Centre at Trichy district, Tamilnadu, India. The target population of this study was pregnant women. Permission was obtained from the concerned authority, at Trichy District. One hundred and sixty five pregnant women who have attended antenatal clinic between 12-20 weeks of gestation in Primary Health Centre, at Trichy District were selected as sample. Sample size was determined by 4pq  /d.2

 

Convenient sampling technique was used for the study. The demographic proforma was used for data collection. It consists of age, education, religion, parity, spacing interval, weight and height of the women, and Hemoglobin level. Hemoglobin estimation was done by sahli’s method. After data collection,, the data were organized, tabulated, and analyzed. Descriptive statistics (Percentage, Mean) was used to assess the prevalence of maternal anemia and factors associated with anemia among pregnant women and inferential statistics (chi-square) was used to associate prevalence of maternal anemia with age, education, religion, parity, spacing, weight and height of antenatal women.

 

RESULTS:

Table.1. Distribution of demographic characteristics of the pregnant women.

Demographic variables

Frequency

Percentage

Age( in years)

 

 

Below 20

6

3.63

20-30

147

89.09

Above 30

12

7.27

Education

 

 

Illiterate

10

6.06

Primary school

8

4.84

Middle school

15

9.09

High school

68

41.21

Higher secondary school

60

36.36

Graduates

4

2.42

Religion

 

 

Hindu

139

84.24

Christian

22

13.33

Muslim

4

2.42

Parity

 

 

Primi

98

59.39

Multi

67

40.60

Spacing Interval

 

 

< 2years

25

37.31

>2years

42

62.68

Weight of women (in kg)

 

 

≤40

10

6.06

41-50

84

50.90

51-60

40

24.24

>60

31

18.78

Height( in cm)

 

 

≤145

19

11.51

146-150

34

20.60

151-160

94

56.96

>160

18

10.90

 

 

Table.2 Distribution of anemia among pregnant women according to their religion

 

Degree of  Anemia

Normal

Total

Mild Anemia

Moderate  Anemia

Severe Anemia

f                               %

f                  %

f                   %

f            %

Hindu

81

49.09

58

35.15

-

-

-

-

139

Christian

20

12.12

2

1.21

-

-

-

-

22

Muslim

1

0.60

3

1.81

-

-

-

-

4

Total

103

62.42

62

37.57

-

-

-

-

165

 

 

Degrees of Anemia among Pregnant Women

 

Table.3.Association between maternal anemia and demographic variables.

Demographic variables

Mild Anemia

Moderate anemia

Severe Anemia

DF

χ2

Age in years

 

 

 

 

1

 

5.383*

Below 20-30

101

52

-

Above 30

2

10

-

Education

 

 

 

 

5

 

22.97*

Illiterate

3

7

-

Primary school

2

6

-

Middle school

10

5

-

High school

35

33

-

Higher secondary school

50

10

-

Graduates

3

1

-

Parity

 

 

 

 

1

 

5.644*

Primi

68

30

-

Multi

35

32

-

Religion

 

 

 

 

2

 

12.10*

Hindu

82

57

-

Christian

20

2

-

Muslims

1

3

-

Weight of women (in kg)

 

 

 

 

3

 

20.02*

≤40

6

4

-

41-50

39

45

-

51-60

35

5

-

>60

23

8

-

*Significant at 0.05 level

 

DISCUSSION:

·        The study finding in Table.1 shows the distribution of demographic characteristics of the pregnant women. Out of 165 pregnant women, majority of the subjects 89.09% were in the age group of 20-30 years, 41.21% of them had high school  education,  59.39 % of them were primi women, and 50.90% of them had weight as 41- 50 kg.

·        The degree of anemia among pregnant women according to their religion. 49.09% and 35.15% of the Hindu pregnant women, 12.12% and 1.21% of the Christian pregnant women and 0.60% and 1.81% of the Muslim pregnant women had mild and moderate anemia. The study findings was associated with Biswash M and Baruah R(2014) 8 revealed that a high prevalence of anemia among Pregnant Hindu women as compared to Muslim women. Religion itself is not the sole factor but different food taboos, customs, beliefs, habit, different dietary pattern. 8

·        The prevalence of anemia among pregnant women revealed that 62.42% of them had mild anemia, 37.57% of them had moderate anemia and none of them had severe anemia as well as no anemia. In this study, no pregnant women have entered into severe anemic and it indicates that pregnant women from rural areas utilized antenatal care services. The finding of the study was consistent with Ansari NB, et al (2008) 9 shows the prevalence of anemia in these subjects was 90.5%; of these, 75.0% had mild anemia and 14.8% had moderate anemia. Only 0.7% were severely anemic.9

·        There were significant association of maternal anemia with age (χ2=5.383), education (χ2=22.97) parity (χ2=5.644), and weight of women (χ2=20.02).The study was similar to Baidoo  S. E , etal(2010).6

CONCLUSION:

Anemia is more in the age group of 20-30 years. Health education plays a major role in adapting positive health behavior against the factors which influences anemia and its effects during pregnancy. Nurses have a great opportunity to counsel the pregnant women to prevent from anemia by advising them to consume green leafy vegetables daily in their diet along with vitamin ‘C’ rich food as preventive approach.

 

REFERENCES:

1.       Kumar KJ, et al., Maternal anemia in various trimesters and its effect on newborn weight and maturity: An observational study. Int J Prev Med. 2013; 4:193-9.

2.       Lone FW, et al, Maternal anaemia and its impact on perinatal outcome, Tropical medicine and international health, volume 9 no 4 pp 486–490 April 2004.

3.       Daftary SN, and Desai S V, Obstetric and Gynecology for postgraduate students and practitioners, First edition, New Delhi, 2003, 1-3

4.       Kapur D, et al, Nutritional Anemia and ITS Control, Springer link Date 2003, October; 13: Saturday.

5.       Kamath R, et al, Prevalence of Anemia among Tribal Women  Age in Udupi Taluk, Karnataka. Journal of Family Medicine and Primary Care 346 Oct-Dec 2013 : Volume 2 : Issue 4.

6.       Baidoo S. E et al Intestinal helminth infection and anaemia during pregnancy: A community based study in Ghana. African Journal of Microbiology Research Vol. 4(16), pp. 1713-1718, 18 August, 2010.

7.       Pavord S et al, UK Guidelines on the Management of Iron Deficiency in Pregnancy, British Committee for Standards in Haematology, July 2011.

8.       Biswash M and Baruah R, Maternal anaemia associated with socio-demographic factors among pregnant women of Boko-Bongaon Block Kamrup, Assam, Indian Journal of Basic and Applied Medical Research; March 2014: Vol.-3, Issue- 2, P.712-721.

9.       Ansari NB, et al, Anemia Prevalence and Risk Factor in Pregnant Women in an Urban area of Pakistan. Food Nutr Bull 2008 Jun; 29(2):132-9.

 

 

 

 

Received on 06.09.2014           Modified on 07.10.2014

Accepted on 15.10.2014           © A&V Publication all right reserved

Int. J. Adv. Nur. Management 2(4): Oct. - Dec., 2014; Page 231-234