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Kumari et al. European Journal of Biomedical and Pharmaceutical Sciences
275
PREVALENCE OF ANEMIA AND KNOWLEDGE OF RISK FACTORS ABOUT ANEMIA
IN PREGNANT WOMEN: A STUDY AT PRIMARY HEALTH CENTERS IN RURAL
AREAS OF NORTH INDIA
Priyanka Kumari*1, Neetu2 and Amoldeep3
1Assistant Professor, M.M Institute of Nursing, Mullana, Ambala.
2,3Assistant Professor, M.M College of Nursing, Mullana, Ambala.
Article Received on 11/11/2017 Article Revised on 01/12/2017 Article Accepted on 21/12/2017
INTRODUCTION
Anemia is major health problems in developing
countries. In pregnancy, anemia is major public health
concern. Anemia is decrease in concentration of red
blood cells, which result in reduced in oxygen carrying
capacity of blood[1] whereas in pregnancy plasma volume
increase which lead to dilution of hemoglobin. Different
causes of anemia are reduced absorption of iron, dengue,
malaria, inadequate intake of diet, diarrhea, and
thalasemia, sickle cell anemia, excessive blood loss
during labor etc.[2,3] Anemia is commonly prevalent in
young children and pregnant women. Risk of iron
deficiency anemia will lead to perinatal and maternal
morbidity and mortality.[4] During pregnancy
hemoglobin concentration less than 7.0g/dl is consider
severe, moderate falls between 7.0 and 9.9 g/dlwhile
10.0 to 11g/dl is considered as mild anemia.[5,6] Intake of
elemental iron tablet (100mg) with 500mcg folic acid for
100 days will prevent the risk of iron deficiency anemia.
According to World Health Organization, female having
more risk of disability and adjusted life year (15 to 44
years) due to the iron deficiency.[7,8] Deficiency of
hemoglobin lead to 20% of total maternal deaths.[9] The
present research study was designed to estimate the
prevalence, knowledge on risk factors of anemia among
pregnant women attending primary health centers North
India. Therefore this study was conducted to assess
prevalence of anemia and knowledge of risk factors
about anemia in pregnant women.
MATERIAL AND METHODS
Study was conducted on the pregnant women who are
attending primary health centers by using purposive
sampling. Oral consent was taken from the mother. The
sampling procedure started in July 2016 and ended in
March 2017. Total sample of study subject was 250
pregnant women, interviewed by using self-structured
questionnaire, including prime gravid, second gravid and
multigravida. The tool used for the study was
demographic variable and structure knowledge
SJIF Impact Factor 4.382
Research Article
ejbps, 2018, Volume 5, Issue 1 275-279.
European Journal of Biomedical
AND Pharmaceutical sciences
http://www.ejbps.com
ISSN 2349-8870
Volume: 5
Issue: 1
275-279
Year: 2018
*Corresponding Author: Priyanka Kumari
Assistant Professor, M.M Institute of Nursing, Mullana, Ambala.
ABSTRACT
Background: Anemia is one of contributing factor for morbidity and mortality during pregnancy in developing
country and has fetal and maternal consequences. Growing baby depends completely on mothers for all needs.
Anemia is one of nutritional deficiency disorder and around 56% of women are suffering from anemia. Anemia is
one of the reasons for maternal deaths. The study was aimed to assess the prevalence of anemia and to determine
the knowledge of antenatal mothers regarding the risk factors of anemia during pregnancy. Material and
Methods: Research study was conducted on Antenatal women who were attending and admitted in primary health
centers. A sample size consists of 250 pregnant mothers were selected through non probability purposive
sampling. The data was collected by using pretested structured knowledge questionnaire, to assess the knowledge
of pregnant women regarding the risk factors of anemia during pregnancy. Shale’s haematin method is used to
assess the range of hemoglobin. Anemia was classified according to world health organization criteria. Data was
analyzed using SPSS v. 17. Result: Among 250 samples, the prevalence of anemia is 56.8% including mild,
moderate and severe anemia. The majority of pregnant mothers had poor 50%, 34.4% had satisfactory and 14.4
%had good and 1.2% had excellent knowledge on risk factors of anemia. Conclusion: Higher prevalence of
anemia indicate the regularly and strictly implementation of nutritional anemia programme in hospital and
community. By implementing educational teaching strategy will enhance the awareness about the prevention of
anemia among pregnant mothers.
KEYWORDS: Prevalence, Knowledge, Pregnant Mother, Anemia, Primary Health Centers.
