Investigation of factors influencing the occurrence of anemia among pregnant women accessing comprehensive health service centers in Sarakhs County

Document Type : Original article

Authors

1 Ph.D, Health Education, Health Education and Health Promotion Group, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran Ph.D, Health Education, Social Factors Affecting Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Ph.D, Health Education, Social Factors Affecting Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Bachelor of Public Health, Sarkhes Health Center, Vice Chancellor of Health, Mashhad University of Medical Sciences, Mashhad, Iran

4 Doctorate, Sarkhes Health Center, Vice Chancellor of Health, Mashhad University of Medical Sciences, Mashhad, Iran

5 Master of Health and Medical Services Management, Sarkhes Health Center, Vice Chancellor of Health, Mashhad University of Medical Sciences, Mashhad, Iran

6 Bachelor of Nutrition, Sarkhes City Health Center, Vice Chancellor of Health, Mashhad University of Medical Sciences, Mashhad, Iran

7 Bachelor of Midwifery, Sarkhes City Health Center, Vice Chancellor of Health, Mashhad University of Medical Sciences, Mashhad, Iran

8 Professional Doctorate, Sarkhes City Health Network, Vice Chancellor of Health, Mashhad University of Medical Sciences, Mashhad, Iran

9 Ph.D, Health Education, Social Factors Affecting Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Associate Professor, Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/nnj.2025.87287.1483

Abstract

Background and Aims: Anemia is recognized as a significant nutritional issue, with multiple etiological factors contributing to its prevalence. This condition poses considerable risks during pregnancy and the postpartum period. The objective of this study is to evaluate the factors associated with the prevalence of anemia among pregnant women who visit the comprehensive health service centers in Sarkhes city in the year 2024.
Materials and Methods: This cross-sectional analytical study utilized pregnancy care form data collected from 904 individuals attending both urban and rural comprehensive health service centers in Sarkhes city, as part of the Integrated Health System (SINA). The data were analyzed using SPSS software version 25, employing the Chi-square statistical test and Fisher’s exact test, with a designated significance level.
Results: The overall prevalence of anemia in the region was 17.7%, with an estimated distribution of 62.5% among rural women and 37.5% among urban women. The prevalence rates of anemia during the first, second, and third trimesters were 5%, 3.4%, and 5.7%, respectively. Place of residence, ethnicity, body mass index (BMI), gestational age, infants weighing under 2500 grams, and iron intake were significantly associated with maternal anemia (P < 0.001).
Conclusion: Although the prevalence of anemia in the Sarakhs region is mild, it remains essential for specialists and healthcare providers to identify risk factors and implement preventive measures. These measures should include prenatal care and proper nutritional counseling with emphasis on iron supplementation during pregnancy to reduce anemia rates effectively.

