الملخص الإنجليزي
The current World Health Organization (WHO) estimates (1993-2005) indicate that around 42% of pregnant women worldwide are anemic and the percentage is 52% in developing countries. Oman is one of the countries in which the anemia in pregnancy (AIP) is considered as a severe public health problem (prevalence of AIP= 42,7%) according to WHO estimates (1993-2005). According to Omani national health statistics, the prevalence of anemia in pregnancy was 31.8% in 2006. Although the problem is common, the studies conducted in this field are few. One of the important recommendations in the current various national surveys in Oman is to conduct separate studies as a means to set control measures for this problem. Aim and importance of the study: Therefore, a hospital-based cross-sectional study was carried out in order to estimate the prevalence of anemia among Omani pregnant women (during March-June 2009) and explore the associated risk factors. Furthermore, it studied the impact of anemia during pregnancy on the gestational age at labour and neonatal birth weight. Hopefully, the study provides the decision makers with some suggestions to control and reduce the prevalence of aneinia in pregnancy.
Methods: The study was conducted during March-June 2009 in two Omani regions: the capital Muscat and South Batinah. Total of 4 hospitals were involved in the study: Sultan Qaboos University Hospital (SQUH), Royal Hospital, Khawla Hospital and Rustaq Hospital. Total of 830 women who had just delivered and were inpatient were selected randomly (sample size estimated based on P=0.05, CL=95%, error rate=10% and previous anemia in pregnancy prevalence of 31.8% in 2006). English / Arabic questionnaires were distributed to the participants and questions were filled by 2 methods: self administration and face-to-face interview. Data were collected from women, their maternal health cards and hospital computerized patient's reports. All Omani women with singleton deliveries and aged between 15 and 49 years old were included in the study. Anemia in pregnancy was defined using WHO cut off point value, namely, when (Hb] < 11.0g/dl anemia was diagnosed. Results: Overall prevalence of anemia among the study population was (28.6%, 95% CI: 25.3 - 31.9). The majority of study population (25.8%) was mildly anemic and 2.8 % were moderately aneinic but no severe cases were detected. Total of 23 risk factors were studied to evaluate their associations with the prevalence of anemia before delivery.
The results indicated that the high prevalence of anemia may be due to iron deficiency anemia (as majority of the anemic women had both low MCV/MCH values) and the common associated risk factors were: non adherence to iron supplements (OR= 3.35, CI= 1.92-5.87, P= 0.0001), adolescents or <4 years menarche -the 1pregnancy interval (OR= 3.96, C1- 1.31- 12.01, P=0.015) and had similar history of anemia in previous pregnancies (OR= 2.51, C1= 1.32- 4.80, P= 0.005) and were anemic during the 1st trimester (OR=2.73, CI= 1.54-4,84, P=0.001). The prevalence of anemia in pregnancy was not associated with preterin deliveries among the study population. However, a pregnant women anemic at first trimester had higher chance of delivering low birth weight baby (OR= 2.81, CI= 1.1 7.16, P=0.031).
Conclusion: It is essential to educate women for early ANC registration, namely, during the 1s trimester in order to early detect and control anemia in pregnancy and prevent low birth weight deliveries. Mass media, nutritionist, health educators and ministry of education must actively be involved to increase woman's especially adolescent's awareness about this problem. Every married woman planning for pregnancy should be aware of the importance of adherence to iron supplements and diet required during pregnancy. There is a great need for future community-based cross sectional, longitudinal and case control studies to find out causes of non adherence to iron supplements and high prevalence of anemia.