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Kumari et al. European Journal of Biomedical and Pharmaceutical Sciences
276
questionnaire consisted 30 items. Shale’s haematin
method of hemoglobin was used for each pregnant
mother who was attending or admitted in Hospital. The
diagnosis of anemia were made as per the classification
of world health organization i.e hemoglobin
concentration less than 7.0g/dl is consider severe,
moderate falls between 7.0 and 9.9 g/dl and hemoglobin
concentration 10 to 11g/dl is considered mild anemia
among pregnant mother.
Inclusion criteria: The study subjects age of less than
18 years to >30 years. We had also observed the finding
of Hemoglobin from the diagnostic test.
Exclusion criteria: Study group exclude the women
who had bleeding disorder, or antepartum hemorrhage
and chronic medical disease were excluded.
Statistical analysis
Data were analyzed by using SPSS Version 17.0 and chi
square test for categorical data were performed. If p
<0.05, statistical value is consider significant.
RESULT
The total study sample comprised of 250 pregnant
women. Among them 142 pregnant women (56.8%)
suffered with mild, moderate and severe anemia. Table 1,
shows that high prevalence of anemia found in pregnant
women who belongs to age group 20-24 years, 55% of
pregnant women having low education status were found
to be anemic and 48% primigravida mothers have
anemia. Based on structured knowledge questionnaire
regarding the management of Anemia, Table 2 shows
that 86(34.4%) of pregnant women have average and 125
pregnant women (50%) of mothers have poor knowledge
for the prevention of anemia. Table 3 represent the Chi
square test association with knowledge on management
significant relation with religion (p<0.02), education
status of mother (p<0.001) and monthly income of
family (p<0.02). Significant socio demographic factor
affect the knowledge of risk factors of anemia.
Table. 1: Distribution of Anemia in Study Group According to Age, Education, Occupation & Parity.
Groups
Severity of Anemia
Normal
Mild
Moderate
Severe
Age group
F
N
%
N
%
N
%
N
%
< 20
6
1
0.4
1
0.4
3
1.2
1
0.4
20-24
116
40
16
30
12
40
16
6
2.4
25-29
102
52
20.8
30
12
16
6.4
4
1.6
30-34
23
13
5.2
5
2
3
1.2
2
0.8
35 and above
3
2
0.8
1
0.4
0
0
0
0
Education
Non-Literate
23
01
0.4
4
1.6
16
6.4
2
0.8
Primary education
113
58
23.2
20
8.0
34
13.6
1
0.4
Secondary education
66
27
10.8
29
11.4
9
3.6
1
0.4
Graduate and above
48
22
8.8
17
6.6
7
2.8
2
0.8
Parity
Primi Gravida
126
58
23.2
28
11.2
38
15.2
2
0.8
Multi Gravida
97
40
16
25
10
29
11.6
3
1.2
More than two
27
10
4
6
2.4
9
3.6
2
0.8
Table. 2: Frequency and Percentage Distribution in Terms of Knowledgescore regarding risk factors of Anemia
in Antenatal Mothers. N= 250
Level of Knowledge
Score
F
%
Excellent
24-30
3
1.2
Good
19-23
36
14.4
satisfactory
15-18
86
34.4
Poor
0-14
125
50
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Kumari et al. European Journal of Biomedical and Pharmaceutical Sciences
277
Table. 3: Association between Knowledge on management of anemia with Selected Sample Characteristics
among Pregnant women N=250.
Sr. No
Sample Characteristics
Knowledge Scores
df
Chi- square
p value
Above median
Below median
1
Age in (years)
18-19
03
03
4
2.22
0.69NS
20-24
75
40
25-29
59
45
30-34
11
09
35 and above
03
02
2.
Religion
Hindu
123
86
4
9.27
0.02*
Muslim
02
06
Sikh
24
06
Christian
02
01
Others
3.
Educational Status of mother
Non-Literate
08
13
3
16.42
0.001*
Upto Primary education
60
55
Upto Secondary education
42
20
Graduate and above
41
11
4.
Occupation
Self-employers
05
02
4
3.56
0.47NS
Private job
07
03
Government job
03
00
Home maker
135
94
Daily worker
0
00
5.
Monthly income of family(in rupees)
1001-5000
45
33
2
7.97
0.02*
5001-10,000
58
50
Above 10,000
48
16
6.
Gravida
Primi
85
45
2
2.98
0.23NS
Multi
48
41
More than two
18
13
7.
Trimester of current pregnancy
1st trimester
23
15
2
0.31
0.86NS
2nd trimester
59
42
3rd trimester
69
42
8.
