Predisposing Factors of Anaemia among Pregnant Mothers with ≤ 12 Weeks of POA Receiving Antenatal Care in the Eastern Province of Sri Lanka

Abstract

Background: Anaemia in pregnant mothers is associated with increased rates of maternal and perinatal morbidity and mortality. Therefore, identifying predisposing factors of anaemia in pregnant mothers is essential for results based intervention modalities. The aim of this study was to describe the predisposing factors for anemia and its related factors among pregnant mothers. Objectives: To describe the prevalence and the predisposing factors for anemia in pregnant mothers in the Eastern Province. Methods: Simple descriptive cross-sectional study included 1334 pregnant mothers in first trimester. Pre-tested, structured questionnaire and Qualitative components such as Focus group discussion, In-depth interviews, and Key informant interviews were conducted to relevant participants and care providers. Results: The overall prevalence of anemia was 32.9% (439/1334). Among 439 mothers with anaemia, 87.24% had mild level anaemia, 12.53% had moderate level anaemia, and 0.23% with severe anaemia. Following factors were related to the high prevalence of anaemia among pregnant mothers such as recurrent miscarriages three or more, increased number of gravidity, marital age of less than 18 years, and pregnancy after the age of 30, mothers studied up to primary level of education and with body mass index of < 18.5. In-Depth Interview pointed numerous supporting issues such as less value for nutrition and it related diseases among service providers, availability and adequacy of services for nutrition awareness and modification. Discussion: Association of anaemia was found to be more significant in the age group of <20 years and >35 years. Analyzing possible predisposing factors shown, dietary habit, medical condition, number of pregnancy, and miscarriage are some positive contributing factors for anaemia during the pregnancy. Focus group discussion of PHM revealed service related issues such as inadequacy of facilities and manpower, maldistribution of service providers and area specific problems in remote areas. FGD conducted to pregnant mother’s revealed negligence by service provider, lack of communication, and less priority for nutrition enhancement are identified as predisposing factors. Both types of evaluation show the education status of mothers and spouse play key role of iron deficiency anaemia. They gave less priority for control of anaemia, even most of them not bother about their nutritional status.