Predictors of immediate postpartum anemia among singleton postpartum women, Dire Dawas, Ethiopia: hospital based cross sectional study

Authors

  • Asma B. Beshir Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
  • Aminu M. Yasin Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
  • Mickiale H. Tekle Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
  • Daniel T. Asegid Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20241663

Keywords:

Immediate postpartum anemia, Singleton postpartum-women, Postpartum

Abstract

Background: Immediate postpartum anemia is a condition where hemoglobin concentrations are lower than normal, which complicates maternal lives, including death. But so far, studies across Ethiopia have been inconsistent and lacking in the study area. Therefore, this study was aimed at assessing the magnitude and predictors of immediate postpartum anemia among singleton postpartum women which could help in interventions.

Methods: A cross-sectional study was conducted in May 2022 in the public hospitals in Dire Dawa, Ethiopia. Participants were selected using a systematic random sampling technique. Data were collected using a structured questionnaire and medical card review, entered into EPI DATA (version 3.1) and analyzed using statistical package for the social sciences (SPSS) (version 22). A p value of 0.05 or less at multivariate with 95% confidence intervals was considered statistically significant.  

Results: Of 476 participants, 26.9% had immediate postpartum anemia and significantly associated with lack of formal education (AOR=3.01, 95% CI: 1.12–8.08), unemployment (AOR=2.72, 95% CI: 1.02–7.21), number of ANC visits (AOR=2.40, 95% CI: 1.32–4.30), instrumental delivery (AOR=3.70, 95% CI: 1.952–6.86), pre-delivery anemia (AOR=2.96, 95% CI: 1.48–5.91), gastro-intestinal parasites (AOR=3.23, 95% CI: 1.37–7.59), low dietary diversity (AOR=3.10, 95% CI: 1.65–5.79), and no iron supplementation during pregnancy (AOR=2.69, 95% CI:1.10–6.58).

Conclusions: Almost one in four singleton postpartum women had immediate postpartum anemia. Findings indicate a public health problem and interventions need on risk factors.

Metrics

Metrics Loading ...

References

World Health Organization. Global Health Sector Strategy On Sexually Transmitted Infections, 2016–2021. 2016. Available at: https://www.who.int/ publications-detail-redirect/WHO-RHR-16.09. Accessed on 07 March 2024.

Kofie P, Tarkang EE, Manu E, Amu H, Ayanore MA, Aku FY, et al. Prevalence and associated risk factors of anaemia among women attending antenatal and post-natal clinics at a public health facility in Ghana. BMC Nutr. 2019;5(1):1-9.

Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low-and middle-income countries. Ann New York Acad Sci. 2019;1450(1):15.

Kassebaum NJ. The global burden of anemia. Hematol Oncol Clin. 2016;30(2):247-308.

Khaskheli M-N, Baloch S, Sheeba A, Baloch S, Khaskheli FK. Iron deficiency anaemia is still a major killer of pregnant women. Pak J Med Sci. 2016;32(3):630.

Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol. 2011;90(11):1247-53.

Markova V, Norgaard A, Jørgensen KJ, Langhoff‐Roos J. Treatment for women with postpartum iron deficiency anaemia. Cochrane Database Systematic Rev. 2015(8).

Ruiz de Viñaspre‐Hernández R, Gea‐Caballero V, Juárez‐Vela R, Iruzubieta‐Barragán FJ. The definition, screening, and treatment of postpartum anemia: A systematic review of guidelines. Birth. 2021;48(1):14-25.

Munoz M, Peña‐Rosas J, Robinson S, Milman N, Holzgreve W, Breymann C, et al. Patient blood management in obstetrics: management of anaemia and haematinic deficiencies in pregnancy and in the post‐partum period: NATA consensus statement. Transfus Med. 2018;28(1):22-39.

Breymann C, Honegger C, Holzgreve W, Surbek D. Diagnosis and treatment of iron-deficiency anaemia during pregnancy and postpartum. Arch Gynecol Obstet. 2010;282(5):577-80.

Milman N. Postpartum anemia II: prevention and treatment. Ann Hematol. 2012;91(2):143-54.

Barroso F, Allard S, Kahan BC, Connolly C, Smethurst H, Choo L, et al. Prevalence of maternal anaemia and its predictors: a multi-centre study. Eur J Obstet Gynecol Reprod Biol. 2011;159(1):99-105.

Bergmann RL, Richter R, Bergmann KE, Dudenhausen JW. Prevalence and risk factors for early postpartum anemia. Eur J Obstet Gynecol Reprod Biol. 2010;150(2):126-31.

Zamane H, Coulibaly A, Ouédraogo I, Coulibaly-Diallo G, Ouedraogo A, Bonané-Thieba B. Postpartum moderate to severe anemia in a low-income country, Burkina Faso. 2019;v1.

Emegoakor C, Iyoke C, Ezegwui H, Umeora O, Lawani L, Madu A. Rates and determinants of peripartum and puerperal anemia in Enugu, Nigeria. Niger J Clin Pract. 2016;19(6):709-14.

