Magnitude and associated factors of anemia among pregnant women in Dera District: a cross-sectional study in northwest Ethiopia

BACKGROUND: Anemia is associated with adverse health and socio-economic consequences among pregnant women. Particularly, severe anemia increases the risk of maternal mortality by 20%. However, literatures are scarce in the northwest Ethiopia. Therefore, this study aimed to determine the magnitude and associated factors of anemia among pregnant women attending antenatal care in Dera District, South Gondar Zone, northwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted in Dera District health centers from June 27 to September 2, 2015. Capillary blood samples were taken from 348 pregnant women. The raw measured values of hemoglobin were obtained using the portable Hb301 instrument and adjusted for altitude. Besides, nutritional status of the women was assessed by the mid upper arm circumference (MUAC) taken on non-dominant upper limb, mostly of the left hand. Socio-demographic factors, obstetric history, environmental related factors and dietary intake were collected by interviewing the pregnant women. A multivariate logistic regression analysis was employed to identify factors associated with anemia. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was computed to show the strength of association. In multivariable analysis, a P value of <0.05 was used to declare statistical significance. RESULTS: The overall prevalence of anemia among pregnant women was 30.5% [95% CI 21.0, 40.0]. The result of multivariable analysis revealed that the likelihood of anemia was higher among pregnant women living in rural areas [AOR = 3.03, 95% CI 1.17, 7.82], had no latrine [AOR = 4.75, 95% CI 1.15, 16.60], low monthly income: <Eth. Birr 1200 (US dollar 52.22) [AOR = 2.56, 95% CI 1.17, 5.60], five or above parity [AOR = 4.17; 95% CI 1.62, 10.69], MUAC < 23 cm [AOR = 4.97; 95% CI 2.61, 9.43] and did not prenatal take iron supplementation [AOR = 5.63; 95% 2.21, 14.32]. CONCLUSION: So far in the district, the magnitude of anemia existed as a moderate public health concern. Thus, improved socio-economic status, latrine and maternal iron supplementation coverage are essential to mitigate the high burden of anemia. In addition, nutritional counseling and education on the consumption of extra meals and iron-rich foods should be intensified.