Predictors of Anemia Among Pregnant Women Attending Public Healthcare Facilities in Bengaluru, South India

Abstract

Background and Aims Anemia in pregnancy leads to poor outcomes. The Indian government has reduced anemia only at a marginal level from 58 in the National Family Health Survey NFHS-3 to 50.4 in the NFHS-4 survey. This study aims to determine the predictors of anemia among pregnant women in the maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin MAASTHI cohort of Bengaluru. This will help provide valuable information to design the appropriate intervention to lower the prevalence of anemia.Method The study was nested in the MAASTHI cohort study in public health facilities in Bengaluru. The present study was a multi-center prospective cohort study. Pregnant women attending health facilities for antenatal care were included in the study after obtaining their written consent. Socio-demographic information obstetric details smoking status and alcohol consumption among participant and their spouse were noted. Social support psychosocial stress and detailed anthropometry were recorded. All eligible pregnant women were asked to undergo a blood hemoglobin and oral glucose tolerance test after the completion of 26 weeks of gestation.Results A total of 2447 study participants with a mean age of 24.28 plusmn 4.07 years were included in the study. The overall prevalence of maternal anemia was 44.4 N 1375. Among them 24 had mild Hb 10ndash10.9 gmdl 15.8 had moderate Hb 7-9.9gmdl and 0.4 had severe anemia Hb lt7gmdl. Multivariate analysis showed that obstetric factors such as parity had a significant association with anemia. In contrast nutrition-related factors such as not consuming iron and folic acid IFA supplements and being underweight were positively associated with anemia.Conclusion Our study found a higher prevalence of maternal anemia during pregnancy in urban Bengaluru. The government should take proactive health promotion initiatives such as effective campaigns and nutrition-specific interventions especially iron supplementation. Integrated dietary interventions such as food fortification with iron and folate and IFA supplementation targeting from childhood to adolescence and reproductive age rather than targeting pregnant women may help to reduce the burden of anemia.