Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria

PLoS One. 2020 Jan 23;15(1):e0227965. doi: 10.1371/journal.pone.0227965. eCollection 2020.

Abstract

Anaemia in pregnancy is a major health problem and an important cause of adverse foetomaternal outcomes in developing countries. Iron deficiency is the cause of the overwhelming majority of the cases of anaemia in pregnancy. Iron deficiency anaemia (IDA) has been linked with adverse foetal and maternal outcomes. This study investigated the prevalence of IDA and evaluated its effects on foetomaternal outcomes among parturients in Lagos, Nigeria. This was a cross-sectional study that enrolled 220 women aged 15-49 years with singleton gestation at term, between May 1, 2016, and March 31, 2017. Participants were selected by systematic sampling and baseline data were collected through interviews. Venous blood samples were obtained to measure haemoglobin and serum ferritin concentrations, and the associations between IDA (defined as anaemia and iron deficiency) and pregnancy outcomes were examined. A P-value <0.05 was considered as statistically significant. The prevalence of IDA was 12.3%. Routine antenatal iron supplementation (adjusted odds ratio 0.18, 95% confidence interval 0.07-0.46; P = 0.001) and interpregnancy interval of at least 2 years (adjusted odds ratio 0.20, 95% confidence interval 0.05-0.97; P = 0.021) have significant association with IDA. Iron deficiency anaemia was not significantly associated with adverse perinatal outcomes but there were significant associations with increased risk of blood transfusion (P = 0.001) and maternal infectious morbidities such as puerperal pyrexia (P = 0.041) and wound infection (P = 0.020). IDA is still a fairly common condition among parturients in Lagos and it's mostly associated with maternal peripartum morbidities. Adequate pregnancy spacing through the use of effective contraception and routine antenatal iron supplementations in pregnancy is a recommended preventive measure against IDA and its adverse sequelae. Future studies should adopt the use of transferrin saturation (TSAT) in compliment with serum ferritin assay as a more sensitive marker of iron deficiency.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / complications
  • Anemia, Iron-Deficiency / epidemiology*
  • Anemia, Iron-Deficiency / pathology
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Iron / blood*
  • Middle Aged
  • Nigeria / epidemiology
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology*
  • Pregnancy Complications, Hematologic / pathology
  • Pregnancy Outcome / epidemiology*
  • Prevalence
  • Young Adult

Substances

  • Hemoglobins
  • Iron