Prevalence and factors associated with anemia at fourteen weeks post-delivery in mothers attending child health clinic at Webuye Hospital

Abstract

Background: Anaemia is a major cause of morbidity and mortality in developing countries. Globally, 29.4 % women of the reproductive age group are anaemic while in Kenya the prevalence was 25% in 2013. Anaemia in the postpartum period has not been widely described as most of the studies have concentrated on anaemia in pregnancy. Our literature search yielded scarce data on prevalence and factors associated with postpartum anaemia for Western Kenya. Objective: To determine the prevalence and factors associated with anaemia at fourteen weeks post-delivery in mothers attending child health clinic at Webuye County Hospital. Study Methods: This was a cross-sectional study carried out at the child health clinic at Webuye County Hospital in Bungoma County. Mothers fourteen weeks postdelivery who brought their children for immunizations and fulfilled the criteria were enrolled. Using a systematic random sampling technique, 245 mothers were recruited. Data were collected using a pre-tested interviewer-administered questionnaire. Secondary data were extracted from the mother-child clinic booklet. At the end of the interview, Mission Plus Hemoglobin Testing System device was used to test haemoglobin using a 10 micro-litre blood finger prick sample. Data were verified and cleaned before entry into my personal computer in Microsoft Excel software. The analysis was carried out in STATA version 14. Median, frequencies and proportions were generated. Chi-square test was used to check for associations for categorical variables. Multiple logistic regression was used to adjust for confounders. A paired ttest was used to compare the significance of the mean difference of haemoglobin level during the entire ANC and at 14 weeks post-delivery. The level of significance was p<0.05. Results: The median age was 26 years (IQR 22,31), 86.5% were married. The prevalence of anaemia at 14 weeks post-delivery was 26.94% (95% CI:21.34,32.53. Haematinics use during pregnancy and post-delivery was 63.27 % and 17.6% respectively. Place of delivery was associated with postpartum anaemia with those who had delivered at home having the highest rates of postpartum anaemia (44.4%), p=0.03. On multiple logistic regression, adjusting for the place of delivery, age and marital status, women who delivered at home, their odds of developing anaemia was 2.365 times that of women who delivered in a health facility (p=0.041;95% CI: 1.036- 5.399). The difference in mean haemoglobin at 14 weeks post-delivery and antenatal care was -0.871(95% CI: -1.116, -0.627). The mean haemoglobin at 14 weeks postdelivery was higher than at antenatal care and the difference was statistically significant (p<0.001). Conclusions: The prevalence of anaemia in the postpartum period was 26.94%. This is lower than the global prevalence of 29.4%, however, it is in the same range as the Kenya national prevalence of 25%. The haematinics use of 63.27% during ANC is lower than the National uptake of 68.7%. Haematinics use post-delivery was low at 17.6%. Women who had delivered at home had higher rates of anaemia compared to those who delivered in a health facility. The mean haemoglobin at 14 weeks postdelivery was higher than the entire Antenatal Care Clinic period. Recommendations: All postnatal mothers should be screened for anaemia during postnatal care visit at 14 weeks post-delivery. Health facility delivery should be encouraged during antenatal care clinic visits. Iron and folic acid supplementation as an intervention to reduce the prevalence of anaemia prevalence should be strengthened during the antenatal and postnatal period.