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 Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 140-144

Knowledge on management of anemia during pregnancy: A descriptive study


1 4th year B.Sc Nursing Students, Yenepoya Nursing College, Mangalore, Karnataka, India
2 Lecturer, Department of OBG Nursing, Yenepoya Nursing College, Mangalore, Karnataka, India

Date of Web Publication11-Nov-2014

Correspondence Address:
T Vinaya Kumary
Department of OBG Nursing, Yenepoya Nursing College, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.144308

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  Abstract 

Background of the study: The growing fetus depends entirely on its mother's healthy body for all needs. However, sometimes it can be a time of fear of suffering and death, in case women begin pregnancy with low or absent stores of iron because of previous pregnancy, poor iron intake, substance abuse; increased fetal demands of iron leads to iron deficiency anemia. Iron deficiency anemia is the most common form of malnutrition in the world and is the eighth leading cause of death in pregnant women in developing countries leading to the low birth weight, which is in turn an important risk factor for infant mortality. Objectives: To determine the knowledge of antenatal mothers regarding management of anemia during pregnancy. Materials and Methods: Non-experimental descriptive study was conducted to assess the knowledge of antenatal mothers from Yenepoya Medical College Hospital. A sample size consists of 50 antenatal mothers were selected through non-probability purposive sampling. The data was collected by using pretested structured knowledge questionnaire. Data was analyzed using SPSS version 16 and the results expressed as proportions. Results: The majority of the antenatal mothers (54%) had satisfactory knowledge, 38% had poor knowledge, and 8% had good knowledge regarding anemia during pregnancy. Conclusion: The overall knowledge in the study population was 29.9%. Hence, the researcher emphasizes the need for more research to improve the knowledge of antenatal mothers on anemia during pregnancy.

Keywords: Knowledge, antenatal mothers, anaemia during pregnancy


How to cite this article:
Baby A, Venugopal J, D'silva R, Chacko S, Vineesha P V, Kumary T V. Knowledge on management of anemia during pregnancy: A descriptive study . Arch Med Health Sci 2014;2:140-4

How to cite this URL:
Baby A, Venugopal J, D'silva R, Chacko S, Vineesha P V, Kumary T V. Knowledge on management of anemia during pregnancy: A descriptive study . Arch Med Health Sci [serial online] 2014 [cited 2017 Apr 23];2:140-4. Available from: http://www.amhsjournal.org/text.asp?2014/2/2/140/144308


  Introduction Top


Womanhood is the period in a female's life after she passes through childhood and adolescence, generally age 18. Pregnancy is a unique, exciting, and often joyous time in a woman's life as it highlights the woman's amazing creative and nurturing powers while providing a bridge to the future. Pregnancy comes with some cost, however, for the pregnant woman also needs to be a responsible woman to best support the health of her future child. The growing fetus depends entirely on its mother's healthy body for all needs. Consequently, pregnant women must take steps to remain as healthy and well nourished as they possibly can. Pregnant women should take into account the many healthcare and lifestyle considerations since pregnancy women need healthy and nutritious food in order for their baby to be healthy. [1]

The lack of nutritional and other factors may cause many of the problems during the antenatal period. One of the major problems can be detected in antenatal mothers in developing countries such as India is anemia during pregnancy.

In developed countries, it is estimated that approximately 2% of woman are anemic; in developing world, this figure may be as high as 50% and this contributes to the high rate of maternal mortality. Iron, folic acid, and vitamin B 12 deficiencies are more common; the unavailability of nutritious food, food taboos, and eating and cooking customs all play a part. In order to prevent anemia, midwives must not only understand the medical problem but also any social circumstances that give rise to it. [2]

It has been estimated that over half of the pregnant woman have a hemoglobin (Hb) level indicative of anemia. In industrialized countries, anemia in pregnancy occurs in less than 20% of woman. Published rates of prevalence for developing countries range from 35% to 72% for Africa, 37% to 75% for Asia, and 37% to 52% for Latin America. Not only is anemia common, it is often severe. From the published reports available, it can be estimated that 2-7% of pregnant women have Hb values less than 7.0 g/dl and probably 15-20% have values less than 8.0 g/dl. In 1993, the World Bank ranked anemia as the eighth leading cause of disease in girls and women in developing countries. [3]

Prenatal care is important in preventive obstetrics. The factors responsible for anemia during pregnancy should be identified and eradicated. Iron supplement to prevent anemia in pregnancy is a well-known strategy. The National Nutritional Anaemia Prophylaxis Program (NNAPP) advised 60 mg of elemental iron and 500 mg of folic acid daily for 100 days to all pregnant women. Prevention and management of nutritional anemia is easy and cheap. [4]

Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women. It has multiple causes, both nutritional (vitamin and mineral deficiencies) and non-nutritional (infection) that frequently co-occur. It is assumed that the most common contributing factors are iron deficiency, folic acid deficiency, and vitamin B 12 deficiency. Anemia resulting from iron deficiency is considered one of the top ten contributors to the global burden of disease. [5]

