Ejidokun, Oluwatoyin Oyindamola; (1996) Maternal anaemia and morbidity in South-western Nigeria. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

489 pregnant Nigerian women aged 16 to 45 years randomly selected from antenatal clinics of a peri-urban slum and two rural coastal areas in South-western Nigeria were followed up throughout pregnancy. They were interviewed individually and in focus groups to enquire about their use of iron, folic acid and antimalarials, and their health status before their first antenatal clinic attendance. The prevalence of anaemia (Hb < 110 g/l) and severe anaemia (Hb < 80 g/l) was 70.3% and 8.6% respectively. Among women who booked in the first, second and third trimesters, the prevalence of anaemia was 54.3%, 77.3% and 69.2% respectively. Although a high proportion of women claimed to consume iron (43.9%) and antimalarials (43.3%), there were no significant differences in haemoglobin (Hb) values between those who took these haematinics and those who did not. Rather fewer women (18.4%) took folic acid tablets. Of 441 blood films examined, malaria parasitaemia was present in 63 (14.3%), with a higher prevalence among rural women. Of these, 49 (77.8%) were P. malariae and 9 (14.3%) were P. falciparum. There was no association between malaria parasitaemia and anaemia. One (0.2%) of the women had Sickle Cell Anaemia (Hb SS), 18.9% had Hb AS and 6.5% were Hb AC. 25 (21.9%) of 114 stool samples examined for parasites were positive. Of these, 19 (76%) were due to Ascaris lumbricoides, 2 (8%) had Trichuris trichuria, 1 (4%) had Ancylostoma duodenale and 3 (12%) had multiple parasites. The prevalence of anaemia was similar in infected and uninfected subjects. The highest levels of serum ferritin, alpha- 1 -acid glycoprotein (AGP) and C-reactive protein (CRP) occurred in the most anaemic women. Presumably elevated ferritin here is a result of infection, making the assessment of iron status rather difficult. These subjects also had lower levels of serum retinol and there was a significant association between serum retinol and Hb values. The contributions of infection and vitamin A deficiency to anaemia of pregnancy are discussed.

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