Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia

Abstract

Background. Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, fall below established cut-off values. Low hemoglobin level during pregnancy favors the alteration of placental angiogenesis and resulted in restricting the availability of nutrients to the fetus and consequently causing fetal growth retardation and low weight at birth. This study is aimed at assessing the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia. Methods. A community-based cross-sectional study design was carried out among 367 pregnant women from June 1 to 30, 2020. Systematic random sampling was used to select study subjects. Hemoglobin level was measured by using HemoCue HB 301. An interviewer-administered structured questionnaire was used to collect the data. Descriptive statistics were used to describe the study subjects. A multivariable linear regression model was employed after the linearity, normality, multicollinearity, and homoscedasticity assumptions were checked. The unstandardized beta ( $\beta$ ) coefficient along with a 95% confidence interval was computed to estimate the association between explanatory and dependant variables. Statistical significance was declared at $P$ value < 0.05. Results. The mean (± SD) hemoglobin level of the respondents was 12.66 (±1.44) g/dl. The overall magnitude of anemia ( $\text{hemoglobin}\text{level}<11\text{g}/\text{dl}$ ) among pregnant women was found to be 85 [23.16%, (95% CI: 18.3%-27.5%)]. Meal frequency [ $\beta =0.40$ , (95% CI: 0.12, 0.69), $P=0.005$ ], interpregnancy interval [ $\beta =0.08$ , (95% CI: 0.02, 0.15), $P=0.007$ ], mid-upper arm circumference measurement [ $\beta =0.13$ , (95% CI: 0.07, 0.20), $P\le 0.001$ ], own fruits/vegetable [ $\beta =0.55$ , (95% CI: 0.79, 0.31), $P\le 0.001$ ], coffee consumption [ $\beta =-1.00$ , (95% CI: -1.31, -0.68), $P\le 0.001$ ], and having history of still birth [ $\beta =-0.63$ , (95% CI: -1.06, -0.20), $P=0.004$ ] were significantly associated with the hemoglobin level of pregnant women. Conclusions. Anemia was identified to be a moderate public health problem in the study area. Therefore, nutritional counseling should focus on the necessity of at least one extra meal, promotion of fruits/vegetable consumption, and improving the nutritional status of the women during antenatal care follow-up. Moreover, early screening and management of women with a history of stillbirth for anemia are also essential.