Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania

• Published in: PloS one Vol. 13; no. 12; p. e0208413
• Main Authors: Msemo, Omari A, Bygbjerg, Ib C, Møller, Sofie L, Nielsen, Birgitte B, Ødum, Lars, Perslev, Kathrine, Lusingu, John P A, Kavishe, Reginald A, Minja, Daniel T R, Schmiegelow, Christentze
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18-12-2018; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Age; Alanine; Analysis; Anemia; Anemia - complications; Anemia - epidemiology; Anthropometry; Archives & records; Arm circumference; Biology and Life Sciences; C-reactive protein; Confidence intervals; Cross-Sectional Studies; Cyanocobalamin; Female; Ferritin; Folic acid; Health care facilities; Health risks; Hemoglobin; HIV; Households; Human immunodeficiency virus; Humans; Identification methods; Immunology; Infections; Iron; Iron deficiency; Laboratories; Malaria; Malaria - blood; Malaria - complications; Malaria - epidemiology; Medical research; Medicine and Health Sciences; Methods; Nutrient deficiency; Nutrition; Occupational health; Parasitology; Population; Pregnancy; Pregnancy Complications, Hematologic - epidemiology; Pregnancy Complications, Infectious - blood; Pregnancy Complications, Infectious - epidemiology; Pregnancy Outcome - epidemiology; Prevalence; Proteins; Public health; Regression analysis; Residence Characteristics - statistics & numerical data; Risk analysis; Risk Factors; Rural areas; Rural communities; Rural Population - statistics & numerical data; Social class; Statistical analysis; Studies; Tanzania - epidemiology; Vector-borne diseases; Vitamin B; Vitamin B12; Women's health; Womens health; Workers; Young Adult; Tanzania; Denmark; Aarhus Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0208413

Anemia is a major public health problem that adversely affects pregnancy outcomes. The prevalence of anemia among pregnant women before conception is not well known in Tanzania. The aim of this study was to determine the prevalence, types, and risk factors of preconception anemia in women of reproductive age from a rural Tanzanian setting.
Trained field workers visited households to identify all female residents aged 18-40 years and invited them to the nearby health facility for screening and enrolment into this study. Baseline samples were collected to measure hemoglobin levels, serum ferritin, vitamin B12, folate, C-reactive protein, alanine amino-transferase, the presence of malaria, HIV, and soil transmitted helminth infections. Anthropometric and socio-economic data were recorded alongside with clinical information of participants. Logistic regression analysis was used to determine the adjusted odds ratios (AOR) for the factors associated with preconception anemia.
Of 1248 women enrolled before conception, 36.7% (95% confidence interval (CI) 34.1-39.4) had anemia (hemoglobin <12 g/dL) and 37.6% (95% CI 34.9-40.4) had iron deficiency. For more than half of the anemic cases, iron deficiency was also diagnosed (58.8%, 95% CI 54.2-63.3). Anemia was independently associated with increased age (AOR 1.05, 95% CI 1.03-1.07), malaria infection at enrolment (AOR 2.21, 95% CI 1.37-3.58), inflammation (AOR 1.77, 95% CI 1.21-2.60) and iron deficiency (AOR 4.68, 95% CI 3.55-6.17). The odds of anemia were reduced among women with increased mid-upper arm circumference (AOR 0.90, 95% CI 0.84-0.96).
Anemia among women of reproductive age before conception was prevalent in this rural setting. Increased age, iron deficiency, malaria infection and inflammation were significant risk factors associated with preconception anemia, whereas increased mid-upper arm circumference was protective against anemia. Interventions to ensure adequate iron levels as well as malaria control before conception are needed to prevent anemia before and during pregnancy and improve birth outcomes in this setting.
NCT02191683.