BACKGROUND: Anaemia is considered a severe public health
problem by WHO and is seen as such in Ghana. Its prevalence
in pregnancy has remained high despite improved antenatal
care. The main purpose of this study was to determine the current
anaemia prevalence and aetiology other than iron deficiency.
METHODS: This was a cross-sectional study. A total of 214
pregnant women were studied. Women were administered a
questionnaire related with the subject and blood samples were
drawn. Full blood count was performed within four hours and
serum iron, folate and vitamin B12 were studied. Other tests
done included sickling and Hb electrophoresis , stool routine
examination for hookworm infestation, thick and thin film for
malaria parasitaemia. Dietary intake was also looked at to
determine whether it contributed to anaemia seen in these
subjects.
RESULTS: Anaemia was detected in 150 (70%) of the 214 pregnant
women studied. Using the World Health Organisation criteria
for anaemia, 81 subjects had mild, 66 moderate and 3 had severe
anaemia. Anaemia was more prevalent in young adults (82%)
than in teenagers and subjects above 35years (p=0.018).
Primigravidae (21%) and multigravidae (67%) were more likely
to be anaemic than grandmultigravidae (12%). Anaemia was
more prevalent in the low social class group (94%). Nutritional
intake of both anaemic and non-anaemic subjects was found to
be adequate and thus iron deficiency anaemia, which was found
to be the commonest cause of anaemia, was probably due to
intake of diet low in bioavailable iron. There was very little
consumption of fruits and vegetables that facilitate iron
absorption. Twenty seven anaemic subjects had low serum iron
levels. Transferrin saturation was low in 39 subjects; 24 of these
also had low serum iron, which was suggestive of iron deficiency.
Folate and vitamin B12 deficiency did not play significant role
in the aetiology of anaemia. Malaria and hookworm infestation
were also not found to be significant in the causation of anaemia.
CONCLUSIONS: The prevalence of anaemia (70%) in pregnant
Ghanaians in their second trimester is unacceptably high.
Twenty seven (18%) of the 70% anaemic subjects had low serum
iron and six (4%) had low serum folate levels. None of the subjects
had vitamin B12 deficiency. Generally dietary intake in pregnant
women in this study was adequate, but significant proportion of
their meals was of the type low in bioavailable iron as more
cereals and tubers were consumed. The kind of diet, which most
people can afford in Africa is low in proteins and vitamins, but
high in carbohydrate with high phytate contents and this reduces
iron absorption. Iron and folic acid prophylaxis for all women of
child bearing age is recommended and emphasis on a more
balanced nutritional intake at antenatal clinics should be
encouraged.