Prevalence of anemia, hematocrit variations, and micronutrient supplementation practices among pregnant women attending antenatal clinics in Ibadan, Southwest Nigeria

Abstract

Background: Anemia is a prevalent complication of pregnancy that poses significant a risk to both maternal and fetal health, potentially leading to adverse pregnancy outcomes.  According to the World Health Organization (WHO), anemia is diagnosed when hemoglobin (Hb) levels are below 11g/dL, with nutritional deficiencies being the most common underlying cause.

Aim: This study aimed to evaluate the prevalence of anemia, the intake of common micronutrient supplements, and other factors influencing changes in hematocrit levels among pregnant women.

Patients and Methods: A cross-sectional study was conducted in antenatal clinics in Ibadan from January to February 2023. Data were collected from 309 pregnant women in their third trimester using a pre-tested, interviewer-administered questionnaire. The questionnaire captured socio-demographic details, obstetric characteristics, packed-cell volume, and the intake of micronutrient supplements. Descriptive statistics were performed, and paired sample t-test along with linear regression analyses were used to determine associations. Statistical significance was set at p < 0.05.

Results: The mean age of the participants was 30.49 ± 5.03 years, with the majority having tertiary education (77%) and identifying as Christians (57%). At the time of booking, 42.9% of participants were anemic, with a mean packed cell volume (PCV) of 33.46% (SD = 3.83). A significant reduction in anemia prevalence was observed during the interview, with 26.8% f participants classified as anemic (Mean PCV = 34.03, SD=2.90) [t (155) = 2.089, p = 0.038]. While 73.5% of participants reported adequate folic acid intake, only 51.1% consumed sufficient ferrous tablets. Fewer than 30% of participants reported adequate intakes of calcium, vitamin A and other micronutrients. Changes in hematocrit levels were not significantly associated with micronutrient intake but were significantly influenced by participants’ age group (p = 0.029), level of education (p = 0.041), and religion (p = 0.007).

Conclusion: The study observed a significant reduction anemia prevalence during the third trimester among participants, despite suboptimal micronutrient supplementation. This suggests the possible contribution of alternative sources of micronutrients, likely dietary, with age and educational attainment emerging as significant influencing factors.

Keywords: Anemia, hematocrit changes, micronutrients supplementation, pregnancy women.