Determination of Prevalence and Cause of Anaemia Among Adolescent Pregnant Girls in Ussher Hospital, James Town, Ghana

Determination of Prevalence and Cause of Anaemia Among Adolescent Pregnant Girls in Ussher Hospital, James Town, Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Determination of Prevalence and Cause of Anaemia Among Adolescent Pregnant Girls in Ussher Hospital, James Town, Ghana Emmanuel Opoku Antwi, Barry Kojo Whyte, Sa-eed Alhassan, Adjoa Florence Ayirezang, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6540463/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 01 Oct, 2025 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted 10 You are reading this latest preprint version Abstract The association of anaemia with maternal and perinatal mortality poses a significant public health threat. This challenge is often exacerbated among adolescent pregnant women in low and middle-income countries. However, the prevalence of this devastating condition and its causes among pregnant teenagers in Ghana remain unclear. This study aimed to address the knowledge gap about the causes of anaemia among adolescent pregnant women attending antenatal care services at Ussher Hospital in Accra. About 329 pregnant adolescents aged 13–19 were recruited and questionnaires were administered to collect socio-demographic information. The laboratory result for the participants with respect to Haemoglobin (Hb) level and sickling status were recorded from their ANC book between June, 2023 to August, 2023. Data was presented in percentage in a tabular format. The findings revealed that 72% of pregnant adolescents were anaemic. About 5.8% had severe anaemia, while 43.1% and 23.1% had moderate and mild anaemia, respectively. Non-compliance with intake of iron and folate supplements and poor dietary practices due to financial constraints as well as genetic factors such as sickle cell disease were the primary causes of the high prevalence of anaemia recorded in this study. This study recommends nutritional education and counselling as well as interventions that promote access to healthcare and utilization of iron-folate supplements that promote nutritional balance and help to prevent anaemia especially during pregnancy. Anaemia Teenage Pregnancy sickle cell Haemoglobin BACKGROUND OF STUDY Anaemia in pregnancy is defined as having a haemoglobin concentration less than 11.0 g/dl (Wemakor, 2019). Anaemia affects half a billion women of reproductive age globally and about 1.62 billion individuals worldwide (WHO, 2016). In 2011, 29 % of non-pregnant women and 38% of pregnant women aged 15-49 years were anaemic worldwide, with South Asia and Central and West Africa having the highest frequencies (Stevens, 2013). In Ghana, 45% of pregnant women were reported to be anaemic (Wemakor, 2019). Anaemia is common, and the risk rises with each pregnancy trimester (Wemakor, 2019). According to the World Health Organization (WHO), the global annual burden of deaths attributed to anaemia among women of reproductive age ranges from 16,800 to 28,000, with younger women being at a higher risk of anaemia-related death. Iron deficiency anaemia (IDA) remains a major contributing factor to this effect (Sifakis & Pharmkides, 2018; WHO, 2002). The causes of anaemia in pregnancy have been attributed but not limited to deficiencies in iron, folate and other micronutrients (Zerfu & Ayele, 2013; Noronha et al., 2010). Studies have shown that, nutritional anaemia in pregnancy occurs when the quantity of these micronutrients are insufficient to meet normal physiological requirements (Samuel, 2013). Parasitic infections, pregnancies at old age, recurrent childbirth, diminished body mass index and haemoglobinopathies such as sickle cell and α -thalassemia have been implicated in anaemia (Annan et al.,2021; Ouma et al., 2007; Baidoo et al., 2010; Al-Farsi et al., 2011; Tay et al., 2013; Christian et al., 2020). Other socio-cultural factors including regional, economical, religious, culture, demography and access to proper health care services such as antenatal care (ANC) have been reported to contribute to anaemia in pregnancy (Alemu & Umeta, 2016). Anaemic pregnant adolescents have an increased risk of morbidity, mortality, and poor birth outcomes such as low birth weight, premature birth, and stillbirths (Mengistu, Azage, & Gutema, 2019). This work aimed to determine the prevalence of anaemia among adolescent girls and the underlying contributing factors. METHODS The study employed the cross-sectional approach involving one-time sample collection within a three-month period (June, 2023 to August, 2023 ). It was a non-invasive study conducted at the Maternity Unit of Ussher Hospital located at Akoto Lantey, a suburb of Accra Central metropolis in Ghana. Approval for data collection was obtained from the health facility before the study commenced. Ethics approval and consent to participate Approval for the study was obtained from the management of Ussher Hospital. Informed consent was obtained from all participants aged 16 years and above. Consent to participate was obtained from the guardians of participants aged bellow 16 years. Informed consent was obtained from all participants before they were enrolled onto the study. Data collection This study employed convenient sampling method to recruit participants. Informed consent was obtained from the participants or their guardians before questionnaires were administered. A total of 329 adolescent pregnant women between the ages of 13 to 19 years consented either by themselves or by their guardians to partake in the study. Socio-demographic information including age, ethnicity, religion, level of education, dietary intake habit, type of residence, occupation of parents or guardian, and sources of income were obtained from the study participants using structured close-ended questionnaire. Haematological data collection. The results for Full Blood Count (FBC) and sickling tests performed by the facility’s laboratory unit using whole blood sample were retrieved from the participants antenatal record book. These tests constitute part of the recommended laboratory investigations for pregnant women in Ghana. They are conducted to help the clinicians alleviate complications associated with pregnancy caused by sicking and low haemoglobin level. The full blood count in addition helps to assess the patients anaemic. RESULTS Sociodemographic data A total of 329 adolescent pregnant girls were recruited in this study. The majority 164 (49.8%) were between the ages of 18-19 years and almost an equal number of participants 139 (42.2 %) were between the ages of 16 to 17 years ( Table 1 ). With respect to ethnicity, more than half 174 (52.9 %) of the participants were Ga/Adangbes whiles 49 (14.9 %) was Akan. The Ewes and the Dagombas constituted 25 (7.6 %) and 28 (8.5 %) respectively ( Table 1 ). On account of religious affiliations, a significant number 263 (80 %) of the participants were of the Christian belief whiles 66 (20 %) were of the Islamic belief. Data obtained showed that the majority (77.2%) of the participants had formal education out of which 67.2% ended at the Junior High School level and only 1 (0.3%) was in senior high school. About 75 (22.8 %) of the participants had no formal education ( Table 1 ). Table 1: Socio-demographic data of participants Variables Frequency (n=329) Percentage (%) Age groups 13 – 15 26 8.0 16 – 17 139 42.2 18 – 19 164 49.8 Ethnicity Akan 49 14.9 Ewe 25 7.6 Ga/Adangbe 174 52.9 Dagomba 28 8.5 Other 53 16.1 Religion Christianity 263 80.0 Islam 66 20.0 Traditional 0 0.0 Level of education Basic school 32 9.7 Junior high school 221 67.2 Senior high school 1 0.3 No formal education 75 22.8 Results from this study showed that 48 (14.6 %) and 137 (41.6 %) of the respondents lived with both parents and single parents respectively. Only 16.7 % of the respondents live with their partners. In addition, only 11.3% of their dependents had white-collar jobs. The majority of dependants (47.4 %) were traders, 14.3 % were artisans and 9.4 % were farmers. The