Nature of current pregnancy
Single
150
98
1
0.09
0.76NS
Twin
01
01
Multiple
00
00
9.
Number of antenatal visit
1
31
20
2
0.04
0.98NS
2
50
34
3
70
45
10.
Number of living child
One
45
36
2
3.89
0.14NS
Two or above
23
21
None
83
42
11.
Type of previous delivery
Normal delivery
23
21
3
8.61
0.35NS
Caesarean section
07
13
Normal delivery with episiotomy
36
22
None
85
43
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Kumari et al. European Journal of Biomedical and Pharmaceutical Sciences
278
12.
Dietary pattern
Vegetarian
139
85
1
2.46
0.12NS
Non-vegetarian
12
14
13.
source of information
Through health care worker
11
30
3
2.256
0.52NS
Through Neighborhood
03
06
Through T.V.
13
35
Through newspaper
01
11
p< 0.05* (*significant)
p>0.05 (NS=Non Significant)
DISCUSSION
Anemia is common public health problem among the
pregnant women increased the risk of mortality as well
as morbidity. Present research study represents the
prevalence of anemia and risk factors of anemia. Out of
250 pregnant women 56.7% of pregnantwomenwere
suffering from anemia whereas same result was shown in
another research study of African countries.[10,11] Similar
study was conducted in one of the developed state of
India that is Maharashtra where registered prevalence of
anemia among antenatal women came out to be
56.4%.[12] Similarly According to the WHO reports are
showing56% of all women residing in developing
countries are anemic.[13] In India national Family health
survey-2 reported that 54% of women residing in rural
area and 46% of women residing in urban area are
anemic. In 1970, The National Nutritional anemia
prophylaxis programme was started targeting for
reducing the prevalence of anemia upto25%.[14]
Table 1, reveals that high occurrence of casesof anemia
found in pregnant women who belong to age group 20-
24 years, 55% of pregnant women having low education
status were found to be anemic and 48% primigravida
mothers have anemia. A similar study had been
conducted on sociodemographic and maternal factors in
anemia during pregnancy in Kerno, Northern Nigeria in
2009. The findings of the study revealed that age of the
pregnant women ranged from 15-45 years, nearly 11.3%
had no formal education. [15] In the present study majority
of pregnant women have poor knowledge 50% while
34% of pregnant mothers fall in average category
regarding the prevention of anemia. Similar study was
conducted by Venugopal BA, assessed the knowledge of
pregnant mothers regarding prevention of anemia. The
result shows that 38% had average knowledge and 8%
had good knowledge about anemia during pregnancy.[16]
Results of another shows that 59.9% of antenatal mothers
had good practices anemia in pregnancy.[17] Present study
shows the significant association with religion, education
status of mother and monthly income of family. Study
conducted in Gondar Northwest Ethopia and Addis
Ababa shows that socio demographic factors are also
responsible for the prevalence of anemia[18-21] Monthly
income of family also have significant relation with the
prevalence of anemia, which lead to inadequate diet and
risk of anemia among pregnant women.[21-22] Educational
status of women is also affecting the knowledge and lead
to the more risk of anemia in the pregnant women. Good
educational background have less risk of getting anemic
by taking nutritional diet compared to illiterate women.
This shows the significant association with the education
status in regards to anemic mothers.[23] The study is
limited to small group of pregnant women. More sample
of pregnant mother would help to determine the more
generalize result.
CONCLUSION
Prevalence of anemia was 56.8% among the antenatal
mothers.Anemia is one of public health problem in India,
which is by far higher than the nationalprevalence,
Religion, educational status of mother and income of
family, were significantly associated withanemia. Higher
prevalence of anemia indicate the failure of maternal and
child health programme to address this problem. Regular
supply of iron and folic acid tablets to adolescent and
pregnant women can rectify the nutritional deficiency.
Home based dietary management with food fortification
and balanced diet can also overcome with the problem of
anemia. Special emphasis by using primordial prevention
about the counseling on consumption of iron
supplementation as nutritional foods, birth spacing could
help to prevent the anemia amongpregnant women in
hospital and community. Early detection and
management strategy regarding anemia should be helpful
to prevent the further complication.
FINANCIAL SUPPORT AND SPONSORSHIP
Nil.
CONFLICT OF INTERESTS
The authors declare that they have no conflict of
interests.
ACKNOWLEDGEMENT
Researcher would like to thank the all pregnant mothers
who willingly contribute their time for this study.
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