Exploration of predictors of anemia among pregnant women in India using the 2015-16 National Family Health Survey (NFHS-4)

Abstract

Pregnant women with severe iron deficiency anemia are at high risk for rapid heart failure and neurological complications, as well as for having a preterm delivery, stillbirth, and low-birth-weight baby. World Health Organization in 2015 showed that around 32.4 million pregnant women are suffering from anemia. One out of five deaths in pregnant women are due to anemia, and it is accountable for 16% of maternal mortality in India. Low socioeconomic status, malnutrition, starvation, parasitic infections, and pregnancy are among the known risk factors for anemia. Aim: The study aimed to identify the predictors of anemia in pregnant women living in India using the data from the National Family Health Survey-4 (2015-16) dataset. Methods: Secondary data analysis using NFHS-4 collected data which features India's population was conducted. The woman’s questionnaire dataset available in the demographics and health survey site was downloaded, opened in the SPSS software and, after applying the eligibility criterion of being pregnant at the time of the survey, a sample size of 32,428 women was obtained for data analysis, which included descriptive, univariate and multivariable logistic regression analyses and fitting a model of predictors of pregnancy anemia. Results: The predictors of anemia among pregnant women in India were: poor wealth index (OR= 1.31, 95% CI: 1.23 – 1.40), no educational background (OR= 1.42, 95% CI: 1.34 – 1.51), scheduled caste/scheduled tribe/other backward caste category (OR= 1.15, 95% CI: 1.09 – 1.22), low BMI (OR= 1.11, 95% CI: 1.03 – 1.21), young age of pregnant women (OR= 0.99, 95% CI: 0.98 – 0.99), and low food diversity score (OR= 0.98, 95% CI: 0.97 – 0.99). The prevalence rate of anemia among pregnant women in India from the NFHS-4 survey was 50.2%. Conclusion: The study found that pregnant women from low-socioeconomic backgrounds, with no educational experience, backward caste and having low food diversity score are vulnerable for developing pregnancy anemia. Therefore, promotional interventions are recommended, such as nutritional education, awareness campaigns, and iron and folic acid supplementation targeted at-risk categories. Also, the “National Anemia Awareness and Treatment Day” initiative could invite the attention of the women’s population towards anemia and its seriousness.