Clinical Dynamics of Anemia in Pregnancy: A 16-week Cross-sectional Study of Pregnant Women Who Attended Antenatal Clinic of Federal Medical Center, Keffi, Nasarawa State, Nigeria

Azubuike Uma Inya¹, Amaechi Peter Achara¹, Aloysius Obinna Ikwuka^2, , Francis Chigozie Udeh², Ukoma Chi-kadibia¹ and Ochima Onazi¹

¹Federal Medical Center (FMC), Keffi, Nasarawa State, Nigeria

²College of Medicine and Health Sciences, American International University West Africa, The Gambia

Cite this paper:
Azubuike Uma Inya, Amaechi Peter Achara, Aloysius Obinna Ikwuka, Francis Chigozie Udeh, Ukoma Chi-kadibia and Ochima Onazi. Clinical Dynamics of Anemia in Pregnancy: A 16-week Cross-sectional Study of Pregnant Women Who Attended Antenatal Clinic of Federal Medical Center, Keffi, Nasarawa State, Nigeria. American Journal of Clinical Medicine Research. 2023; 11(1):1-9. doi: 10.12691/ajcmr-11-1-1

Abstract

Background: Anemia in pregnancy is a global public health burden. It is the commonest medical disorder of pregnancy and a major cause of maternal and perinatal morbidity and mortality in most developing countries including Nigeria. Aim: To determine the prevalence of anemia and red cell morphological patterns amongst pregnant women attending antenatal clinic of Federal Medical Center, Keffi, Nasarawa State, Nigeria. Materials and Methods: This was a prospective, analytical study involving 415 women at the antenatal booking clinic for a period of 16 weeks. The Packed Cell Volume (PCV) also known as hematocrit, red cell morphology, HIV status and genotype of each pregnant woman were determined. Their biodata, obstetric and medical histories, and results of the routine investigations were documented with structured questionnaires and analyzed with statistical package for social science (SPSS) software (version 20, Chicago 11, USA). Continuous variables were presented as mean and standard deviation (mean±SD), while categorical variables were presented as numbers and percentages. Comparative analysis was done with chi-square test and the level of significance was set at p<0.05. The association between anemia and some social factors was tested using t-test. Results: Mean age of respondents was 29.7±5.3 years, mean BMI was 28.0±7.2kg/m², and mean parity was 1.9±1.7. Mean packed cell volume was 32.7±3.1% and 42.5% of the women were anemic. Specifically, 29.0% and 13.5% of the women had mild and moderate anemia respectively. The commonest blood picture was microcytic hypochromia and normocytic hypochromia suggesting iron-deficiency anemia. Anemia was significantly and independently related to educational level (p=0.00) and socio-economic class (p=0.00). Conclusion: Every pregnant woman should be encouraged to obtain antenatal care, where hematinic supplements can be given for prophylaxis of iron-deficiency anemia. Appropriate clinical investigations, treatment of fever and management of HIV should be instituted for pregnant women attending antenatal care whenever and wherever necessary.

Keywords:
Anemia iron-deficiency anemia dimorphic anemia red cell morphology pregnancy antenatal clinic risk factors prevalence