Keywords


[1]     Shi H, Chen L, Wang Y, Sun M, Guo Y, Ma S, et al. Severity of anemia during pregnancy and adverse maternal and fetal outcomes. JAMA network open. 2022;5(2):e2147046-e.
[2]    Alwan NA, Cade JE, McArdle HJ, Greenwood DC, Hayes HE, Simpson NA. Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study. British Journal of Nutrition. 2015;113(12):1985-92.
[3]     Stevens GA, Beal T, Mbuya MN, Luo H, Neufeld LM, Addo OY, et al. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from population-representative surveys. The Lancet Global Health. 2022;10(11):e1590-e9.
[4]     Faghir-Ganji M, Amanollahi A, Nikbina M, Ansari-Moghaddam A, Abdolmohammadi N. Prevalence and risk factors of anemia in first, second and third trimesters of pregnancy in Iran: A systematic review and meta-analysis. Heliyon. 2023;9(3).
[5]     Geta TG, Gebremedhin S, Omigbodun AO. Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis. PloS one. 2022;17(7):e0267005.
[6]    Karami M, Chaleshgar M, Salari N, Akbari H, Mohammadi M. Global prevalence of anemia in pregnant women: a comprehensive systematic review and meta-analysis. Maternal and child health journal. 2022;26(7):1473-87.
[7]     Kinyoki D, Osgood-Zimmerman AE, Bhattacharjee NV, Kassebaum NJ, Hay SI. Anemia prevalence in women of reproductive age in low-and middle-income countries between 2000 and 2018. Nature medicine. 2021;27(10):1761-82.
[8]     Geng F, Mai X, Zhan J, Xu L, Zhao Z, Georgieff M, et al. Impact of fetal-neonatal iron deficiency on recognition memory at 2 months of age. The Journal of pediatrics. 2015;167(6):1226-32.
[9]     https://www.who.int/data/gho/data/themes/topics/ W, anaemia_in_women_and_children.
[10]  Alem AZ, Efendi F, McKenna L, Felipe-Dimog EB, Chilot D, Tonapa SI, et al. Prevalence and factors associated with anemia in women of reproductive age across low-and middle-income countries based on national data. Scientific Reports. 2023;13(1):20335.
[11] Dehghani A, Molani-Gol R, Rafraf M, Mohammadi-Nasrabadi F, Khodayari-Zarnaq R. Iron deficiency anemia status in Iranian pregnant women and children: an umbrella systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2024;24(1):381.
[12]   Abd Rahman R, Idris IB, Isa ZM, Rahman RA, Mahdy ZA. The prevalence and risk factors of iron deficiency anemia among pregnant women in Malaysia: a systematic review. Frontiers in nutrition. 2022;9:847693.
[13]   Wang R, Xu S, Hao X, Jin X, Pan D, Xia H, et al. Anemia during pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis of cohort studies. Frontiers in Global Women's Health. 2025;6:1502585.
[14]   World Health O. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015 2015.
[15]   Rajabzadeh R, Hoseini SH, Rezazadeh J, Baghban A, Nasiri M, Hosein Ayati M. [Prevalence of anemia and its related factors in pregnant women referring to health centers of Mane and Samalghan city (Persian)]. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015;18(171):1-7.
[16]   Majidnia M, Kalteh Ei A, Nooreddini A, Kohi H. Prevalence of Maternal Anemia Among Pregnant Women in Golestan Province of Iran in 2020. Journal of Guilan University of Medical Sciences. 2022;31(1):2-17.
[17]   Mostajeran M, Hassanzadeh A, Tol A, Majlessi F, Shariat M, Aghdak P. Prevalence of iron deficiency anemia in unwanted and high risk pregnancies in Isfahan Province, Iran. Journal of Health System Research. 2013;9(1):66-75.
[18]   Igbinosa II, Leonard SA, Noelette F, Davies-Balch S, Carmichael SL, Main E, et al. Racial and ethnic disparities in anemia and severe maternal morbidity. Obstetrics & Gynecology. 2023;142(4):845-54.
[19]   Barton JC, Wiener HH, Acton RT, Adams PC, Eckfeldt JH, Gordeuk VR, et al. Prevalence of iron deficiency in 62,685 women of seven race/ethnicity groups: the HEIRS study. PLoS One. 2020;15(4):e0232125.
[20]   Cheng H, Bryant C, Cook R, O'connor H, Rooney K, Steinbeck K. The relationship between obesity and hypoferraemia in adults: a systematic review. obesity reviews. 2012;13(2):150-61.
[21]   D’Souza R, Horyn I, Pavalagantharajah S, Zaffar N, Jacob C-E. Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis. American journal of obstetrics & gynecology MFM. 2019;1(4):100041.
[22]   Sanayifar A, Emami Z, Rajabzade R, Sadeghi A, Hosseini SH. The prevalence of anemia and some of its related factors in the pregnant women referred to Bojnurd health and treatment centers, 2014. Sadra Med Sci J. 2015;3(4):246-35.
[23]   Taghizadeh R, Khadem al-hosseini M, Janani L, Amiri F. Prevalence of Iron Deficiency Anemia Among Pregnant Women Referred to Fardis Health Centers in 2018. Alborz University Medical Journal. 2022;11(3):271-9.
[24]   sarparast razmju P, torklalebaq F. Prevalence of iron deficiency anemia and its related factors in pregnant women referring to health centers in Fanuj city in 2024. SJNMP 2024; 10 (2) :187-19.
[25]   Yaghoobi H, Zolfizadeh F, Asadollahi Z, Vazirinejad R, Rezaeian M. Prevalence of iron deficiency anemia and some related factors among pregnant women referred to healthcare centers in Bandar Lengeh, Iran, in 2015. Journal of Occupational Health and Epidemiology. 2015;4(2):92-100.
[26]   Hansen R, Sejer EP, Holm C, Schroll JB. Iron supplements in pregnant women with normal iron status: A systematic review and meta‐analysis. Acta obstetricia et gynecologica Scandinavica. 2023;102(9):1147-58.
[27]  Figueiredo AC, Gomes-Filho IS, Silva RB, Pereira PP, Mata FAD, Lyrio AO, et al. Maternal anemia and low birth weight: a systematic review and meta-analysis. Nutrients. 2018;10(5):601.
[28]   Kumari S, Garg N, Kumar A, Guru PKI, Ansari S, Anwar S, et al. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: A cross sectional study from Jharkhand, India. One Health. 2019;8:100098.