Juul SE, Derman RJ, Auerbach M. Perinatal iron deficiency: implications for mothers and infants. Neonatology. 2019;115(3):269-74.

Abebaw A, Gudayu TW, Kelkay B. Proportion of Immediate Postpartum Anaemia and Associated Factors among Postnatal Mothers in Northwest Ethiopia: A Cross-Sectional Study. Anemia. 2020;8979740.

Ali SA, Khan US, Feroz A. Prevalence and determinants of anemia among women of reproductive age in developing countries. 2020;30(2):177-86.

UNICEF, WHO. The state of food security and nutrition in the world 2017: Building resilience for peace and food security. 2017. Available at: https://data.unicef.org/wp-content/uploads/2017/12/web_I7787EN_SOFI2017_InBrief.pdf. Accessed on 07 March 2024.

Stevens GA, Finucane MM, De-Regil LM. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16-e25.

Kassebaum N, Khader Y. The Global Burden of Anemia. Hematol Oncol Clin North Am. 2016;30:247-308.

Daru J, Zamora J, Fernández-Félix BM. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. Lancet Glob Health. 2018;6(5):e548-54.

Teshale AB, Tesema GA, Worku MG, Yeshaw Y, Tessema ZT. Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model. Plos One. 2020;15(9):e0238957.

Nair M, Choudhury MK, Choudhury SS, Kakoty SD, Sarma UC, Webster P, et al. Association between maternal anaemia and pregnancy outcomes: a cohort study in Assam, India. BMJ Global Health. 2016;1(1):e000026.

Mekonnen W, Gebremariam A. Causes of maternal death in Ethiopia between 1990 and 2016: systematic review with meta-analysis. Ethio J Health Develop. 2018;32(4).

World Health Organization. Global anaemia reduction in reprductive age group. 2020. Available at: https://www.who.int/publications/i/item/978924 0012202. Accessed on 07 March 2024.

Gardner W, Kassebaum N. Global, Regional, and National Prevalence of Anemia and Its Causes in 204 Countries and Territories, 1990–2019. Curr Develop Nutr. 2020;4(2):830.

Central statistical agency (CSA)[Ethiopia] and ICF. Ethiopia demographic and health survey, Addis Ababa, Ethiopia and Calverton, Maryland, USA. 2016. Available at: https://dhsprogram.com/ pubs/pdf/FR328/FR328.pdf. Accessed on 07 March 2024.

DDHB. Dire Dawa Health Bereau Health Demographic Statistics. 2020. Available at: https://www.moh.gov.et/en/Diredawa_Regional_Health_Bureau?language_content_entity=en. Accessed on 07 March 2024.

World Health Organization. Haemoglobin concentration for the diagnosis of anaemia and assessment of severity. 2011. Available at: https://www.who.int/publications/i/item/WHO-NMH-NHD-MNM-11.1. Accessed on 07 March 2024.

Medina Garrido C, León J, Romaní Vidal A. Maternal anaemia after delivery: prevalence and risk factors. J Obstet Gynaecol. 2018;38(1):55-9.

Nawagi F. Incidence and Factors Associated with Postpartum Anemia at Mbarara Regional Referral Hospital. Mortality. 2016;23.

Bhagwan D, Kumar A, Rao CR, Kamath A. Prevalence of anaemia among postnatal mothers in coastal Karnataka. J Clin Diagnost Res. 2016;10(1):LC17.

Fanta GA. Prevalence and associated risk factors of immediate postpartum anemia in two teaching hospitals in Mekelle. Ethio J Reprod Health. 2020;12(1):7.

Alemayehu M. Factors associated with anemia among lactating mothers in subsistence farming households from selected districts of Jimma zone, south western Ethiopia: a community based cross-sectional study. J Nutr Food Sci. 2017;7(3).

Rabia S, Jalil N, Feroze S, Iqbal M. Frequency and determinants of maternal anaemia in early postpartum period. Ann Abbasi Shaheed Hospital Karachi Med Dent Coll. 2018;23(1):15-20.

Zhao A, Zhang J, Wu W, Wang P, Zhang Y. Postpartum anemia is a neglected public health issue in China: a cross-sectional study. Asia Pac J Clin Nutr. 2019;28(4):793.

Dündar B, Çakmak BD. The prevalence and analysis of risk factors for postpartum anemia in women without prepartum anemia. Haydarpaşa Numune Training Res Hospital Med J. 2019;59(2):165-70.

Butwick AJ, Walsh EM, Kuzniewicz M, Li SX, Escobar GJ. Patterns and predictors of severe postpartum anemia after C esarean section. Transfusion. 2017;57(1):36-44.

Rukiya A, Gachuno O, Machoki J. Determinants of post-partum anaemia–a cross sectional study. J Obstet Gynecol Eastern Central Africa. 2015;27(1):33-82.

Downloads

Published

2024-06-25

Issue

Section

Original Research Articles