Anemia is defined as decrease in Hb levels to below the normal range of 13.5 gm/dl (men), 11.5 gm/dl (women), and 11.0 gm/dl (children and pregnant women). The effect on the individual will depend on the severity and speed of onset of anemia and the degree to which the oxygen-carrying capacity of the blood is diminished. Signs and symptoms include pallor of the mucous membrane, fatigue, dizziness and fainting, headache, exertion, shortness of breath, tachycardia, and palpitation. Very severe anemia is defined as an Hb level <4 gm/dl in pregnant women; this is a medical emergency due to the risk of congestive heart failure and maternal death (World Health Organization). [2]

The studies from industrialized countries shows that 2.0-45.0% of pregnant women in the world have anemia, and This percentage is generally higher in developing countries (5.0-90.0%). Prevalence of anemia in India is 33.0-89.0% and anemia is the second most common cause of maternal deaths accounting for 20% of total maternal deaths. In Karnataka, prevalence of anemia among pregnant women is significantly higher in women above 26 years of age (97.7%) and in those from below class IV socioeconomic status (90.7%). The prevalence of anemia was relatively higher in those nuclear families (84.3%) and in women who studied secondary level (89.3%).

According to World Health Organization, the prevalence of anemia in developing countries among pregnant women averages 56% ranging between 35-100%, in the year 2009 among different regions of the world. Various studies from different regions of the country have reported the prevalence of anemia to be between 33-100%. [4] In India, the prevalence of iron deficiency anemia is perhaps the highest in the world that is 80% among pregnant women are affected. [5]

Advice in early pregnancy regarding the dietary intake of iron, the midwife needs to take into consideration how the intake of iron may be affected by social, religious, and cultural preferences. She also needs to explain how iron is absorbed and identify the optimal sources of iron. World Health Organization data on the prevalence of anemia in women suggest that the normal dietary intakes of iron are insufficient to meet these requirements for the majority of women and recommend that all pregnant women should be given iron and folic acid daily in pregnancy. [2]

Anemia is the most common condition prevalent in most part of the world and a major cause of morbidity and mortality, especially in malaria endemic areas. In pregnancy, anemia has a significant impact on the health of the fetus as well as of mothers. About 20% of maternal deaths in Africa have been attributed to anemia. [6]


  Materials and Methods Top


The research approach adopted for the study is descriptive research approach. Data was collected using non-probability purposive sampling technique. The total number of antenatal mothers included was 50. The study was conducted in Yenepoya Medical College Hospital, Deralakatte, Mangalore. The tools used for this study were demographic proforma and structured knowledge questionnaire. The structured knowledge questionnaire consisted of 27 items. After the ethical approval from the Ethical Committee of Yenepoya University, the tool was pre-tested by administering it to five antenatal mothers. The samples found that the instructions and the language of the tool were clear and understandable and the time taken to complete the tool was 25 minutes. The reliability of the tool was tested by split half method. A pilot study was conducted to find out the feasibility of the study. Correlation of the half test was found by using Karl Pearson correlation co-efficient formula, and the reliability co-efficient of the whole test was established by Spearman Brown prophecy formula. Data analysis was done by using both descriptive and inferential statistics.


  Results Top


The study sample consisted of 50 antenatal mothers. About 40% of antenatal mothers belonged to the age group of 19-22 years, and majority (56%) of antenatal mothers belonged to gravid 2 and above. Maximum percentage (58%) of antenatal mothers had high school education. About 58% of the participants belonged to a nuclear family. Most of the antenatal mothers (78%) were housewives. Nearly (62%) of the samples had income Rs. 5001-10000. Most of the mothers (64%) had information about anemia from health workers. The details are depicted in [Table 1].
Table 1: Descriptions of demographic characteristics of antenatal mothers of Yenepoya Medical College Hospital N = 50

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The majority of the antenatal mothers (54%) had satisfactory knowledge, 38% had poor knowledge, and 8% had good knowledge about anemia during pregnancy. The details of the findings are summarized in [Table 2] and [Figure 1].
Table 2: Knowledge grading N = 50

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Figure 1: Bar diagram showing level of knowledge of antenatal mothers on anemia during pregnancy The data presented in the diagram shows that the majority of the antenatal mothers (54%) had satisfactory knowledge, 38% had poor knowledge and 8% had good knowledge about anemia during pregnancy

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The chi-square values of demographic variables such as age, gravida, type of family, education, occupation, monthly family income, and source of information, regarding anemia during pregnancy among antenatal mothers were not significant at 0.05 level of significant. Thus, it is concluded that there was no association between knowledge score and selected demographic variable [Table 3].
Table 3: Association between knowledge of antenatal mothers regarding anaemia during pregnancy and selected demographic variables N = 50

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  Discussion Top


Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality especially in pregnant women. The current study was conducted in one of the medical college hospital in Mangalore to assess the knowledge level of antenatal mothers regarding the management of anemia during pregnancy.

