Determinants of anaemia in pregnancy among women attending Mosoriot Sub-County Hospital, Nandi County, Kenya

Abstract

Background: The global prevalence of Anaemia in Pregnancy (AIP) stands on average at 41.8% and 61.8% in Africa contributing to 20% maternal deaths and increased risks of morbidity, stillbirths, foetal low-birth weight, and neonatal morbidity and deaths. Despite improvements in access and provision of free prenatal care, the prevalence of AIP in Kenya is at 57%. The research was to study several contributing factors to current anaemia levels and their identification to support the improvement in prenatal care and the promotion of positive birth outcomes in the sub-county hospital Objectives: The objectives were to determine the prevalence of AIP; describe the socio-demographic and clinical factors of AIP; explore the commonly used interventional services for AIP and describe the birth outcomes of both mother and baby with AIP at Mosoriot Sub-County Hospital. Methods: This was a retrospective review of medical records of women who had delivered at Mosoriot Sub-County Hospital in 2018. A total of 624 records with correctly recorded Hb levels was the study sample. Descriptive statistical data were analysed using measures of central tendency, mean and standard deviation for continuous variables and frequency for discrete variables. Chi-square inferential analytical statistic was used to measure the associations between the dependent and independent variables at a 95% level of confidence and 0.05 margin of error. Results: A total of 400 records were reviewed and the prevalence of AIP was 64% during the study period. The mean Hb was 11.68 g/dl. The proportion of women aged 20 - 34 years was 35%. The age categories 25 – 29 and 40 – 44 years were significantly predisposed to AIP POR: 2.10 (CI 0.58-7.64) and 5.4 (0.03-3.6) respectively. There was a significant association between age and AIP; X2 = 5, p=. 005. Logistic regression showed the following variables to be significantly associated with AIP: rural residence POR; 2.36 (CI 0.17-2.4), the primary and secondary level of education POR;1.86 (0.67-5.16) and 1.69 (CI 0.63-4.6) respectively. The proportion of women who had used iron or folic acid supplementation was 96% and those who used insecticide-treated mosquito nets were 22%. The common outcomes of women with AIP were normal deliveries (94%) and mild to severe blood loss (14%). Important foetal outcomes included underweight babies and birth asphyxia at five minutes (2.8%). Conclusion: The prevalence of AIP was higher than the national and Nandi County average Most women who had mild anaemia were married, had achieved the primary level of education, were housewives with at least one child. Elderly women were more predisposed to AIP. There was significant use of mineral supplements among these women with few using mosquito nets. Under-weight and asphyxia were the major birth outcomes. Recommendations: There was a need to scale up the awareness of the AIP contributing factors. The study advocates for use of specific recommended interventions and targeted support programs to reduce sociodemographic and health barriers that predispose pregnant women to AIP.