study revealed that most of these adolescents (48.0 %) depended on their partners for income while (35.6 %) depended on either their parents or guardian for income. About 16.7 % were self-dependent ( Table 2 ). Table 2 Residency type, occupation and income source of respondents Variables Frequency (n=329) Percentage (%) Residency type Both parents 48 14.6 Single parents 137 41.6 Guardian 49 14.9 Partner 55 16.7 Other 40 12.2 Occupation of parent, guardian or partner White collar 37 11.3 Artisans 47 14.3 Trader 156 47.4 Farmer 31 9.4 Others 58 17.6 Source of income Parents 73 22.2 Guardian 43 13.1 Partner 158 48.0 Self 55 16.7 CONTRIBUTION OF DIETARY INTAKE TO ANAEMIA IN PREGNANCY About 24.0% of participants had an acceptable dietary intake, primarily consisting of carbohydrates with sufficient protein and occasional fruit and vegetable consumption ( Table 3 ). Also, 19.8% demonstrated good dietary habits, prioritizing carbohydrates, protein, and green leafy vegetables, while frequently consuming fruit ( Table 3 ). The majority of participants (56.2%) however, reported poor dietary intake. More than half (62.9%) of the participants did not frequently take iron supplements while a few (15.2%) adhered to the iron and folate supplement intake. About 21.9% followed their prescribed regimen of both iron supplements and folic acid. Almost all participants (94.5%) did not experience heavy menstrual flow or blood loss before or during pregnancy. However, a small percentage (5.5%) claimed to have experienced heavy blood loss prior to pregnancy. About 90.6% of the participants did not experience malaria in pregnancy, nor were they diagnosed. Only 5.5% of the participants reported having been diagnosed with malaria once during pregnancy, with none having been diagnosed twice or more ( Table 3 ). Table 3: Relationship between dietary intake and anaemia among adolescent pregnant women Variables Frequency (n=329) Percentage (%) Dietary level (iron-rich foods) Poor 185 56.2 Satisfactory 79 24.0 Good 65 19.8 Adherence to iron supplement intake. Always 72 21.9 Mostly 50 15.2 Rarely 207 62.9 Heavy menstrual flow or blood lost Yes 18 5.5 No 311 94.5 Malaria in Pregnancy None 308 90.6 Once 31 9.4 Twice 0 0.0 Thrice 0 0.0 2.1 MATERNAL BEHAVIOURAL FACTORS THAT CONTRIBUTE TO ANAEMIA With respect to frequency of visit for antenatal care (ANC), 122 (37.1 %) had visited the facility twice. In addition, 92 (28 %) of participants were attending antenatal care for the first time, while 77 (23 %) had already completed three visits. However, 38 (11.6 %) had visited the facility more than three times during the study period ( Table 4 ). Table 4: Relationship between frequency of visits to hospital and anaemia Number of visits to the Hospital Frequency (n=329) Anaemic Normal One 92 69 23 Two 122 81 41 Three 77 48 29 Four and more 38 25 13 CONTRIBUTION OF GESTATIONAL PERIOD TO ANAEMIA AMONG THE STUDY POPULATION For the occurrence of Anaemia at time of gestation among the study population, 102 (31 %) was in the first trimester, 138 (42 %) in the second, and 89 (27.1) in the third trimester ( Table 5 ). Six (5.9%), 49(48%) and 22(21.6%) of the participants in their first trimester had severe, moderate and mild anaemia respectively. Also, 9 (6.5 %), 55 (40%) and 30 (22%) of the participants in their second trimester had severe, moderate and mild anaemia respectively. About 4 (4.5%), 38 (42.7%) and 24 (27 %) of the participants in their third trimester had severe, moderate and mild anaemia respectively. About (24.51%), 44(31.9%) and 23(25.8%) of participants in their first, second and third trimester had no anaemia ( Table 5 ). Table 5: Relationship between anaemia and stage of pregnancy. Stage of pregnancy Frequency (n=329) Anaemic condition Normal Severe Moderate Mild Trimester 1 102 6 49 22 25 Trimester 2 138 9 55 30 44 Trimester 3 89 4 38 24 23 Contribution of genetic factors (Sickling cell disease) to anaemia The study revealed that, 295 of the participants were sickling negative while 34 were positive, out of which 29 were anaemic. Most sickling positive participants (85.29%) were anaemic while 70.51% of sickling negative participants was also anaemic ( Table 6 ). Table:6 Relationship between sickling status and anaemia Sickling status Frequency (n=329) Percentage (%) Anaemic (%) Normal (%) Positive 34 10.3 85.29 14.71 Negative 295 89.7 70.51 29.41 PREVALENCE OF ANAEMIA The haemoglobin level (Hb) records of the participants showed that, majority (72%) were diagnosed with anaemia. This was categorized as severe (5.8 %), moderate (43.1 %) mild (23.1 %), and normal Hb levels (28.0 %) (Table 7). Table 7: Relationship between level of Hb and type of anaemia . Type of anaemia Hb Range Frequency(n=329) Percentage (%) Normal Greater than 11.0 g/dL 92 28.0 Mild Anaemia 10.0 g/dL to 11.0 g/dL 76 23.1 Moderate Anaemia 7.0 g/dL to 9.9 g/dL 142 43.1 Severe Anaemia Less than 7.0 g/dL 19 5.8 DISCUSSION This study aimed to determine the prevalence of anaemia and its causative factors among pregnant adolescents receiving antenatal care (ANC) at the Ussher Hospital, Accra, Ghana Socio-demographic factors The study observed high rate of adolescent pregnancy between the ages of 16 to 19 years. This could largely be attributed to stages of adolescent characterized by active sexual desires. Result of this study is confirmed by de Groot et al., (2018) who concluded that teen age pregnancy rates are high. The authors further confirmed that 1 in 5 and 1 in 20 girls get pregnant before turning 18 and 15 respectively. Again, the age of adolescent predicts childbearing. As their ages increased from15 to 19years, the likelihood of childbearing also increases. This could could be so because increasing the age of adolescents is associated with sexual activeness and fertility (UN, 2020). In addition, a high percentage of participants was of the Ga/Adangbe ethnic group. This is due to the fact that, the study community is densely populated by the Ga/Adangbes who are the indigenes whiles other ethnic sects such as the Akans and the Ewes constitute a few proportions. In Ghana, religious sects are predominated by Christians followed by Muslims. Thus, the observe high percentage of participants belonging to Christianity and Islam in this study only confirms this fact. This observation is in consonance with the investigation of Sifakis & Pharmkides, (2018) that the most common type of anaemia in pregnancy is the iron deficiency anaemia which contributes to 75% of anaemia in pregnancy. This study further reports that, a large proportion of the participants lived with single parent. This single parenting could serve as a risk factor for teenage pregnancy. This is because single parenting is widely known to place several burdens on a family. Lack of financial support from the parents and time spent with children and adolescent to provide guidance could have compelled the participants into engaging in sexual activities resulting in teenage pregnancy (Bunting & McAuley, 2004)). Lack of parental guidance largely reported to compel the adolescents to succumb to peer pressure relating to sexual misconduct with the opposite sex as a means of obtaining financial assistance could have attributed to this observation. This observation is further in concordance with the findings of Thobejane (2015) in South Africa that showed that about 80 percent of participants in a study of factors that contribute to adolescent teenage pregnancy had friends that influenced their decision to engage in teenage sexual intercourse that resulted in pregnancy. Earlier, Gows et al (2008) had reported similar findings stating Peer pressure as the main contributing factor for teenage pregnancy due to the association of most teenagers with peers who may be sexually active. In furtherance to the above, majority of the participants in this study lived with guardians who were either petty traders or artisans that are known to live below the poverty belt or slightly below the average economic ladder often classified as the third class (Thiemann, 2022). This further suggests the