Abstract
BACKGROUND: Anemia during pregnancy is among the leading causes of poor outcomes among mothers and neonates in low-resource settings like Zambia. This study aimed to determine the prevalence and factors associated with anemia among pregnant women attending antenatal care (ANC) at Livingstone University Teaching Hospital (LUTH). METHODS: A retrospective cross-sectional study was conducted of which 307 records using a systemic random sampling method were abstracted among pregnant women attending ANC from 12th October 2023-12th January 2024. Demographic and clinical factors were collected from medical records using the Kobo Toolbox application and analyzed using STATA version 15. Descriptive statistics were used to summarize participant characteristics, and multi-variable logistic regression was employed to identify factors associated with anemia. RESULTS: The median age of the participants was 26 years (interquartile range 21, 32) and the overall prevalence of anemia was 42.7% (mild: 16.8%, moderate: 20.8%, and severe: 5.1%). Factors positively associated with anemia were being in the second and third trimesters (adjusted odds ratio (AOR) =9.06, 95% confidence interval (CI): 1.72, 47.79, p = 0.009 and AOR = 4.14, 95% CI: 1.05, 16.31, p = 0.042, respectively), history of abnormal uterine bleeding (AOR = 4.09, 95% CI: 1.14, 14.72, p = 0.031), high parity (AOR = 2.09, 95% Cl: 1.19, 1.61, p = 0.025), and having an underlying medical condition (AOR = 2.23, 95% Cl: 1.13, 4.42, p = 0.021). CONCLUSION: Anemia in pregnancy is common in our setting, associated with being in an advanced gestational age, having a history of abnormal uterine bleeding, having high parity, and having underlying medical conditions. Targeted interventions in the second and third trimesters and among women with underlying medical conditions are imperative in reducing the burden of anemia in pregnancy and improving maternal and neonatal outcomes.