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Bassi AP, Idoko L, Dibigbo-Ibeaji NM et al. Prevalence of anaemia in pregnancy among women visiting antenatal clinic in Bingham University Teaching Hospital Jos, Nigeria. Clinical Medicine Research. 2016; 5(3): 52-62.
[2]	Agan TU, Ekabua JE, Udoh AE, Ekanem EI, Efiok EE, Mgbekem MA. Prevalence of anaemia in women with asymptomatic malaria parasitemia at first antenatal care visit at the University of Calabar Teaching Hospital, Calabar, Nigeria. International Journal of Women’s Health. 2010; 2(1): 229-233.
[3]	Bull BS, Lichtman MA, Beutler B, Kipps TJ, Seligsohn U, Kaushansky K, Prchal JT. Morphology of the Erythron, InWJ Williams (Ed), Williams Haematology, McGraw-Hill, USA. 2006; 369-385.
[4]	Arnolu RI, Oluwole AA, Abudu OO. Socio-demographic factors in anaemia in pregnancy at booking in Lagos, Nigeria. Journal of Obstetrics and Gynaecology. 2006; 28(6): 773-776.
[5]	De Benoist B, McLean E, Egli I, Cogswell M. Worldwide prevalence of anaemia 1993-2005. WHO Global Database on Anaemia. 2008. WHO Press, Geneva, Switzerland. Pp 7-25.
[6]	Harrison KA, John C, Stoffen B. Anaemia in pregnancy, Maternity care in developing countries. Royal College of Obstetrics and Gynaecology Press. 2001; 112-128.
[7]	Omigbodun OA. Recent trends in the management of anaemia in pregnancy. Tropical Journal of Obstetrics and Gynaecology, 2004; 21(1): 1-3.
[8]	Komolafe JO, Kuti O, Oni O, Egbewale BE. Socio-demographic characteristics of anaemic gravidae at booking; a preliminary study at Ilesha, Western Nigeria. Nigerian Journal of Medicine. 2005; 4(2): 151-154.
[9]	World Health Organisation. The prevalence of anaemia in women: A tabulation of available information. 2nd edition. Geneva WHO; 1992 (WHO/MCH/MSM/92.2).
[10]	Bukar M, Audu BM, Sadauki HM, Elnafaty AU, Mairiga AG. Prevalence of Iron Deficiency and Megaloblastic anaemia at Booking in a secondary Health facility in North-Eastern Nigeria. Nigerian Journal of Medicine. 2009; 50(2): 33-37.
[11]	Reviez L, Gyte GM, Cuervo LG. Treatments for Iron-deficiency anaemia in pregnancy. Cochrane Database of Systematic Reviews. 2007; 2: CD 003094.
[12]	Mclean E, Cogswell M, Egli I, Wojdyla D, DeBonist B. Worldwide prevalence of anaemia, WHO, vitamin and mineral nutrition information system 1993-2005. Public Health Nutrition. 2009; 12(4): 444-454.
[13]	Garner P, Gilmezoglu AM. Drugs for preventing malaria in pregnant women. Cochrane Database of Systemic Reviews. 2006; 4: CD000169.
[14]	World Health Organisation. Hookworm-related anaemia among pregnant women: A systemic review. A peer-review publication. 2008.
[15]	Udeh FC, Ikwuka AO, Epete MA, Igwe EC. Effects of Local Tobacco Snuff Ingestion during Pregnancy on Renal Functions and Histology Architecture of Female Wistar Rats and on the Birth Weight of Their Pups. American Journal of Medical Sciences and Medicine. 2023; 11(1): 1-5.
[16]	Mohammed YG, Emmanuel AU. The pattern of anaemia in Northern Nigerian Women. Journal of Medicine and Medical Sciences. 2013; 4 (8): 319-323.
[17]	Ikwuka AO, Virstyuk NG, Luchko OR, Kobitovych I. Heterogeneity Of Renal Pathogenicity On The Background Of Asymptomatic Hyperuricemia In Patients With Dual Metabolic Syndrome Diseases (Essential Hypertensive Disease and Type 2 Diabetes Mellitus). British Journal of Medical and Health Research. 2023; 10(2): 1-9.
[18]	Virstyuk NG, Ikwuka AO. Asymptomatic hyperuricemia and functional state of the kidneys in patients with essential arterial hypertension and concomitant diabetes mellitus type 2. European Journal of Clinical Medicine. 2021; 2(3): 100-104.
[19]	Virstyuk NG, Ikwuka AO. Nephropathic characteristics in patients with diabetes mellitus type 2 and essential hypertensive disease. Art of Medicine. 2019; 1(5): 44-47.
[20]	Virstyuk NG, Ikwuka AO. Features of asymptomatic hyperuricemia in patients with diabetes mellitus type 2 and concomitant essential arterial hypertension. Clinical and Experimental Pathology XVIІ. 2018; 1(63): 22-26.
[21]	Van den Broek NR, Letsky EA. Etiology of anaemia in pregnancy in south Malawi. The American Journal of Clinical Nutrition. 2000; 72(1): 247-256.
[22]	Esike CO, Anozie OB, Onoh RC, Sunday UC, Nwokpor OS, Umeora OU. The prevalence of anemia in pregnancy at booking in Abakaliki, Nigeria. Tropical Journal of Obstetrics and Gynaecology. 2016; 33: 332-336.
[23]	Olusanya O, Okpere E, Ezimolehai M. The importance of social class in voluntary fertility control in developing countries. West African Journal of Medicine. 1985; 4: 205-207.