strong role of peer pressure and lack of financial support as contributing factors to the high prevalence of teenage pregnancy observed in this study respectively. Dietary contribution to anaemia among the study participants The study observed poor dietary intake and non-compliance with the iron and folate supplement intake meant to boost their haemoglobin level. This factor could have transiently contributed to the observed high prevalence of anaemia among the study participants. Iron deficiency is the most frequent nutritional cause of anaemia, accounting for nearly 50% of all global cases and anaemia incidence in pregnancy (Mistry et al., 2017). Iron deficiency is mainly caused by a lack of iron in the diet. Some other haemopoietic micronutrient deficiencies like folate, riboflavin, and Vitamins A and B 12 may increase the risk for anaemia (Mistry et al., 2017). W.H.O. recommends oral daily iron and folic acid supplementation for pregnant women because of the high iron requirements in pregnancy which cannot be met from dietary sources alone. This study showed that 62.9% of the participants did not adhere to the iron supplement intake whiles others claimed they were not provided with the supplement at the hospital and did not have money to buy. Others however attributed it to having unpleasant side effects. This may have resulted in the high prevalence of anaemia recorded in this study. A study by Annan et al (2021) revealed that, participants who were anaemic were more likely to suffer from both severe deprivation of food and exhausted body iron reserves, suggesting a combined effect. Wemakor (2019) suggested that among adolescents, anaemia is most commonly caused by nutritional deficits induced by fast development and physical changes associated with adolescence. In this study, we observed that, the majority of the participants (83.3 %) depended on their parents, guardians, or partners for income. Because education has an impact on employment possibilities, money, and potential dietary consequences, a parent's economic or income level is likely to reflect their child's nutritional status. As a result, the education and income of the parent, guardian, or partner may have influenced how much iron was consumed, either through well-informed decisions or greater incomes making iron-rich foods such as meat and fish more readily available in the households. Similarly, teenage girls whose fathers had no formal education reported to have higher risk of anaemia than those whose fathers had obtained a considerable level of education. (Nelima, 2015). Behavioural attitude towards antenatal care (ANC) services. Participants in this study had varied attitudes towards visitation to the hospital for antenatal care services. Majority of participant who had not visited hospital previously before the study were found to be anaemic as compared to those who had frequently visited the hospital for antenatal care (Table 4). In Ghana, the ANC services include provision of dietary supplement such iron and folate to the pregnant women to boast their blood levels and to prevent developmental anomalies. An earlier supporting finding by Saapiire et al (2022) stated that, pregnant women who could not achieve adequate ANC services were 2-3 times more likely to be anaemic compared with their counterparts who regularly attended ANC services. Effect of gestational stage on anaemia There was no significant association between gestational stage and occurrence of anaemia among the study participants. However, majority of the participants in any of the gestational stages (first, second, and third trimesters) had moderate anaemia. Thus, the occurrence of anaemia among the adolescent participants in this study was independent of the gestational stage of the pregnancy. However, a similar study conducted in rural northern Ghana revealed an important association between anaemia and gestational stage (Nonterah et al., 2019). An earlier report by Menon et al (2016) also indicated an association between anaemia in the second trimester of gestation and postnatal infant growth. These contrasting findings calls for a more rigorous research that seeks to address the relation between anaemia and developmental stages of pregnancy and the contribution of dietary supplements to these complications. Contribution of malaria and sickling to maternal anaemia The prevalence of sickle cell among the study participants in this study was 10.3 % which is slightly below the 15 % frequency reported by WHO (2006) in African countries. high percentage (85.29 %) of individuals who were sickling positive were anaemic . This confirms that, sickling is a risk factor that might have contributed to the observed high number of anaemic cases recorded in this study. The study also reports that, a larger number (70.51 %) of sickling negative participants were anaemic. This observation indicates that, maternal anaemia might be independent on sickling status further confirming the role of other risk factors not limited to lack of regular intake of iron and folate supplements and poor dietary regimen. Malaria in pregnancy is associated with poor maternal outcomes such as intrauterine growth retardation, preterm birth, low birth weight, and maternal anaemia. Only 9.4 % of participants were malaria positive ( Table 3 ) as oppose to the 72 % that were anaemic ( Table 7 ). This data suggests that the reported high level of anaemic cases among the study participants is independent of malaria infection and was therefore not considered a significant determinant factor in this study even though it remains a burden on anaemia in pregnancy (White, 2011). Our research has revealed that the prevalence of anaemia among teenagers is greater than that among pregnant adults in previous studies conducted in Ghana (Ayensu et al., 2020). These studies, which include UNICEF (2017), Ayensu et al (2020) reported that, the prevalence of anaemia among pregnant adults was 56.0 %. These studies have reported anaemia prevalence rates in pregnant adults. Furthermore, Ampiah et al. (2019) found that 70 % of pregnant teenagers in Ghana were anaemic. In comparison to the outcome of similar studies in other African countries, our prevalence rate is higher than estimates made for pregnant women in South Eastern Nigeria (58 %), Eastern Ethiopia (56.8 %), Southern Ethiopia (51.9 %), Kiboga, Uganda (63.1 %), Derna, Libya (54.6 %), and Niger Delta, Nigeria (69.6 %), South West Ethiopia (23.5 %), North West Ethiopia (25.2 %), and Mpigi, Uganda (32.5 %) (Wemakor, 2019). Declarations DECLARATION OF CONFLICT OF INTEREST The authors bare no conflict of interest with any person or persons or third party. All data and results accumulated in this study have not been submitted for publication in any journal ETHICS APPROVAL AND CONSENT TO PARTICIPATE Institutional approval for the study was obtained from the management of Ussher Hospital. Informed consent was obtained from each participant prior to administration of questionnaire to collect sociodemographic and clinical data. All participants willingly consented to partake in this research before they were enrolled. CONSENT FOR PUBLICATION The authors of this work need no consent from any third party before publication. AVAILABILITY OF DATA AND MATERIALS . All data generated and analyzed in this study are available from the corresponding author upon reasonable request. These have further been deposited at the Accra Technical University Data Space repository (DSpace) and are accessible via the corresponding author. COMPETING INTERESTS The authors have no competing interest with any third party, institution or entity. Funding NA AUTHORS CONTRIBUTIONS A.E.O. Experimental design, supervision, data collection and analysis. manuscript writeup. W.B.K, A.S, A. A. F and A.E.R were involved in data analysis and manuscript preparation A.A.J. Formatted and arranged the data tables. O. P., O-A. G. Were involved in the technical review and final organization of the manuscript. A.A.E., A.J.Y., C. M., S. R., and O.T. A. were involved in data collection. ACKNOWLEDGEMENT Profound gratitude goes to Dr. Archibald Dankwaa-Amoah of Accra Technical University for his relentless directives and support. Our gratitude is further extended to the management of Ussher Hospital especially the staff of the laboratory units for their unperturbed contribution and overwhelming support to this work. We also acknowledge the staff of the Department of Science Laboratory Technology, Accra Technical University for their assistance during the internal review process of this work. References Alemu, T., & Umeta, M. (2016). 