Factors Associated With Anaemia in Pregnancy: a Retrospective Cross-sectional Study in Northern Ghana

Abstract Background: Anaemia in pregnancy (AIP) is associated with adverse pregnancy outcomes. AIP occurs when a pregnant woman’s haemoglobin level falls below 11.0 g/dl, and 10.5g/dl specifically in the second trimester of pregnancy if adjustment for haemodilution is considered. This study assessed the prevalence of AIP at antenatal care (ANC) registration, 28 weeks and 36 weeks of pregnancy gestation and the correlates of AIP in the Bolgatanga Municipality of northern Ghana. Methods: A retrospective cross-sectional design was implemented among a random sample of 372 pregnant women within 36-40 weeks of pregnancy gestation, who were receiving ANC in the Bolgatanga Municipality. Data were collected via clinical records review and a questionnaire-based survey between October and November, 2020. Using the Statistical Package for Social Science, descriptive analysis of haemoglobin levels and the prevalence of anaemia was done and binary logistic regression was used to identify the correlates of AIP. Results: At ANC registration, the prevalence of AIP was 35.8% (95%CI:30.9, 40.9) which decreased to 25.3% (95%CI:20.9, 30.0) after Haemodilution. At 28 weeks of gestation, the AIP prevalence was 53.1% (95%CI:45.8, 60.3) which fell to 37.5 (95%CI:30.6, 44.8) with haemodilution. At 36 weeks of pregnancy, AIP prevalence was 44.8% (95%CI:39.2, 50.4) without the need for haemodilution. At 5% significance level, the odds of AIP at registration increased if the woman registered for ANC after the first trimester of pregnancy and at a regional hospital but decreased if she registered at a private hospital. At 28 weeks of gestation, age group 26 – 35 years, Christianity, high wealth and tertiary education were associated with lower odds of AIP. At 36 weeks of gestation, booking after first trimester of pregnancy was associated with higher odds whilst high wealth, higher age groups (26–35 and 36–49 years) and secondary education of spouse were associated with reduced odds of AIP. Conclusion: AIP consistently increased from registration to 36 weeks of gestation. Given the observed correlates of AIP, we recommend that interventions aimed at encouraging early ANC registration, improved household wealth, and improved maternal education are required to reduce AIP.