Factors Associated With Anaemia in Pregnancy among Antenatal Care Attendants in Keta Municipality

Abstract

Background: Globally, anaemia in pregnancy has been a public health challenge, especially in developing countries like Ghana. Ghana has achieved remarkable decline in the prevalence of anaemia in pregnancy from 70% in 2008 to 45% in 2014. However, anaemia in pregnancy remains a threat to maternal and foetal outcomes. To reduce the risk, indigenous factors associated with anaemia must be identified. Few studies were conducted in Ghana, but no study was carried out in Keta Municipality in the Volta Region on factors associated with anaemia in pregnancy. Methods: Hospital-based cross-sectional study design was employed to determine the prevalence of anaemia in pregnancy and associated factors in Keta Municipality in the Volta region. Participants were pregnant women attending antenatal care at Keta Municipal Hospital and Sacred Heart Hospital between May and June, 2018. Pregnant women who consented to be part of the study, attended antenatal care for at least four times and were not haemotransfused four weeks prior to data collection were included in the study. Participants’ haemoglobin level were assessed by qualified phlebotomists. Structured questionnaires were used to collect information on sociodemographic, obstetric and behavioural characteristics, as well as nutritional adequacy using a 24-hour recall. Maternal haemoglobin levels at first and current visit were retrieved from antenatal record booklets. Current haemoglobin level was used as outcome variable for this study. Multivariable logistic regression was performed to determine associations between current haemoglobin level and independent variables at 95% confidence interval. Independent variables with p-value less than 0.05 were considered statistically significant. Results: A total of 426 pregnant women partook in the study. Out of 426 participants, 330/426 (77.5%) participants were anaemic (haemoglobin < 11 grams per deciliter). While 216/426 (50.7%) participants were moderately anaemic at first visit, 167/426 (39.2%) participants were moderately anaemic on day of interview (current visit). The median current haemoglobin level was 10.2 g/dl. Factors associated with anaemia in pregnancy were maternal age (AOR: 0.02, 95% CI: 0.00-0.53, p < 0.05), sickle cell status (AOR: 0.08, 95% CI: 0.02-0.44, p < 0.05), moderate anaemia at first visit (AOR: 5.1, 95% CI:1.19-21.74, p < 0.05), food taboos (AOR: 0.25, 95% CI: 0.06-0.96, p < 0.05) and mode of abortion (AOR: 4.58, CI: 1.14-18.46, p < 0.05). Conclusion: The prevalence of anaemia in pregnancy in Keta Municipality was high. Participants’ age, sickle cell status, moderate anaemia at first visit, food taboos and mode of abortion were significantly associated with anaemia in pregnancy.