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6540463","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":463309335,"identity":"d411fbbe-23e4-4441-a048-f9a6f82e2990","order_by":0,"name":"Emmanuel Opoku Antwi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYPACCTkIzQZiE6PhAIOEMVg1KVoYEhuI1sLP3vzs8cc2i/T++T0GDB/KDjPIRzfg1yLZc8zc4GCbRO6MYzwGjDPOHWYwvHMAvxaDGwlmEge3SeQ2ALUw87YBtcxIwK/F/kb6N5CWdHmQlr/EaDGQyAHbkmAA0sII1CIvQUCLxJkzZRJn/0kYbjyWVnCw51w6jwEhLfzt7dskKs7UycsdPrzxwY8yazl5Qg5DAQeAmMfgAAk6IEC+gWQto2AUjIJRMMwBANJrQt5EahxhAAAAAElFTkSuQmCC","orcid":"","institution":"Accra Technical University","correspondingAuthor":true,"prefix":"","firstName":"Emmanuel","middleName":"Opoku","lastName":"Antwi","suffix":""},{"id":463309336,"identity":"cc46d297-c9a5-4ec0-a156-eaa30f0e96c4","order_by":1,"name":"Barry Kojo Whyte","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Barry","middleName":"Kojo","lastName":"Whyte","suffix":""},{"id":463309338,"identity":"35042316-9fca-4560-9c40-c3ea7a0f8ddb","order_by":2,"name":"Sa-eed Alhassan","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Sa-eed","middleName":"","lastName":"Alhassan","suffix":""},{"id":463309340,"identity":"a9b4eb34-a427-40a3-a1cd-4c5606e63d19","order_by":3,"name":"Adjoa Florence Ayirezang","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Adjoa","middleName":"Florence","lastName":"Ayirezang","suffix":""},{"id":463309342,"identity":"8c3812d3-1ca7-4ada-a789-f83cc6e3dde9","order_by":4,"name":"Essel Reuben Arhin","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Essel","middleName":"Reuben","lastName":"Arhin","suffix":""},{"id":463309344,"identity":"147d18a9-f523-486b-b5ce-a3545663a2e3","order_by":5,"name":"Jacob Apibilla Ayembilla","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Jacob","middleName":"Apibilla","lastName":"Ayembilla","suffix":""},{"id":463309346,"identity":"fa4a5b4d-a454-40e6-91fc-7d2eb901e79a","order_by":6,"name":"Phyllis Otu","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Phyllis","middleName":"","lastName":"Otu","suffix":""},{"id":463309348,"identity":"ba690ad2-3c87-485e-840d-8133962c2fb0","order_by":7,"name":"George Osei-Adjei","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"George","middleName":"","lastName":"Osei-Adjei","suffix":""},{"id":463309349,"identity":"4a5e4556-2d22-41c6-ac59-df61a51bc1e2","order_by":8,"name":"Elizabeth Afrifa Adwubi","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Elizabeth","middleName":"Afrifa","lastName":"Adwubi","suffix":""},{"id":463309350,"identity":"62ddb8db-fef2-4ec9-a0b8-b9cb4a98949f","order_by":9,"name":"John Adalan Yaw","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"Adalan","lastName":"Yaw","suffix":""},{"id":463309351,"identity":"abb36858-7f35-4cff-8431-26d47a26cb28","order_by":10,"name":"Maxwell Cobbinah","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Maxwell","middleName":"","lastName":"Cobbinah","suffix":""},{"id":463309352,"identity":"d7ffa19a-4f58-45a5-bc2c-2c55f39a768d","order_by":11,"name":"Reuben Sackitey","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Reuben","middleName":"","lastName":"Sackitey","suffix":""},{"id":463309353,"identity":"65f0e8a0-4155-47dd-8d3c-9e81ceb52ebf","order_by":12,"name":"Agnes Osei Tenkorang","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"prefix":"","firstName":"Agnes","middleName":"Osei","lastName":"Tenkorang","suffix":""}],"badges":[],"createdAt":"2025-04-27 12:53:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6540463/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6540463/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12884-025-08017-w","type":"published","date":"2025-10-01T15:57:04+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":92883636,"identity":"2107c0c6-8f38-40b4-9549-622269956e72","added_by":"auto","created_at":"2025-10-06 16:06:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1354439,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6540463/v1/78d4c623-fb03-47ee-80d6-337d5f7f92f6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eDetermination of Prevalence and Cause of Anaemia Among Adolescent Pregnant Girls in Ussher Hospital, James Town, Ghana\u003c/p\u003e","fulltext":[{"header":"BACKGROUND OF STUDY","content":"\u003cp\u003eAnaemia in pregnancy is defined as having a haemoglobin concentration less than 11.0 g/dl (Wemakor, 2019). Anaemia affects half a billion women of reproductive age globally and about 1.62 billion individuals worldwide (WHO, 2016). In 2011, 29 % of non-pregnant women and 38% of pregnant women aged 15-49 years were anaemic worldwide, with South Asia and Central and West Africa having the highest frequencies (Stevens, 2013). In Ghana, 45% of pregnant women were reported to be anaemic (Wemakor, 2019). Anaemia is common, and the risk rises with each pregnancy trimester (Wemakor, 2019). According to the World Health Organization (WHO), the global annual burden of deaths attributed to anaemia among women of reproductive age ranges from 16,800 to 28,000, with younger women being at a higher risk of anaemia-related death. Iron deficiency anaemia (IDA) remains a major contributing factor to this effect (Sifakis \u0026amp; Pharmkides, 2018; WHO, 2002). The causes of anaemia in pregnancy have been attributed but not limited to deficiencies in iron, folate and other micronutrients (Zerfu \u0026amp; Ayele, 2013; Noronha et al., 2010). Studies have shown that, nutritional anaemia in pregnancy occurs when the quantity of these micronutrients are insufficient to meet normal physiological requirements (Samuel, 2013). Parasitic infections, pregnancies at old age, recurrent childbirth, diminished body mass index and haemoglobinopathies such as sickle cell and \u0026alpha; -thalassemia have been implicated in anaemia (Annan et al.,2021; Ouma et al., 2007; Baidoo et al., 2010; Al-Farsi et al., 2011; Tay et al., 2013; Christian et al., 2020). Other socio-cultural factors including regional, economical, religious, culture, demography and access to proper health care services such as antenatal care (ANC) have been reported to contribute to anaemia in pregnancy (Alemu \u0026amp; Umeta, 2016). Anaemic pregnant adolescents have an increased risk of morbidity, mortality, and poor birth outcomes such as low birth weight, premature birth, and stillbirths (Mengistu, Azage, \u0026amp; Gutema, 2019). This work aimed to determine the prevalence of anaemia among adolescent girls and the underlying contributing factors.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003eThe study employed the cross-sectional approach involving one-time sample collection within a three-month period (June, 2023 to August, 2023\u003cspan id=\"_Toc148601623\"\u003e). It was a non-invasive study conducted at the Maternity Unit of Ussher Hospital located at Akoto Lantey, a suburb of Accra Central metropolis in Ghana. Approval for data collection was obtained from the health facility before the study commenced.\u003c/span\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval for the study was obtained from the management of Ussher Hospital. Informed consent was obtained from all participants aged 16 years and above. Consent to participate was obtained from the guardians of participants aged bellow 16 years. Informed consent was obtained from all participants before they were enrolled onto the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study employed convenient sampling method to recruit participants. Informed consent was obtained from the participants or their guardians before questionnaires were administered. A total of 329 adolescent pregnant women between the ages of 13 to 19 years consented either by themselves or by their guardians to partake in the study.