AFJOG

African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | 13 ORIGINAL RESEARCH African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 3 | 2025 | A cross-sectional study of the prevalence of iron deficiency anaemia in pregnant patients presenting for antenatal care at a secondary level institution, Mowbray Maternity Hospital ABSTRACT Background: Iron deficiency anaemia (IDA) is a global health concern, particularly affecting vulnerable populations such as pregnant women. The prevalence of IDA during pregnancy is higher in low-and-middle-income countries (LMIC), leading to adverse maternal and neonatal outcomes. Addressing this issue is essential for improving maternal and child health. Woman with pre-existing IDA are at higher risk for postpartum haemorrhage, which is a leading cause of maternal mortality globally. Routine screening and early identification of IDA would allow timely intervention and mitigation of mortality. Objectives: The primary aim of the study was to establish the prevalence of anaemia among all women who presented for antenatal care at a secondary level institution in the Western Cape, Mowbray Maternity Hospital, during a one-week period. The secondary aim of the study was to categorise the type and severity of anaemia in the study population, comorbidities associated with anaemia, as well as to identify any treatment measures that were instituted. Methods: A one-week cross-sectional prospective study was conducted on consenting pregnant women over 18 years old who attended the antenatal clinic. Point-of-care haemoglobin measurements were taken, and patients with anaemia (World Health Organisation definition of anaemia in pregnancy- haemoglobin (Hb) <11g/dL) underwent formal laboratory testing, including a full blood count and iron-related parameters. Data were collected on patient demographics, symptoms, and compliance with iron supplementation. Results: Among 132 participants, the prevalence of anaemia was 57.6%. Of the anaemic patients, 73.7% had absolute iron deficiency, and 15.8% had relative iron deficiency. Iron deficiency was prevalent in 89.5% of anaemic patients. Over 90% of patients had been prescribed routine oral iron supplementation from the time of booking and at least 75% had been compliant. Conclusion: The study reveals a high prevalence of iron deficiency anaemia in pregnant patients at Mowbray Maternity Hospital, emphasizing the need for targeted interventions. Absolute iron deficiency was strongly associated with anaemia, highlighting the importance of iron supplementation and nutritional interventions during pregnancy. Routine formal testing for anaemia, patient education, and adherence enhancement strategies should be implemented to alleviate the burden of IDA during pregnancy, improving maternal and neonatal health outcomes. Keywords: Anaemia, Iron deficiency, prevalence, pregnancy, ferritin. INTRODUCTION: Iron deficiency, and specifically IDA, poses a significant global health challenge, [1] ranking among the most severe and prevalent nutritional deficiencies currenlty. [2] It is estimated that a quarter of the world's population suffers from anaemia, [3] affecting individuals across all age groups. However, certain vulnerable populations, including children under the age of five, women of child bearing age, and expectant mothers, are particularly susceptible to this condition. [4] Over the years, the WHO has demonstrated an increase in prevalence of IDA in pregnant women, with global estimates approaching 38%. [5] LMIC in particular, exhibit the highest rates of iron deficiency among pregnant women, ranging from 43% to 73%, with up to 33% experiencing iron deficiency anaemia. [68] This wide spread issue has profound implications for maternal health, leading to complications such as poor maternal weight gain, preterm labour, pregnancy-induced hypertension, abnormal placentation, eclampsia and premature rupture of membranes. [9] There is however limited local literature available regarding the extent of the problem in South Africa. One study conducted in a regional hospital in Durban, KwaZulu- Natal (KZN) showed the prevalence of anaemia among antenatal attendees was 42.7%.The prevalence of anaemia was significantly higher in Human Immunodeficiency Virus (HIV) -positive compared with HIV-negative pregnant women, 42,2% of study population being HIV positive. [40] A systematic review and meta-analysis revealed that KZN has a prevalence of anaemia of 38%, Gauteng 22% and other provinces were grouped together due to fewer studies conducted in these provinces (prevalence 41%). [41] Furthermore, anaemia following child birth has detrimental effects on women's well-being, including feelings of depression, cognitive difficulties, fatigue, reduced work productivity, compromised immune system function, and inadequate production of breast milk. These effects not only impair breastfeeding and bonding with the newborn but also hinder the mother's overall physical and mental health. [10-12] The Saving Mothers report, published in 2013, showed significant association between anaemia and adverse maternal outcomes, with 40% of maternal deaths associated with this condition. [13] Considering that postpartum Pawel Scislowski 1 , Christella Alphonsus 2 , Vernon Louw 3 1 Registrar, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Groote Schuur Hospital, Western Cape, South Africa 2 Specialist Anaesthetist, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Groote Schuur Hospital, Western Cape, South Africa 3 Clinical Haematologist, Division of Clinical Haematology, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Western Cape, South Africa CORRESPONDENCE: Dr C Alphonsus | Email: csalphonsus@gmail.com A cross-sectional study of the prevalence of iron deficiency anaemia in pregnant patients presenting for antenatal care at a secondary level institution, Mowbray Maternity Hospital