Prevalence of Anemia among Antenatal mothers attending antenatal OPDꞌs in selected hospitals of Punjab

 

Mr. Sunil Kumar Garg, Mrs. Harpreet Kaur, Harpreet Kaur, Jagdeep Sharma, Jaspreet Kaur, Kirandeep Kaur, Kuljeet Kaur, Maninder Kaur

State Institute of Nursing and Paramedical Sciences, Badal, Sri Muktsar Sahib, BFUHS, Faridkot (Pb), India

 

ABSTRACT:

 

INTRODUCTION:

ꞌꞌThe most precious jewels you’ll ever have around your neck are the arms of your childrenꞌꞌ

Paul J. Meyer Womanhood is the period in a female’s life after she passes through childhood and adolescence, generally age 18. Pregnancy is a unique, exciting, and often joyous time in woman’s life as it highlights the woman’s amazing creative and nurturing powers while providing a bridge to the future. Pregnancy comes with some cost, however, for the pregnant woman also needs to be a responsible woman to best nutritious food, food taboos, and eating and cooking customs all play a part. In order to prevent anemia, midwives must not only understand the medical problem but also any social circumstances that give rise to it.¹

 

Anemia is defined as decrease in haemoglobin (Hb) levels to below the normal range of 13.5gm/dl (men), 11.5gm/dl (women), and 11.0gm/dl (children and pregnant women)¹. It is the most common condition prevalent in most part of the world and a major cause of morbidity and mortality, especially in malaria endemic areas. In pregnancy, anemia has a significant impact on the health of the foetus as well as of mothers.² Prenatal care is important in preventive obstetrics. The factors responsible for anemia during pregnancy should be identified and eradicated. Iron supplement to prevent anaemia in pregnancy is a well-known strategy. TheNational Nutritional Anaemia Prophylaxis Program (NNAPP) advised 60mg of elemental iron and 500 mg of folic acid daily for 100days to all pregnant womens.³

 

According to World Health Organization, the prevalence of anemia in developing countries among pregnant women averages 56% ranging between 35-100%, in the year 2009 among different regions of the world. Various studies from different regions of the country have reported the prevalence of anemia to be betw-een 33-100%.³

 

Throughout pregnancy, iron deficiency anemia adversely affects the maternal and foetal well-being, and is linked to increased morbidity and foetal death. Affected mothers frequently experience breathing difficulties, fainting, tiredness, palpitations and sleep difficulties.⁴ They also have an increased risk of developing prenatal infection, pre-eclampsia, and bleeding. Postpartum cognitive impairment and behavioural difficulties were also reported.⁵The researcher felt need to assess the prevalence of anemia among antenatal mothers (aged 15-45 years) attending antenatal OPD’s in district Sri Muktsar Sahib and Bathinda.

 

MATERIAL AND METHODS:

A descriptive cross-sectional survey design was used to assess the prevalence of anemia, among antenatal mothers aged 15-45 years. A sample size of 400 antenatal mothers was selected using convenient sampling technique and the study was conducted in block Lambi, District Sri Muktsar Sahib.The main study was conducted in Civil Hospital Malout and Civil Hospital Bathinda. The data was collected by structured interview schedule and was analysed and interpreted according to the objective.

 

Descriptive statistics includes frequency and percentage distribution. Further, in inferential statistics, chi-square test was used to assess Association of anemia with selected socio-demographics variables among antenatal mothers aged 15-45 years at 0.05 level is significance. The result found were presented in the form of tables and graphs and interpreted for research report.

 

SECTION A:      

PART-A: Demographic variables:              

This section contain items for obtaining information about age (in years), type of family, residence, educational status, working status, family monthly income (in rupees), diet pattern, BMI.

 

PART-B: Gestational variables:

This section contain items for obtaining information about gestational age, gravida, previous pregnancy interval, number of antenatal visit.

 

SECTION B:

PART-A: Profile of mother regarding haemoglobin (Hb) level:

LMP. EDD

haemoglobin (Hb) estimation

Lab reports were used to get the haemoglobin level to find the prevalence of anemia among antenatal mothers in selected hospitals of Punjab.

 

WHO Criteria for classification of anemia degree Level of anemia                                Range of score Mild                                                   10-10.9gm/dl Moderate                                           7.0-9.0gm/dl Severe                                                <7gm/dl

 

RESULTS:

TABLE-1: Frequency and percentage distribution of prevalence of anemia among antenatal mothers.

N=400

Level of Scores	ƒ (%)
Normal. (11.1gm/dl-and Above)	24 (6%)
Mild Anemia. (9.1-11gm/dl)	179 (44.75%)
Moderate Anemia. (7.1-9gm/dl)	178 (44.50%)
Severe Anemia. (<7gm/dl)	019 (04.75%)
Maximum frequency percentage= 44.75 %                         Minimum frequency percentage = 4.75%

 

Table-1 and figure1 shows that the maximum prevalence rate of anemia was 179 (44.75%) among mild category (9.1-11gm/dl), 178 (44.50%) was in moderate category (7.1-9gm/dl), 24 (6%) was normal (11.1gm/dl andabove) and 19 (4.75%) was in severe category (<7gm/dl) of anemia respectively.

