Abstract
BackgroundIron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. Although there is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a very limited understanding of factors associated with iron consumption among Pakistani pregnant women. Thus, this study aimed to investigate the predictors of iron consumption for at least ≥90 days during pregnancy in Pakistan.MethodsWe analyzed dataset from the nationally representative Pakistan Demographic Health Survey 2017–2018. The primary outcome of the current study was the consumption of iron supplementation for ≥90 days during the pregnancy of the last birth. Women who had last childbirth 5 years before the survey and who responded to the question of iron intake were included in the final analysis (n = 6370). We analyzed the data that accounted for complex sampling design by including clusters, strata, and sampling weights.ResultsAround 30% of the women reported consumed iron tablets for ≥90 days during their last pregnancy. In the multivariable logistic regression analysis, we found that factors such as women’s age (≥ 25 years) (adjusted prevalence ratio (aPR) = 1.52; 95% CI: 1.42–1.62)], wealth index (rich/richest) (aPR = 1.25; [95% CI: 1.18–1.33]), primary education (aPR = 1.33; [95% CI: 1.24–1.43), secondary education (aPR = 1.34; [95% CI: 1.26–1.43), higher education (aPR = 2.13; [95% CI: 1.97–2.30), women’s say in choosing husband (aPR = 1.68; [95% CI: 1.57–1.80]), ≥ five antenatal care visits (aPR =2.65; [95% CI (2.43–2.89]), history of the last Caesarian-section (aPR = 1.29; [95% CI: 1.23–1.36]) were significantly associated with iron consumption for ≥90 days.ConclusionThese findings demonstrate complex predictors of iron consumption during pregnancy in Pakistan. There is a need to increase the number of ANC visits and the government should take necessary steps to improve access to iron supplements by targeting disadvantaged and vulnerable women who are younger, less educated, poor, and living in rural areas.
Highlights
Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan
There is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a dearth of research on the factors associated with iron consumption among women during pregnancy
There is some evidence on the predictors of iron deficiency anemia among Pakistani women [21, 22, 29], there is a very limited understanding of the factors associated with iron consumption among women, in general, and during pregnancy, in particular, due to a dearth of studies in this area at the national level
Summary
Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. It is estimated that around 120,000 maternal deaths are attributed to severe iron deficiency anemia each year in LMICs [3, 4]. Iron deficiency anemia can lead to adverse perinatal outcomes, such as miscarriage, hemorrhage, macerated and fresh stillbirths, fetal growth retardation, low-birth weight, preterm birth, and neonatal death [5,6,7,8]. 44% of preterm births, 25% of babies with low birth weight, and 21% of perinatal mortality are due to anemia during pregnancy in LMICs [10]. A study based on the World Health Organization (WHO) multi-country survey reported that there is a two-fold increase in risk of maternal mortality due to severe anemia [11]. The findings from a review found that maternal mortality can be plummeted by 29% with each 10 g/L increase in the hemoglobin of women [12]
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