Assessment of Anaemia in Pregnancy a Case Study of Pregnant Women Attending Anc in University of Uyo Teaching Hospital (Uuth)
CHAPTER ONE
Aims And Objectives
To assess the prevalence of anaemia in pregnancy amongst pregnant women attending ANC at University of Uyo teaching Hospital (UUTH). Specifically, the Objectives are
- To determine the knowledge on anaemia amongst women attending ANC at University of Uyo teaching Hospital.
- To estimate the Hb (PCV) level among the pregnant women attending ANC at University of Uyo teaching Hospital.
- To determine the factors that predispose to anaemia in pregnancy amongst pregnant women attending ANC at University of Uyo teaching Hospital.
CHAPTER TWO
LITERATURE REVIEW
Introduction
Anaemia is a common accompaniment of pregnancy because of the relatively greater expansion of plasma volume in comparison to the red blood cells. Adequate oxygen transport from the maternal blood to the fetal circulation is essential throughout pregnancy to deliver a viable and healthy infant.18 Also the maternal morbidity is also affected depending on the degree of anaemia that is present during pregnancy. Anaemia thus, may precede conception, it is often aggravated by pregnancy, and the accidents of labour may perpetuate it.19It is therefore a major public health issue demanding utmost attention, since pregnancy and childbirth are daily occurrences all over the world, and if we must reduce in particular our high maternal mortality rate.
Definition
The word anaemia connotes a deficiency in the number of red blood cells or in their haemoglobin content, which can lead to a decrease in oxygen-carrying capacity of the blood, causing unusual tiredness resulting in pallor, shortness of breath, and lack of energy. Anaemia may be relative or absolute. Relative anaemia is that which occur in pregnancy.20 Absolute anaemia involves a true decrease in red cell mass. The cells are manufactured in the bone marrow and have a life expectation of approximately four months (120 days).20 To produce red blood cells, the body needs (among other things) iron, vitamin B12 and folic acid. If there is a lack of one or more of these ingredients, anaemia will develop.
Red blood cells are the cells that circulate in the blood plasma giving the blood its red colour. Through its pumping action, the heart propels blood around the body through arteries. The red blood cells obtain oxygen in the lungs and carry it to all the cells of the body. The cells use the oxygen to fuel combustion of sugar and fats, which produces the body‟s energy. During this process called oxidation, carbon dioxide is created as a waste product. It binds itself to the red blood cells that have delivered their load of oxygen. The carbon dioxide is then transported via the blood in the veins back to the lungs where it is exchanged for fresh oxygen by breathing.
CHAPTER THREE
RESEARCH METHODOLOGY
Study Design
This is a cross-sectional descriptive study which assesses anaemia in pregnant women attending ANC in the University of Uyo Teaching Hospital, one of the secondary level health facilities in Akwa-Ibom State.
Study Population
All pregnant women registered for antenatal care at the UUTH within the study period served as the study population.
CHAPTER FOUR
PRESENTATION OF DATA AND ANALYSIS
Four hundred and twelve respondents participated in the study out of which, data for this analysis was obtained from 406 respondents, giving a response rate of 98.5%. The respondents were asked questions concerning their socio-demographic data, their obstetric data and their knowledge on anaemia. The results are presented in the following tables and figures.
CHAPTER FOUR
PRESENTATION OF DATA AND ANALYSIS
Four hundred and twelve respondents participated in the study out of which, data for this analysis was obtained from 406 respondents, giving a response rate of 98.5%. The respondents were asked questions concerning their socio-demographic data, their obstetric data and their knowledge on anaemia. The results are presented in the following tables and figures.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
Conclusion
The prevalence of anaemia was high (56.4%) among the pregnant women in this study. Assessment of anaemia during pregnancy is important, because it directly or indirectly contributes to the high Maternal and perinatal morbidity and mortality seen in Nigeria. It also affords one the opportunity to institute interventions to prevent complications especially when carried out at booking. Therefore, there is a need to identify the risk factors for anaemia.
Among other findings, the study showed that the lack of knowledge of anaemia was almost universal.
