INCIDENCE OF ANEMIA AND FOOD HABITS OF PREGNANT WOMEN AT BOOKING IN THE UNIVERSITY OF UYO TEACHING HOSPITAL

 

 

 

 

Anaemia describes a situation in which there is a reduction of haemoglobin concentration in the blood of pregnant women to a level below 11g/dl. Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population (WHO, 2008). Globally, anaemia affects 1.62 billion people (25%), among which 56 million are pregnant women (Balarajan, 2011). It is estimated that 41.8% of pregnant women worldwide are anaemic. At least half of this anaemia burden is assumed to be due to iron deficiency. Iron deficiency anaemia (IDA) is the most common nutritional disorder in the world affecting 2 billion people worldwide with pregnant women particularly at risk (WHO guideline, 2012). In developing countries, the prevalence of anaemia during pregnancy is 60.0% and about 7.0% of the women are severely anaemic (Agan et al., 2010). In Africa 57.1% of pregnant women are anaemic (de Benoist et al., 2008). Sub-Saharan Africa is the most affected region, with prevalence of anaemia estimated to be 17.2 million among pregnant women. This constitutes to approximately 30% of total global cases (WHO, 2008). In Nigeria the prevalence of anaemia among pregnant women is 55.1% and among nonpregnant women is 46.4% (Ministry of Health, 2013). Anaemia during pregnancy is considered severe when haemoglobin concentration is less than 7.0 g/dl, moderate when the haemoglobin concentration is 7.0 to 9.9 g/dl, and mild when haemoglobin concentration is 10.0 to 10.9 g/dl. When the prevalence of anaemia among pregnant women is 40.0% or more, it is considered as a severe public health problem (McLean et al., 2008).

Anaemia during pregnancy has a variety of causes and contributing factors. Iron deficiency is the cause of 75% of anaemia cases during pregnancy. Infectious diseases such as malaria, helminthes infestations and HIV are implicated with high prevalence of anaemia in sub-Saharan Africa (Tolentino and Friedman, 2007). Loss of appetite and excessive vomiting in pregnancy and heavy menstrual flow before pregnancy are also documented causes of anaemia during pregnancy. Socio-economic conditions, abnormal demands like multiple pregnancies, teenage pregnancies, maternal illiteracy, unemployment/underemployment, short pregnancy intervals, age of gestation, primigravida and multigravida, smoking, excessive alcohol consumption, are the main contributing factors of anaemia during pregnancy (Esmat et al., 2010).

Anaemia during pregnancy is a major cause of morbidity and mortality in pregnant women and infants in developing countries (Akhtar and Hassan, 2012). In 2013, an estimated 289,000 women died worldwide. Developing countries account for 99% (286 000) of the global maternal deaths with sub- Saharan Africa region alone accounting for 62% (179 000). About 800 women a day are still dying from complications in pregnancy and childbirth globally. Anaemia contributes to 20% of all maternal deaths. Anaemia in pregnancy causes low birth weight, fetal impairment and infant deaths. Iron deficiency anaemia affects the development of the nation by decreasing the cognitive and motor development of children and productivity of adults (Vivek et al., 2012).

Pregnancy is the period of dynamic change for a mother requiring a lot of care. During this period the fetus is nourished directly by the mother through placenta, and since the baby totally relies upon its mother for nourishment, the pregnant woman is to be provided with an adequate and well-balanced diet (Mudambi, 2012), to ensure that she attains an adequate weight. Proper dietary balance is necessary to ensure sufficient energy intake for adequate growth of fetus without drawing on mother’s own tissues to maintain her pregnancy (Mridula et. al., 2003).

Food is important for humans as part of social life and especially because it contains nutrients needed by humans. Unfortunately, people are not always able to access food, for various political, economic and geographic reasons. Food eaten in amounts that are too small, or too large, or that is unbalanced, results in malnutrition or diseases (WHO, 2010). Feeding habits among pregnant women is a major intrauterine environmental factor that alters expression of the foetal genome and may have life-long consequences (Guoyao et al., 2005). Alterations in foetal nutritional status may result in developmental adaptations that permanently change the structure, physiology and metabolism of the offspring, thereby predisposing individuals to metabolic, endocrine, and cardiovascular diseases in adult life (Guoyao et al., 2005). Maternal nutrition comprises of anthropometric factors such as pre-pregnancy weight for height  (body mass index (BMI) and gestational weight gain which partly reflects the balance between energy intake and energy expenditure, but also includes increases in body water, as well as intake of protein and micronutrients (Tannys et al., 2006).

A woman’s nutritional status has important implications for her health as well as the health of her children. Malnutrition in women results in reduced productivity, an increased susceptibility to infections, slow recovery from illness, and heightened risks of adverse pregnancy outcomes. In Nigeria, the prevalence of anaemia among pregnant women is 55.1%. If the prevalence of anaemia among pregnant women is 40.0% or more, it is considered as a severe public health problem (McLean et al., 2008). Anaemia is a major cause of morbidity and mortality in pregnant women and increases the risks of foetal, neonatal and overall infant mortality (Akhtar and Hassan, 2012). In 2013, an estimated 289,000 women died worldwide. Developing countries account for 99% (286 000) of the global maternal deaths with sub-Saharan Africa region alone accounting for 62% (179 000). About 800 women a day are still dying from complications in pregnancy and childbirth globally. Anaemia during pregnancy contributes to 20% of all maternal deaths (WHOb, 2015). 

However, several studies have shown that poor feeding habits is a leading cause of anemia among pregnant women. A pregnant woman with poor nutritional status has an increased risk of complications like anemia and adverse pregnancy outcomes such as postpartum hemorrhage, preterm births and fetal growth retardation which in turn increases the risk of prematurity and low birth weight. Pregnant women attending antenatal clinics in Nigeria are routinely put on iron supplementation throughout their pregnancy. However, the prevalence of anaemia among pregnant women is still high. This study therefore will assess the incidence of anemia and food habits of pregnant women at booking in the University of Uyo Teaching Hospital.

The general objective of this study is to assess the incidence of anemia and food habits of pregnant women at booking in the University of Uyo Teaching Hospital. 

The specific objectives of the study are to:

 

As data on prevalence and associated factors of anaemia remain important indicators of public health since anaemia is related to morbidity and mortality in the population especially pregnant women. The present study will be helpful to government and healthcare professional bodies as well as NGO’s in the management and control of anaemia in pregnancy by providing data on the prevalence of anaemia among pregnant women in the study area.  

This study aims at providing a link between feeding habits and anaemia among pregnant women at booking in University of Uyo Teaching Hospital, which will be helpful to nutritionist, healthcare workers, and aneamia patients in deciding eating habits and diets that are appropriate to manage the condition.