[24]	Dayyal D. Micro method for estimation of Packed Cell Volume (PCV) or haematocrit. Bioscience. 2018; Extracted from: https://www.bioscience.com.pk/topics/hemotology/item/782-micro-method-for-estimation-of-packed-cell-volume-pcv-or-hematocrit.
[25]	Dayyal D. Red cell morphology. Bioscience. 2017; Extracted from: https://www.bioscience.com.pk/topics/hemotology/item/799-red-cells-morphology.
[26]	Geelhoed D, Agadzi F, Visser L et al. Severe anaemia in pregnancy in rural Ghana: A case-control study of causes and management. Acta Obstetricia et Gynaecologica Scandinavica. 2006; 85(10): 1165-1171.
[27]	Hogue M, Kadar SB, Hogue E, Mugero C. Prevalence of anaemia in pregnancy at Greytown, South Africa. Tropical Journal of Obstetrics and Gynaecology. 2006; 23(1): 3-7.
[28]	Olatubosun OA, Abasiahai AM, Bassey EA, James RS, Ibanga G, Morgan A. Prevalence of anaemia among pregnant women at booking in the University of Uyo Teaching Hospital, Uyo, Nigeria. Biomed Research International. 2014; CD849080.
[29]	Scholl TO, Hediger ML. Maternal anaemia as a factor in prematurity and perinatal mortality. Scottish Medical Journal. 1994; 8: 134.
[30]	Buseri FI, Uko EK, Jeremiah ZA, Usanga EA. Prevalence and risk factors of anaemia among pregnant women in Nigeria. Open Journal of Haematology 2008; 2: 14-19.
[31]	Onoh RC, Ezeonu OP, Umeora OU, Onoh TJ, Anozie BO, Onyebuchi AK. Anaemia in pregnancy in Abakaliki, South East Nigeria. International Federation Gynaecology and Obstetrics Ireland. 2014; 125(3): 280-285.
[32]	Muguleta M, Zelalem A, Meseret A, Banlaku E. Prevalence and predictors of maternal anaemia during pregnancy in Gondar, Northwest Ethiopia. An Institutional based cross-sectional study. Hindawi Publishing Corporation Anaemia. 2013; 20(14): CD108593.
[33]	Dim CC, Onah HE. The prevalence of anaemia among pregnant women at booking in Enugu, South Eastern Nigeria. Medscape General Medicine. 2007; 9(1): 11 PMID: 18092018.
[34]	Dejere L, Matiyas Y, Weldesenbet S, Amanuel A, Mesfin W, Henock A, Misganaw B. Prevalence of anaemia among receiving antenatal care at Boditii Health Centre, Southern Ethiopia. Clinical Medicine Research. 2015; 4(3): 79-86.
[35]	Tadesse SE, Seid O, Mariam Y, Fekadu A, Wasihun Y, Endris K, et al. Determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, Northern Central Ethiopia, unmatched case-control study. PLoSONE. 2017; 12(3): e0173173.
[36]	Agarwal DK, Agarwal KN, Roychaudhary S. Targets in national anemia prophylaxis programme for pregnant women. Indian Paediatrics. 1988; 25: 319-22.
[37]	Rajamouli J, Ravinder A, SCK Reddy, Sujatha Pambi. Study on prevalence of anemia among pregnant women attending antenatal clinic at Rural Health Training Centre (RHTC) and Chalmeda Anand Rao Institute of Medical Sciences Teaching Hospital, Karimnagar, Telangana, India. International Journal of Contemporary Medical Research. 2016; 3(8): 2388-2391.
[38]	Elzahaf RA, Omar M. Prevalence of anaemia among pregnant women in Derma city, Lybia. International Journal of Community Medicine and Public Health. 2016; 3(7): 1915-1920.
[39]	World Health Organisation. Prevention and management of severe anaemia in pregnancy; report of a technical working group Geneva; WHO/FHF/MSH/1993; 5.
[40]	Nwizu EN, Iliyasu SA, Galadanci HS. Socio-demographic and maternal factors in anaemia in pregnancy at booking in Kano, Northern Nigeria. African Journal of Reproductive Health. 2011; 15(4): 33-41.
[41]	Chukwudebelu WO, Obi GO. Anaemia in pregnancy in Nigeria. Nigerian Medical Journal. 1979; 9: 221-223.
[42]	Ojo OA. The clinical features of anaemia in pregnancy in Ibadan. Journal of Nigerian Medical Association.1965; 2: 224-233.
[43]	Jackson DJ, Klee EB, Green SD, Mokili JL, Cutting WA. Severe anaemia in pregnancy; a problem of primigravidae in rural Zaire. Transaction of the Royal Society of Tropical Medicine and Hygiene. 1986; 80: 249-255.
[44]	Hinderaker SG, Olsen BE, Bergsjo P, Lie RT, Gasheka P, Kwale G. Anaemia in pregnancy in the highlands of Tanzania. Acta Obstetricia et Gynaecologica Scandinavica. 2001; 80:18-26.
[45]	Stoltzfus RJ. Iron deficiency: Global prevalence and consequences. Food and Nutrition Bulletin. 2003; 24(4): S99-S103.
[46]	Vanderjagt DJ, Brock HS, Melah GS, El-Nafaty AU, Crossey MJ, Glew RH. Nutritional factors associated with anaemia in pregnant women in northern Nigeria. Journal of Health, Population and Nutrition. 2007; 25(1): 75-81. PMID: 17615906.