“Prevalence and determinants of anaemia among pregnant women attending RHTC and UHTC of a tertiary medical centre of South Bihar: a facility-based cross-sectional analytical study”
Abstract
Background: Anaemia during pregnancy remains a major public-health problem in India and is associated with maternal morbidity, poor foetal growth, preterm birth and low birth weight. Despite iron-folic acid supplementation and antenatal screening, rural–urban and socioeconomic disparities persist. Aim: To determine the prevalence of anaemia and identify its sociodemographic, nutritional and obstetric determinants among pregnant women attending rural and urban health facilities. Methods: A facility-based cross-sectional study was conducted among 400 pregnant women, comprising 200 attending a rural and 200 an urban health facility of Mahabodhi Medical College, Gayaji, Bihar. Sociodemographic, obstetric, dietary, iron-folic acid (IFA) supplementation, and antenatal-care information were collected using a pretested questionnaire. Haemoglobin was estimated using the Acid-Haematin method. Anaemia was classified according to WHO criteria. Associations were assessed using the chi-square test, with p<0.05 considered statistically significant. Results: Anaemia was present in 232/400 (58.0%) women. Prevalence was higher among rural than urban women (64.0% vs. 52.0%; χ²=5.43, p=0.020). Anaemia was significantly associated with lower educational attainment (68.2% vs. 45.6%; p<0.001), inadequate IFA intake (81.0% vs. 35.0%; p<0.001), poor dietary diversity (83.5% vs. 32.5%; p<0.001), and trimester (40.0%, 61.5% and 60.0% in the first, second and third trimesters, respectively; p=0.021). Mild anaemia was most common (28.0%), followed by moderate (26.0%) and severe anaemia (4.0%). Conclusion: Anaemia remains highly prevalent, particularly among rural pregnant women. Lower education, inadequate IFA intake, poor dietary diversity, and later gestation were significantly associated with anaemia. Recommendation: Strengthen early ANC registration, IFA adherence monitoring, dietary counselling, and targeted anaemia-prevention interventions in rural populations.