Can Gestational Anemia be Alleviated with Increased Awareness of its Causes and Management Strategies? Implications for Health Care Services.

ABSTRACT

OBJECTIVES: We conducted this study to assess the risk factors of gestational anemia and evaluate the effectiveness of a culturally-tailored nutrition educational intervention on hemoglobin (Hb) status among pregnant Omani women. Newborn birthweight was used as a birth outcome. METHODS: The study was conducted in two phases. The first phase investigated the risk factors associated with gestational anemia in 206 Omani women who were 3 20 years old and had at least completed 12 weeks of gestation. A suitable sample was recruited at a tertiary teaching hospital in Muscat, Oman. Hb status was recorded, and backward linear regression was used to analyze the demographic and obstetric variables associated with Hb levels. In the second phase, a specially designed culturally-tailored nutrition educational intervention was delivered to women in the study group by trained research assistants whereas women in the control group received routine care only. The Hb levels of the pregnant women and birth weight of newborns after the intervention were evaluated in the second phase of the study. RESULTS: The prevalence of gestational anemia among 206 pregnant Omani women was 41.7%. A significant negative relationship was found between Hb and parity whereas a positive relationship was found between Hb and gestational age. The Hb level increased as the gestational age advanced (ß = 0.31, p < 0.050) and decreased as the parity increased (ß = -0.22, p < 0.050). The pre-post mean difference of Hb levels in the study group was 11.0 g/dL and in the control group was 10.7 g/dL. The difference between the pre- and post-test Hb levels for the study group was significant (t = 3.58, p = 0.001), indicating that the culturally-tailored nutrition education intervention was effective in improving the Hb level in pregnant Omani women. No significant difference was found between the study and control group with respect to birth outcomes. CONCLUSION: The prevalence of gestational anemia is high in pregnant Omani women. The use of a specially designed culturally-tailored nutrition education intervention for pregnant women supplemented with follow-up reminders can reduce the occurrence of gestational anemia. Such programs are ultimately necessary in light of the high prevalence of gestational anemia in developing countries.