Anemia in pregnancy-consequences and challenges: A review of literature

Anemia during pregnancy is a global public health challenge facing the world today, especially in the developing countries. Anemia in pregnancy is an important contributor to maternal mortality/morbidity as well as to the low birth weight which in turn might contribute to increased percentage for infant mortality. Many epidemiological studies in the past have reported the problem in high magnitude. This review was conducted to identify the persistence of the problem in the South Asian countries during the last 5 years irrespective of iron supplementation as a measure to tackle this problem. Materials and methods: A review of all published literature related to prevalence of anemia for a period of 5 years (2007-2011) in South Asian countries was carried out. The online databases MEDLINE, CINAHL, Science Direct, Scopus, and Cochrane were used to identify relevant studies. Data from studies meeting inclusion/exclusion criteria were abstracted into a standardized form. Results: Eleven studies with a total of 1,93,131 pregnant women were included in the review. The maximum and minimum reported prevalence rates of anemia during pregnancy were 80 and 18% respectively. The maximum and minimum prevalence of severe anemia affecting pregnant women is 20 and 2.7%. The risk factors that are involved are young age, educational status and socioeconomic status, poor birth spacing and lack of compliance to iron and folic acid supplementation. Conclusion: Anemia is the most frequent maternal complication of pregnancy. All the 11 studies reviewed focused on assessing the prevalence of anemia during various stages of pregnancy. It shows anemia is prevalent from mild to severe degree with substantial variations across trimesters. The outcomes of these suggest prevalence of anemia is due to associated factors and lack of deficiency of vitamin B₁₂, low BMI, infection with ascariasis, deficient dietary consumption of foods fortified with iron, low socioeconomic conditions and high parity.