\u0026nbsp;Socio-demographic information including\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eage, ethnicity, religion, level of education, dietary intake habit, type of residence, occupation of parents or guardian, and sources of income\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ewere obtained from the study participants using\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003estructured close-ended questionnaire. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eHaematological data collection.\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe results for Full Blood Count (FBC) and sickling tests performed by the facility\u0026rsquo;s laboratory unit using whole blood sample were retrieved from the participants antenatal record book. These tests constitute part of the recommended laboratory investigations for pregnant women in Ghana. They are conducted to help the clinicians alleviate complications associated with pregnancy caused by sicking and low haemoglobin level. The full blood count in addition helps to assess the patients anaemic. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 329 adolescent pregnant girls were recruited in this study. The majority 164 (49.8%) were between the ages of 18-19 years and almost an equal number of participants 139 (42.2 %) were between the ages of 16 to 17 years (\u003cstrong\u003eTable 1\u003c/strong\u003e). With respect to ethnicity, more than half 174 (52.9 %) of the participants\u0026nbsp;were\u0026nbsp;Ga/Adangbes whiles 49 (14.9 %) was Akan. The Ewes and the Dagombas constituted 25 (7.6 %) and 28 (8.5 %) respectively (\u003cstrong\u003eTable 1\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOn account of religious affiliations, a significant number 263 (80 %) of the participants\u0026nbsp;were\u0026nbsp;of the Christian belief whiles 66 (20 %) were of the Islamic belief.\u003c/p\u003e\n\u003cp\u003eData obtained showed that the majority (77.2%) of the participants had formal education out of which 67.2% ended at the Junior High School level and only 1 (0.3%) was in senior high school. About 75 (22.8 %) of the participants had no formal education (\u003cstrong\u003eTable 1\u003c/strong\u003e).\u003c/p\u003e\n\u003cp id=\"_Toc146824257\"\u003e\u003cstrong\u003eTable 1: Socio-demographic data of participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"500\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n=329)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e13 \u0026ndash; 15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e16 \u0026ndash; 17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e42.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e18 \u0026ndash; 19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e49.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eAkan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eEwe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eGa/Adangbe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e52.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eDagomba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eChristianity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eTraditional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eBasic school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eJunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e67.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eSenior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eResults from this study showed that 48 (14.6 %) and 137 (41.6 %) of the respondents lived with both parents and single parents respectively.\u0026nbsp;Only 16.7 % of the respondents live with their partners. In addition, only 11.3% of their dependents had white-collar jobs. The majority of dependants (47.4 %) were traders, 14.3 %\u0026nbsp;were artisans and 9.4 % were farmers. The study revealed that most of these adolescents (48.0 %) depended on their partners for income while (35.6 %) depended on either their parents or guardian for income. About 16.7\u0026nbsp;% were\u0026nbsp;self-dependent (\u003cstrong\u003eTable 2\u003c/strong\u003e).\u003c/p\u003e\n\u003cp id=\"_Toc146824258\"\u003e\u003cstrong\u003eTable 2 Residency type, occupation and income source of respondents\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n=329)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidency type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eBoth parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eSingle parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e41.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eGuardian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003ePartner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;of parent, guardian or partner\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eWhite collar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e11.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eArtisans\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eTrader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e47.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eGuardian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e13.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003ePartner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eSelf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2 id=\"_Toc148601635\"\u003e\u003cstrong\u003eCONTRIBUTION OF DIETARY INTAKE TO ANAEMIA IN PREGNANCY\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eAbout 24.0% of participants had an acceptable dietary intake, primarily consisting of carbohydrates with sufficient protein and occasional fruit and vegetable consumption\u0026nbsp;(\u003cstrong\u003eTable 3\u003c/strong\u003e). Also, 19.8% demonstrated good dietary habits, prioritizing carbohydrates, protein, and green leafy vegetables, while frequently consuming fruit\u0026nbsp;(\u003cstrong\u003eTable 3\u003c/strong\u003e). The majority of participants (56.2%) however, reported poor dietary intake. More than half (62.9%) of the participants did not frequently take iron supplements while a few (15.2%) adhered to the iron and folate supplement intake. \u0026nbsp;About 21.9% followed their prescribed regimen of both iron supplements and folic acid. Almost all participants (94.5%) did not experience heavy menstrual flow or blood loss before or during pregnancy. However, a small percentage (5.5%) claimed to have experienced heavy blood loss prior to pregnancy.\u0026nbsp;About\u0026nbsp;90.6% of the participants did not experience malaria in pregnancy, nor were they diagnosed. Only 5.5% of the participants reported having been diagnosed with malaria once during pregnancy, with none having been diagnosed twice or more\u0026nbsp;(\u003cstrong\u003eTable 3\u003c/strong\u003e).\u003c/p\u003e\n\u003cp id=\"_Toc146824259\"\u003e\u003cstrong\u003eTable 3: Relationship between dietary intake and anaemia among adolescent pregnant women\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n=329)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDietary level (iron-rich foods)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePoor\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e56.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eSatisfactory\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eGood\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e19.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdherence to iron supplement intake.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAlways\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e21.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMostly\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eRarely\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e62.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeavy menstrual flow or blood lost\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e94.