Determinants and Pattern of Anaemia in Pregnancy at Booking in Federal Medical Centre Owerri, South-East, Nigeria

Objective: To determine the prevalence of anaemia, the associated risk factors and the red cell morphological pattern among pregnant women at booking in Federal Medical Centre Owerri.

Materials and Methods: A cross-sectional descriptive study of 400 women at the booking clinic over a 12-week period was done. Pretested structured questionnaire was used to obtain their biodata, obstetric and medical histories with the help of 2 trained assistants. The results of other routine antenatal investigations were obtained and filled on the questionnaire. The venous blood sample collected from each woman under aseptic condition was taken to the haematology laboratory where a full blood count was done with an ERMA PCE-210 auto haematology analyser to obtain the haemoglobin concentration and red cell indices of each woman. Also, a peripheral blood film was made from each sample for red cell morphology analysis using light microscopy. Data obtained was analysed with the IBM® SPSS® statistical package version 20.

Results: The mean haemoglobin concentration was 10.9 ± 1.5g/dl and 55.5% of all the women were anaemic (haemoglobin concentration < 11g/dl). Anaemia was significantly related to level of education (p = 0.02), low socioeconomic class (p =0.04), HIV-positive status (p =0.001), history of fever in the index pregnancy (p = 0.04), history of excessive menstrual flow prior to pregnancy (p = 0.002) but only history of anaemia in the last pregnancy (OR = 0.39; p = 0.03; 95% CI = 0.17 – 0.89) and HIV-positive status (OR = 0.12; p = 0.05; 95% CI = 0.02 – 0.99) were found to be independent determinants of anemia. The commonest red cell morphology on blood film was microcytosis and hypochromasia among the anaemic women suggesting iron deficiency anaemia.

Conclusion: Correction of anaemia and replenishment of iron stores should be ensured during postnatal and preconception care; Women need to be more economically empowered and advocacy for prevention and improved management of HIV among reproductive-aged women, early antenatal booking, proper management of febrile illnesses in pregnancy, and fortification of stable foods with iron.