Progression of anaemia during antenatal period among South African pregnant women

BACKGROUND: Anaemia in pregnancy is a known public health problem in South Africa. Maternal, perinatal morbidity and mortality are known to be associated with anaemia in pregnancy. Very little is known from literature with regards to the progression of anaemia during the antenatal period of pregnancy. OBJECTIVES: To estimate haemoglobin levels, the prevalence and determinants of anaemia at different gestational ages and to show the trend. METHOD: A retrospective cohort (follow-up) study was conducted using the antenatal clinic register. Prevalence rates of anaemia (haemoglobin < 11 g/dl) at different gestational ages were measured. Factors associated with anaemia were assessed using chi-square test and stepwise multivariate logistic regression analysis. RESULTS: A total of 801 pregnant women were enrolled at the booking visit and followed-up during their antenatal period. The prevalence of anaemia at the booking visit was 37%. The prevalence of anaemia at 20, 26, 32 and 36 weeks of gestation were 36.6%, 39.6%, 39.8% and 29.2% respectively. Binary logistic regression at the booking visit showed that teenage women were 2.5 times more likely to have anaemia (OR=2.5, p=0.005) than older women. Women who booked during the first trimester were 60% less likely to have anaemia (OR= 0.40, P=0.005) at the booking visit and 62% less likely to be anaemic at 36 weeks of gestation (OR=0.38, p=0.013) compared to those who booked late for antenatal care. CONCLUSION: Prevalence of anaemia during pregnancy was high. Early booking for antenatal care was a predictor for lower rate of anaemia. Thus, health education strategy should be encouraged for early antenatal booking.