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMalaria in Pregnancy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e90.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eOnce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eTwice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eThrice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2 id=\"_Toc148601636\"\u003e\u003cstrong\u003e2.1 MATERNAL BEHAVIOURAL FACTORS\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;THAT CONTRIBUTE TO ANAEMIA\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eWith respect to frequency of visit for antenatal care (ANC), 122 (37.1 %) had visited the facility twice. In addition, 92 (28 %) of participants were attending antenatal care for the first time, while 77 (23 %) had already completed three visits. However, 38 (11.6 %) had visited the facility more than three times during the study period (\u003cstrong\u003eTable 4\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Relationship between frequency of visits to hospital and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eanaemia\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of visits to the Hospital\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n=329)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnaemic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOne\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTwo\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThree\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFour and more\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRIBUTION OF GESTATIONAL PERIOD TO ANAEMIA AMONG THE STUDY POPULATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor the occurrence of Anaemia at time of gestation among the study population,\u0026nbsp;102 (31 %) was in the first trimester, 138 (42 %) in the second, and 89 (27.1) in the third trimester\u0026nbsp;(\u003cstrong\u003eTable 5\u003c/strong\u003e). Six (5.9%), 49(48%) and 22(21.6%) of the participants in their first trimester had severe, moderate and mild anaemia respectively. Also, 9 (6.5 %), 55 (40%) and 30 (22%) of the participants in their second trimester had severe, moderate and mild anaemia respectively. About 4 (4.5%), 38 (42.7%) and 24 (27 %) of the participants in their third trimester had severe, moderate and mild anaemia respectively. About (24.51%), 44(31.9%) and 23(25.8%) of participants in their first, second and third trimester had no anaemia (\u003cstrong\u003eTable 5\u003c/strong\u003e).\u003c/p\u003e\n\u003cp id=\"_Toc146824261\"\u003e\u003cstrong\u003eTable 5: Relationship between anaemia and stage of pregnancy.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eStage of pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eFrequency (n=329)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eAnaemic condition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eSevere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrimester 1\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrimester 2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrimester 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eContribution of genetic factors (Sickling cell disease) to anaemia\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study revealed that, 295 of the participants were sickling negative while 34\u0026nbsp;were\u0026nbsp;positive, out of which 29 were anaemic. Most sickling positive participants (85.29%)\u0026nbsp;were\u0026nbsp;anaemic while 70.51% of\u0026nbsp;sickling\u0026nbsp;negative participants was also anaemic (\u003cstrong\u003eTable 6\u003c/strong\u003e).\u003c/p\u003e\n\u003cp id=\"_Toc146824262\"\u003e\u003cstrong\u003eTable:6 Relationship between sickling status and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eanaemia\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSickling status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n=329)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnaemic (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e85.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e14.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e89.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e70.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e29.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2 id=\"_Toc148601633\"\u003e\u003cstrong\u003ePREVALENCE OF ANAEMIA\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe haemoglobin level (Hb) records of the participants showed that, majority (72%) were diagnosed with anaemia. This was categorized as severe (5.8 %), moderate (43.1 %) mild (23.1 %), and normal Hb levels (28.0 %) \u003cstrong\u003e(Table 7).\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc146824256\"\u003e\u003cstrong\u003eTable 7: Relationship between level of Hb and type of anaemia\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of anaemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHb Range\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency(n=329)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eGreater than 11.0 g/dL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMild Anaemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e10.0 g/dL to 11.0 g/dL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e23.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModerate Anaemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e7.0 g/dL to 9.9 g/dL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e43.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSevere Anaemia\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eLess than 7.0 g/dL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study aimed to\u0026nbsp;determine the prevalence of anaemia and its causative factors among pregnant adolescents receiving antenatal care (ANC) at the Ussher Hospital, Accra, Ghana\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic factors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study observed high rate of adolescent pregnancy between the ages of 16 to 19 years. This could largely be attributed to stages of adolescent characterized by active sexual desires. \u0026nbsp;Result of this study is confirmed by de Groot et al., (2018) who concluded that teen age pregnancy rates are high. The authors further confirmed that 1 in 5 and 1 in 20 girls get pregnant before turning 18 and 15 respectively. Again, the age of adolescent predicts childbearing. As their ages increased from15 to 19years, the likelihood of childbearing also increases. This could could be so because increasing the age of adolescents is associated with sexual activeness and fertility (UN, 2020). In addition, a high percentage of participants was of the Ga/Adangbe ethnic group. This is due to the fact that, the study community is densely populated by the Ga/Adangbes who are the indigenes whiles other ethnic sects such as the Akans and the Ewes constitute a few proportions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn Ghana, religious sects are predominated by Christians followed by Muslims. Thus, the observe high percentage of participants belonging to Christianity and Islam in this study only confirms this fact. This observation is in consonance with the investigation of Sifakis \u0026amp; Pharmkides, (2018) that the most common type of anaemia in pregnancy is the iron deficiency anaemia which contributes to 75% of anaemia in pregnancy.