The age of majority antenatal mothers was 19-22 years. About 56% were multigravida and 44% were primigravida. About 58% belonged to nuclear family and 42% from joint family. Almost 44% had primary education, 58% had high school education and 18% had secondary school education. Majority (78%) of antenatal mothers were housewives, 16% were coolie workers, 2% were government employees, and 4% were health workers. Most of the antenatal mothers' monthly income was Rs. 5001-10,000. About 64% had information regarding anemia during pregnancy from health workers, 14% from relatives and friends, 14% through mass media, and 8% by self-learning.

A similar study had been conducted on sociodemographic and maternal factors in anemia during pregnancy, in Booking in Kerno, Northern Nigeria in 2009. The finding shows that the demographic variables were as follows: The age of the pregnant women ranged from 15-45 years. Nearly half of the women had tertiary education (47.7%), while 11.3% had no formal education, and the mean parity among the women was 2.0. [7]

In the present study, result revealed that majority of antenatal mothers (54%) had satisfactory knowledge on anemia during pregnancy, 38% had poor knowledge, and 8% had good knowledge score. The mean percentage of knowledge score of antenatal mothers on anemia during pregnancy was 29.9%.

A similar study had been conducted on maternal knowledge and practices related to anemia and iron supplementation in Rural Malawi in 2009. The findings shows that the knowledge of the study sample were as follows: Large majority of the women (96.6%) knew about anemia and most of them correctly indicated its causes, signs, prevention, and treatment. About 78.5% indicated that eating adequate amounts of food is a means of preventing anemia, whereas iron supplementation and blood transfusion were stated as the main ways to treat anemia. [8]

All chi-square values calculated were less than that of table value at 0.05 level of significance. Therefore, the researcher accepted the null hypothesis, and it can be concluded that there was no significant association between knowledge and selected demographic variables such as age, gravid, type of family, education, occupation, monthly income, and source of information.

A similar study had been conducted on the impact of maternal education and socioeconomic status on maternal nutritional knowledge and practices regarding iron-rich foods and iron supplements in Saudi Arabia in 2011. The finding shows that the demographic characteristics of the study sample were influenced the knowledge of mothers as follows: 22% of the women were illiterate, while 25% of the women had passed the 10 th grade, and 12% had completed master's degree. About 12% had a monthly income Rs. 5000-10000 per month, while 38% earning between Rs. 10000-20000 per month and 17% were earning >Rs. 20000 per month. About 29% of the women were experiencing pregnancy for the first time, 18% had one child, and 22% had 2 children. However, significant relationship between educational status and knowledge regarding iron-rich foods was noticed. Higher level of knowledge was observed in subjects with higher educational background compared to illiterate women regarding iron-rich foods. [9]

The incidence of anemia increases among antenatal mothers. Early detection and management strategies should be adopted to prevent complications. Research studies should be conducted to assess the needs of pregnant women. The main focus of research studies should be behavior modification of individual. The approach of primordial prevention should be adopted, which involves preventing anemia and spread of risk factors and lifestyle modification through health education programs conducted by the nursing personal both in hospital and community. The nurse and health workers can distribute iron and folic acid supplements to the antenatal mothers

 
  References Top

1.Doctalk S, Podcasts. Women.net essay. Available from: http://www.mental help.net /poc/view-doc.php. [Last accessed on 2007 Nov 5].  Back to cited text no. 1
    
2.Fraser DM, Cooper MA. Myles Textbook for midwives: Anaemia during pregnancy. 14 th ed. UK: Elsevier; 2003;1:333-40.  Back to cited text no. 2
    
3.Toteja GS, Singh P, Dhillon BS, Saxena BN, Ahmed FU, Singh RP, et al. Prevalence of anaemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull 2006;27:311-5.  Back to cited text no. 3
    
4.Para BE, Manjarres LM, Gomez AL, Ailezate DM, Jaramillo ML. Assessment of nutritional education and iron supplement impact on prevention of pregnancy anaemia. Biomedica 2005;25:211-9.  Back to cited text no. 4
    
5.Saskiade P, Martin V, Regina M. Nutritional Anaemia. Available from: http://www.sightandlife.org, http://www.Ifpri.org/pubs/books/ internet [Last accessed on 2012 Aug].  Back to cited text no. 5
    
6.Rai AK. Wikipedia. Available from: http://www.Ind media. com/journals.php [Last accessed on 2012 Jul].  Back to cited text no. 6
    
7.Nwizu EN, Iliyasu Z, Ibrahim SA, Galadanci HS. Socio-demographic and maternal factors in anaemia in pregnancy at booking in Kano, northern Nigeria. Afr J Reprod Health 2011;15:33-41.  Back to cited text no. 7
    
8.Kalimbira AA, Mtimuni BM, Chilima DM. Maternal knowledge and practices related to anaemia and iron supplementation. Afr J Food Agric Nutr Dev 2009;9:550-64. Available from: http://www. bioline.org.br/requestnd09006 [Last accessed on 2012 Jan].  Back to cited text no. 8
    
9.Abdelhafez AM, El-Soadaa SS. Prevalence and risk factors of anaemia among a sample of pregnant. Pak J Nutr 2012;11:1113-20. Available from: http://www.pjbs.org/pjnonline/fin2492.pdf [Last accessed on 2012 Aug].  Back to cited text no. 9
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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