PREVALENCE OF ANEMIA AND ITS SOCIOECONOMIC DETERMINANTS IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT LAHORE GENERAL HOSPITAL, LAHORE, PAKISTAN
DOI:
https://doi.org/10.71000/s5csh556Keywords:
Anemia, Pregnancy, , Socioeconomic Factors, Maternal Health, Antenatal Care, Family Structure, HemoglobinAbstract
Background: Anemia during pregnancy is a persistent public health challenge, particularly in low- and middle-income countries, where it contributes significantly to maternal morbidity, preterm births, and low birth weight. The World Health Organization identifies anemia in pregnancy as a condition affecting over one-third of pregnant women globally, with South Asian countries bearing a disproportionate burden. Addressing socioeconomic determinants is crucial for designing effective maternal health interventions and reducing anemia-related complications.
Objective: To determine the prevalence of anemia and assess its association with key socioeconomic variables among pregnant women attending antenatal care at Lahore General Hospital (LGH), Lahore.
Methods: This descriptive cross-sectional study was conducted at the antenatal clinic of LGH between September 1 and 30, 2022. A total of 224 pregnant women aged 18–45 years were recruited through non-probability convenience sampling. Data were collected using a structured, interviewer-administered questionnaire covering age, education, employment, income, family structure, and meal frequency. Hemoglobin levels were measured using the Sysmex XN‑1000 automated analyzer. Anemia was defined as hemoglobin <11.0 g/dL. Associations between anemia and socioeconomic variables were analyzed using the chi-square test, with p<0.05 considered statistically significant.
Results: Anemia was observed in 157 out of 224 participants (70.1%). Women from joint families had a significantly higher prevalence (73.2%) compared to those in nuclear families (62.7%, p=0.004). Similarly, participants with household income below PKR 50,000 showed a higher anemia rate (84.4%) than those earning ≥PKR 50,000 (66.5%, p=0.03). No significant associations were found for education level (p=0.52), employment status (p=0.84), or meal frequency (p=0.65).
Conclusion: Anemia in pregnancy remains highly prevalent and is significantly influenced by household income and family structure. Addressing these socioeconomic factors is essential in planning effective antenatal nutritional strategies.
References
Shah N, Zaheer S, Safdar NF, Turk T, Hashmi S. Women's awareness, knowledge, attitudes, and behaviours towards nutrition and health in Pakistan: Evaluation of kitchen gardens nutrition program. PLoS One. 2023;18(9):e0291245.
Aziz Ali S, Khan U, Abrejo F, Vollmer B, Saleem S, Hambidge KM, et al. Use of Smokeless Tobacco Before Conception and Its Relationship With Maternal and Fetal Outcomes of Pregnancy in Thatta, Pakistan: Findings From Women First Study. Nicotine Tob Res. 2021;23(8):1291-9.
World Health Organization. The global prevalence of anemia in 2021. Geneva: WHO; 2022.
Kurian K, Lakiang T, Sinha RK, Kathuria N, Krishnan P, Mehra D, et al. Scoping Review of Intervention Strategies for Improving Coverage and Uptake of Maternal Nutrition Services in Southeast Asia. Int J Environ Res Public Health. 2021;18(24).
Habib A, Kureishy S, Soofi S, Hussain I, Rizvi A, Ahmed I, et al. Prevalence and Risk Factors for Iron Deficiency Anemia among Children under Five and Women of Reproductive Age in Pakistan: Findings from the National Nutrition Survey 2018. Nutrients. 2023;15(15).
Ali SA, Ali SA, Razzaq S, Khowaja N, Gutkind S, Raheman FU, et al. Predictors of iron consumption for at least 90 days during pregnancy: Findings from National Demographic Health Survey, Pakistan (2017-2018). BMC Pregnancy Childbirth. 2021;21(1):352.
Aziz Ali S, Feroz A, Abbasi Z, Aziz Ali S, Allana A, Hambidge KM, et al. Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study. PLoS One. 2021;16(4):e0249360.
Maternal anaemia and the risk of postpartum haemorrhage: a cohort analysis of data from the WOMAN-2 trial. Lancet Glob Health. 2023;11(8):e1249-e59.
Naz S, Shahid S, Noorani S, Fatima I, Jaffar A, Kashif M, et al. Management of iron deficiency anemia during pregnancy: a midwife-led continuity of care model. Front Nutr. 2024;11:1400174.
Ali SA, Tikmani SS, Saleem S, Patel AB, Hibberd PL, Goudar SS, et al. Hemoglobin concentrations and adverse birth outcomes in South Asian pregnant women: findings from a prospective Maternal and Neonatal Health Registry. Reprod Health. 2020;17(Suppl 2):154.
Muhammad A, Saleem S, Ahmad D, Tariq E, Shafiq Y. Gutka consumption and dietary partialities explaining anemia in women of a coastal slum of Karachi, Pakistan: A mixed-method study. PLoS One. 2022;17(10):e0276893.
Shahmir HS, Shafaq M, Samia H, Aruna H, Khadija B, Haleema Y. Frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women. Afr Health Sci. 2023;23(4):406-14.
Aslam S, Farooq N, Ain QU, Khalid L, Siraj N, Mushtaq N. Exploring factors associated with domestic violence among pregnant women in Pakistan and its implications for maternal and perinatal health. Women Health. 2024;64(10):819-28.
Vadsaria K, Nuruddin R, Mohammed N, Azam I, Sayani S. Efficacy of a Personalized mHealth App in Improving Micronutrient Supplement Use Among Pregnant Women in Karachi, Pakistan: Parallel-Group Randomized Controlled Trial. J Med Internet Res. 2025;27:e67166.
Thaver I, Ahmad AM, Ashraf M, Asghar SK, Mirza MS. Effect of multi-pronged interventions in reducing low birth weight and maternal anaemia among pregnant women. A community-based interventions research in non-agrarian resource constrained setting of rural Pakistan. J Pak Med Assoc. 2020;70(12(a)):2092-101.
Iqbal M, Zubair M, Saeed Awan A, Khan Y, Yasmin H, Rahim R, et al. Consensus Statements for Assessment and Management of Threatened Miscarriage in the First Trimester in Pakistan: A Three-Step Modified Delphi Approach. Cureus. 2024;16(7):e65079.
Hassan MM, Ameeq M, Fatima L, Naz S, Sikandar SM, Kargbo A, et al. Assessing socio-ecological factors on caesarean section and vaginal delivery: an extended perspective among women of South-Punjab, Pakistan. J Psychosom Obstet Gynaecol. 2023;44(1):2252983.
Karyadi E, Reddy JC, Dearden KA, Purwanti T, Mardewi, Asri E, et al. Antenatal care is associated with adherence to iron supplementation among pregnant women in selected low-middle-income-countries of Asia, Africa, and Latin America & the Caribbean regions: Insights from Demographic and Health Surveys. Matern Child Nutr. 2023;19(2):e13477.
Ullah S, Burney SA, Rasheed T, Burney S, Barakzia MAK. Space-time cluster analysis of anemia in pregnant women in the province of Khyber Pakhtunkhwa, Pakistan (2014-2020). Geospat Health. 2023;18(2).
Khan A, Ahmed S. Anemia in pregnant women in Pakistan: a multicenter study. J Pak Med Assoc. 2020;70(2):123-128.
Rehman T, Saleem F. Anemia in pregnancy: tertiary care in Lahore. Pak J Med Sci. 2022;38(3):567-572.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ali Huzaifa, Haris Hanif, Rozina Shahadat Khan (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