\u003c/p\u003e\n\u003cp\u003eThis study further reports that, a large proportion of the participants lived with single parent. This single parenting could serve as a risk factor for teenage pregnancy. This is because single parenting is widely known to place several burdens on a family. Lack of financial support from the parents and time spent with children and adolescent to provide guidance could have compelled the participants into engaging in sexual activities resulting in teenage pregnancy (Bunting \u0026amp; McAuley, 2004)). Lack of parental guidance largely reported to compel the adolescents to succumb to peer pressure relating to sexual misconduct with the opposite sex as a means of obtaining financial assistance could have attributed to this observation. This observation is further in concordance with the findings of Thobejane (2015) in South Africa that showed that about 80 percent of participants in a study of factors that contribute to adolescent teenage pregnancy had friends that influenced their decision to engage in teenage sexual intercourse that resulted in pregnancy. Earlier, Gows et al (2008) had reported similar findings stating Peer pressure as the main contributing factor for teenage pregnancy due to the association of most teenagers with peers who may be sexually active. In furtherance to the above, majority of the participants in this study lived with guardians who were either petty traders or artisans that are known to live below the poverty belt or slightly below the average economic ladder often classified as the third class (Thiemann, 2022). This further suggests the strong role of peer pressure and lack of financial support as contributing factors to the high prevalence of teenage pregnancy observed in this study respectively. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDietary contribution to anaemia among the study participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study observed poor dietary intake and non-compliance with the iron and folate supplement intake meant to\u0026nbsp;boost\u0026nbsp;their haemoglobin level. This factor could have transiently contributed to the observed high prevalence of anaemia among the study participants.\u0026nbsp;Iron deficiency is the most frequent nutritional cause of anaemia, accounting for nearly 50% of all global cases and anaemia incidence in pregnancy (Mistry et al., 2017). Iron deficiency is mainly caused by a lack of iron in the diet.\u0026nbsp;Some other haemopoietic micronutrient deficiencies like folate, riboflavin, and Vitamins A and B\u003csub\u003e12\u003c/sub\u003e may increase the risk for anaemia (Mistry et al., 2017). W.H.O. recommends oral daily iron and folic acid supplementation for pregnant women because of the high iron requirements in pregnancy which cannot be met from dietary sources alone. This study showed that 62.9% of the participants did not adhere to the iron supplement intake whiles others claimed they were not provided with the supplement at the hospital and did not have money to buy. Others however attributed it to having unpleasant side effects. This may have resulted in the high prevalence of anaemia recorded in this study. A study by Annan et al (2021) revealed that, participants who were anaemic were more likely to suffer from both severe deprivation of food and exhausted body iron reserves, suggesting a combined effect. Wemakor (2019) suggested that among adolescents, anaemia is most commonly caused by nutritional deficits induced by fast development and physical changes associated with adolescence.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn this study, we observed that, the majority of the participants (83.3 %) depended on their parents, guardians, or partners for income. Because education has an impact on employment possibilities, money, and potential dietary consequences, a parent\u0026apos;s economic or income level is likely to reflect their child\u0026apos;s nutritional status. As a result, the education and income of the parent, guardian, or partner may have influenced how much iron was consumed, either through well-informed decisions or greater incomes making iron-rich foods such as meat and fish more readily available in the households. Similarly, teenage girls whose fathers had no formal education reported to have higher risk of anaemia than those whose fathers had obtained a considerable level of education. (Nelima, 2015).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBehavioural attitude towards antenatal care (ANC) services.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants in this study had varied attitudes towards visitation to the hospital for antenatal care services. Majority of participant who had not visited hospital previously before the study were found to be anaemic as compared to those who had frequently visited the hospital for antenatal care (Table 4). In Ghana, the ANC services include provision of dietary supplement such iron and folate to the pregnant women to boast their blood levels and to prevent developmental anomalies. An earlier supporting finding by Saapiire et al (2022) stated that, pregnant women who could not achieve adequate ANC services were 2-3 times more likely to be anaemic compared with their counterparts who regularly attended ANC services.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEffect of gestational stage on anaemia\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no significant association between gestational stage and occurrence of anaemia among the study participants. However, majority of the participants in any of the gestational stages (first, second, and third trimesters) had moderate anaemia. Thus, the occurrence of anaemia among the adolescent participants in this study was independent of the gestational stage of the pregnancy. However, a similar study conducted in rural northern Ghana revealed an important association between anaemia and gestational stage (Nonterah et al., 2019). An earlier report by Menon et al (2016) also indicated an association between anaemia in the second trimester of gestation and postnatal infant growth. These contrasting findings calls for a more rigorous research that seeks to address the relation between anaemia and developmental stages of pregnancy and the contribution of dietary supplements to these complications.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContribution of malaria and sickling to maternal anaemia\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe prevalence of sickle cell among the study participants in this study was 10.3 % which is slightly below the 15 % frequency reported by WHO (2006) in African countries. \u0026nbsp;high percentage (85.29 %) of individuals who were sickling positive were anaemic\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eThis confirms that, sickling is a risk factor that might have contributed to the observed high number of anaemic cases recorded in this study. \u0026nbsp;The study also reports that, a larger number (70.51 %) of sickling negative participants were anaemic. This observation indicates that, maternal anaemia might be independent on sickling status further confirming the role of other risk factors not limited to lack of regular intake of iron and folate supplements and poor dietary regimen.\u003c/p\u003e\n\u003cp\u003eMalaria in pregnancy is associated with poor maternal outcomes such as intrauterine growth retardation, preterm birth, low birth weight, and maternal anaemia. Only 9.4 % of participants were malaria positive (\u003cstrong\u003eTable 3\u003c/strong\u003e) as oppose to the\u0026nbsp;72 % that were anaemic (\u003cstrong\u003eTable 7\u003c/strong\u003e). This data suggests that the reported high level of anaemic cases among the study participants is independent of malaria infection and was therefore not considered a significant determinant factor in this study even though it remains a burden on anaemia in pregnancy (White, 2011).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur research has revealed that the prevalence of anaemia among teenagers is greater than that among pregnant adults in previous studies conducted in Ghana (Ayensu et al., 2020). These studies, which include UNICEF (2017), Ayensu et al (2020) reported that, the prevalence of anaemia among pregnant adults was 56.0 %. These studies have reported anaemia prevalence rates in pregnant adults. Furthermore, Ampiah et al. (2019) found that 70 % of pregnant teenagers in Ghana were anaemic. In comparison to the outcome of similar studies in other African countries, our prevalence rate is higher than estimates made for pregnant women in South Eastern Nigeria (58 %), Eastern Ethiopia (56.8 %), Southern Ethiopia (51.9 %), Kiboga, Uganda (63.1 %), Derna, Libya (54.6 %), and Niger Delta, Nigeria (69.6 %), South West Ethiopia (23.5 %), North West Ethiopia (25.2 %), and Mpigi, Uganda (32.5 %) (Wemakor, 2019).