Highest prevalence of Anaemia (61.1%) was observed among the women in the age group 15-19years, followed by 20–30 years age group (56.3%) compared to the other age groups. In line with this, it can be concluded that prevalence of anaemia reduces significantly with increasing age of the woman at first pregnancy (“pregnancy too early”).
Additional finding shows a strong correlation between parity and prevalence of anaemia, that the higher the parity, the greater the prevalence of anaemia (“pregnancy too many”).
Prevalence of anaemia was higher among women who booked for ante-natal after the first trimester.
Another finding worthy of note here is the correlation between birth interval and prevalence of anaemia which showed that the prevalence of anaemia is inversely proportional to the birth interval.
From this study it can therefore, be concluded that the prevalence of Anaemia among pregnant women attending ANC in UUTH is high. It is highest among those within the Age 20-30years and also very high among the multiparous women. Factors contributing to this include Educational Status, Occupation, birth interval and parity.
Measures to improve and demonstrate maternal and child health (MCH) effectiveness through built-in evaluation procedures should thus go hand-in-hand with a drive to increase awareness of the need for iron supplements. Such an increased awareness will lead to an increased demand.
Ultimately, adherence with iron therapy at the user level is affected by interactions between policy, service system and user factors. As already mentioned, lack of awareness of the prevalence, health impact and economic cost of anaemia, and the efficacy of iron supplementation at all three levels (health policy makers, health care providers and among vulnerable groups within communities) are all significant problems.
Recommendations
In order to reduce the high Maternal and perinatal morbidity and mortality from anaemia seen in Nigeria, certain measures should be put in place by the government:
- Public enlightenment campaigns should be embarked upon to sensitize the public on what anaemia is, its causes, risk factors and complications.
- Health education and promotion, especially to encourage all pregnant women to book early for antenatal care and to take appropriate intervention measures. Information, Education and Communication (IEC) efforts should be directed towards increasing levels of awareness and commitment at all levels.
- Strategies should be put in place to increase awareness on anaemia. These should include dissemination of information via antenatal and under-five clinics, public radio, and community development meetings conducted by extension workers.
- Education of the girl-child should be made compulsory to avoid teenage and unplanned pregnancy. This can also help in delaying first pregnancy.
- Distribution of iron tablets in communities targeted at adolescent girls and women after marriage and before conception, as well as in the inter-pregnancy period will prevent iron deficiency at the onset of a pregnancy.
- Government should encourage women to delay the first pregnancy, and space successive pregnancies by improving the availability and provision of appropriate family planning devices.
References
- Viteri, F.E. The consequences of iron deficiency and anaemia in pregnancy. In: Nutrient Regulation During Pregnancy, Lactation and Infant Growth. L.
- Alien, J. King and B. Lonnerdal. Eds. Plenum Press, New York,(1994). 121133. http:/www.unsystem.org/scn/archieves/scnn.news.ii/cho7.htm.Accessed 17/1/2010
- Hughes, A. Anaemia in pregnancy, Maternal health and Safe Motherhood (1991)http://www.Unsystem.org/scn/archives/scnnews.ii/cho7.htm. Accessed17/1/2010
- Viteri, F.E. Iron, Global Perspective. In: Ending Hidden Hunger: A Policy Conference on Micronutrient Malnutrition, Atlanta Georgia (1992). http://www.unsystem.org/scn/archives/scnnews.ii/cho7.htm. Accessed 17/1/2010
- WHO National strategies for overcoming micronutrient malnutrition. Document EB 89/27. Executive Board,(1991). 89th session.
- WHO IRIS: Iron deficiency anaemia. Study Group on Iron Deficiency Anaemia. http://www.who.int/iris/handle/10665/40447. Accessed 20/4/2012
- WHO/UNICEF. Focusing on Anaemia towards an integrated approach for effective Anaemia control-A Joint statement. Geneva: World Health Organization 2004.
- Stoltzfus RJ. Global prevalence and consequences. Food Nutrition Bulletin 2003; 24(Suppl): S99-103.