 

 

Fig.1: Pie diagram showing percentage distribution of prevalence of anemia among antenatal mothers.

 

 

Figure 2-: Diagram showing mean, median, S.D. of Hb

 

 

Table-2: Mean, median and S.D. of Hb level.

Variable	Mean	Med.	S.D.	Max.	Min.	Range
Hb Score	9.29	9.1	1.33	13.5	2.5	11

Table 2 and figure 2 depicts that, the Hb level among antenatal mothers was 9.29 +/- 1.326 and median was 9.

 

Table-3: showing association of prevalence of anemia with antenatal visits at <0.05 level of significance.

No. of Antenatal Visit	Severe (f)	Moderate (f)	Mild (f)	Normal (f)	Chi secure test	P value	df	Table value
1st	2	5	39	9	14.45	0.02*	6	12.592
2nd	5	39	62	7
3rd and Above	12	80	78	8
*= Significant NS=Non- significant At <0.05 level of significance.

 

TABLE- 3 shows no significant association of the prevalence of anaemia among antenatal mothers with selected demographic variables. There was significant association found according to number of antenatal visit with χ²= 14.45, df=6 at <0.05 level of significance.

 

DISCUSSION:

The above study was aimed to assess the prevalence of anemia among antenatal mothers of 400 subjects, the result depicts that there were 179 (44.75%) subjects in mild category (9.1-11gm/dl), 178 (44.50%) subjects were in moderate category (7.1-9gm/dl), 24(6%) subjects were normal (11.1 and above) and 19 (4.75%) were in severe category (<7gm/dl) regarding anaemia respectively. Data was analyzed by using frequency, percentage and chi-square tests. There was a statistically significant association of prevalence of anemia with antenatal visits at <0.05 level of significance.

 

The above results were supported by another study conducted on 302 pregnant women to assess the prevalence and predictor of maternal anaemia attending antenatal care at Gondar university hospital revealed that the prevalence of anaemia was 16.6%. Majority were mild type (64%) and morphologically, normocytic, normochromic (76%) anaemia. The prevalence of anemia was high; mild type and normocytic, normochromic anemia was dominant. Low income, large family size, hookworm infection and HIV infection was associated with anemia.⁶

 

These findings are also supported by another study conducted on 539 pregnant women to assess prevalence, Risk Factors, and Adverse Perinatal Outcomes in Northern Tanzania. The results shown that the prevalence of anaemia was 18.0% and 2% had severe anaemia. There was significant association of prevalence of anaemia according to antenatal check ups. Those who attended ANC 4 or more times had lower prevalence of anaemia (17.4%) than those who attended only once (35.3%).⁷

 

CONCLUSION:

On the basis of major findings, following conclusions has been drawn Out of 400 subjects, 24(6%) subjects were normal (11.1gm/dl and above), 179 (44.75%) subjects were in mild category (9.1-11gm/dl), 178 (44.50%) subjects were in moderate category (7.1-9gm/dl), and 19(4.75%) were in severe category (<7gm/dl) of anaemia respectively. There was statistically significant association of prevalence of anemia with antenatal visits at <0.05 level of significance.

 

IMPLICATIONS AND RECOMMENDATIONS:

The findings of the study have several implications which were discussed under certain areas for the nursing profession i.e. nursing practice, nursing administration and nursing research. In all the areas nurse act as an educator, organizer, leader, counsellor and motivator. The nurses should be able to educate the public regarding anemia, its early identification, management and the preventive aspects. On the basis of findings of the study following recommendations have been made. Similar study could be replicated on large sample to validate and generalize its finding. A study can be conducted in different settings. A comparative study can be conducted to assess the prevalence of anemia in hospitals. Randomized control trial can be done for similar type of study.

 

LIMITATIONS:

The study is limited to prevalence of anemia among antenatal mothers from selected hospitals of Punjab. Small number of sample subjects leads in limiting the generalization of the study.

 

FINANCIAL AND MATERIAL SUPPORT:

This research received no specific grant from any funding agency in the public, commercial, or not-for –profit sectors

 

CONFLICT OF INTEREST:

The authors declare that they have no conflict of interest with any organization regarding the materials discussed in this manuscript.

 

ACKNOWLEDGEMENT:

No endeavors can be completed in isolation and likewise this research study too is a product of efforts and blessings of many noble persons around us. We express our very profound gratitude to our teachers, parents, friends and participants of our research for providing us unfailing support and continuous encouragement throughout our research study. This accomplishment would not have been possible without them.

 

REFERENCES:

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Received on 17.12.2019          Modified on 19.01.2020

Accepted on 18.02.2020   © AandV Publications all right reserved