\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDECLARATION OF CONFLICT OF INTEREST\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors bare no conflict of interest with any person or persons or third party. All data and results accumulated in this study have not been submitted for publication in any journal\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eETHICS APPROVAL AND CONSENT TO PARTICIPATE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInstitutional approval for the study was obtained from the management of Ussher Hospital. Informed consent was obtained from each participant prior to administration of questionnaire to collect sociodemographic and clinical data. All participants willingly consented to partake in this research before they were enrolled. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors of this work need no consent from any third party before publication.\u003cbr\u003e\u003cstrong\u003eAVAILABILITY OF DATA AND MATERIALS\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eAll data generated and analyzed in this study are available from the corresponding author upon reasonable request. These have further been deposited at the Accra Technical University Data Space repository (DSpace) and are accessible via the corresponding author. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interest with any third party, institution or entity.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNA \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHORS CONTRIBUTIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.E.O. Experimental design, supervision, data collection and analysis. manuscript writeup.\u003c/p\u003e\n\u003cp\u003eW.B.K, A.S, A. A. F and A.E.R were involved in data analysis and manuscript preparation\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;A.A.J. Formatted and arranged the data tables.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eO. P., O-A. G. Were involved in the technical review and final organization of the manuscript.\u003c/p\u003e\n\u003cp\u003eA.A.E., A.J.Y., C. M., S. R., and O.T. A. were involved in data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProfound gratitude goes to Dr. Archibald Dankwaa-Amoah of Accra Technical University for his relentless directives and support. Our gratitude is further extended to the management of Ussher Hospital especially the staff of the laboratory units for their unperturbed contribution and overwhelming support to this work. We also acknowledge the staff of the Department of Science Laboratory Technology, Accra Technical University for their assistance during the internal review process of this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAlemu, T., \u0026amp; Umeta, M. (2016). 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K., Agula, C., \u0026amp; Jayson-Quashigah, P. N. (2020). Correlates and spatial \u0026nbsp; \u0026nbsp; \u0026nbsp; distribution of the co-occurrence of childhood anaemia and stunting in Ghana. SSM- \u0026nbsp;Population Health, 12, 100683.\u003c/li\u003e\n \u003cli\u003ede Groot, R., Kuunyem, M. Y., \u0026amp; Palermo, T. (2018). Child marriage and associated outcomes in northern Ghana: A cross-sectional study. \u003cem\u003eBMC Public Health, 18\u003c/em\u003e(1), 285. https://doi.org/10.1186/s12889-018-5166-6\u003c/li\u003e\n \u003cli\u003eMengistu, G., Azage, M., \u0026amp; Gutema, H. (2019). Iron deficiency anemia among in-school \u0026nbsp;adolescent girls in rural area of Bahir Dar City Administration, North West Ethiopia. \u0026nbsp;Anemia, 2019.\u003c/li\u003e\n \u003cli\u003eMenon, Kavitha C., Elaine L. Ferguson, Christine D. Thomson, Andrew R. Gray, Sanjay \u0026nbsp;Zodpey, Abhay Saraf, Prabir Kumar Das, and Sheila A. 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(2019). Prevalence and determinants of anaemia in pregnant women receiving \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;antenatal care at a tertiary referral hospital in Northern Ghana. BMC pregnancy and \u0026nbsp;childbirth, 19, 1-11.\u003c/li\u003e\n \u003cli\u003eZerfu, T. A., \u0026amp; Ayele, H. T. (2013). Micronutrients and pregnancy; effect of supplementation \u0026nbsp; \u0026nbsp; \u0026nbsp;on pregnancy and pregnancy outcomes: a systematic review. Nutrition Journal, 12(1), \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;1-5.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Anaemia, Teenage, Pregnancy, sickle cell, Haemoglobin","lastPublishedDoi":"10.21203/rs.3.rs-6540463/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6540463/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe association of anaemia with maternal and perinatal mortality poses a significant public health threat. This challenge is often exacerbated among adolescent pregnant women in low and middle-income countries. However, the prevalence of this devastating condition and its causes among pregnant teenagers in Ghana remain unclear. This study aimed to address the knowledge gap about the causes of anaemia among adolescent pregnant women attending antenatal care services at Ussher Hospital in Accra. About 329 pregnant adolescents aged 13\u0026ndash;19 were recruited and questionnaires were administered to collect socio-demographic information. The laboratory result for the participants with respect to Haemoglobin (Hb) level and sickling status were recorded from their ANC book between June, 2023 to August, 2023. Data was presented in percentage in a tabular format. The findings revealed that 72% of pregnant adolescents were anaemic. About 5.8% had severe anaemia, while 43.1% and 23.1% had moderate and mild anaemia, respectively. Non-compliance with intake of iron and folate supplements and poor dietary practices due to financial constraints as well as genetic factors such as sickle cell disease were the primary causes of the high prevalence of anaemia recorded in this study. This study recommends nutritional education and counselling as well as interventions that promote access to healthcare and utilization of iron-folate supplements that promote nutritional balance and help to prevent anaemia especially during pregnancy.\u003c/p\u003e","manuscriptTitle":"Determination of Prevalence and Cause of Anaemia Among Adolescent Pregnant Girls in Ussher Hospital, James Town, Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-30 13:15:26","doi":"10.21203/rs.3.rs-6540463/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-01T08:02:45+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-04T17:47:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-04T11:19:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282960076740670537805411014764430163901","date":"2025-06-03T17:11:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"26446842237827730266927520496894844153","date":"2025-05-30T10:23:40+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-28T09:33:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-27T07:23:10+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-06T08:47:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-05T20:15:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2025-05-05T16:15:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"63d7dfb0-2a3b-4193-9861-d665760c29e5","owner":[],"postedDate":"May 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-06T15:59:39+00:00","versionOfRecord":{"articleIdentity":"rs-6540463","link":"https://doi.org/10.1186/s12884-025-08017-w","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2025-10-01 15:57:04","publishedOnDateReadable":"October 1st, 2025"},"versionCreatedAt":"2025-05-30 13:15:26","video":"","vorDoi":"10.1186/s12884-025-08017-w","vorDoiUrl":"https://doi.org/10.1186/s12884-025-08017-w","workflowStages":[]},"version":"v1","identity":"rs-6540463","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6540463","identity":"rs-6540463","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}