Anemia in women of reproductive age in Ecuador: Data from a national survey

Anemia is a condition characterized by a decline in the number of functional red blood cells or hemoglobin. Women of reproductive age from low- and middle-income countries are at higher risk of anemia, which could lead to prenatal, obstetric and perinatal complications. The aim of our study was to explore associations between anemia status and a set of demographic, socio-economic and reproductive factors, among Ecuadorian women of reproductive age (WRA).

We used data from non-pregnant, WRA (≥12 and ≤49 years) women enrolled in the nationally representative cross-sectional Ecuadorian National Health and Nutrition Survey 2012 (ENSANUT-ECU 2012). Anemia and moderate-severe anemia were assessed using hemoglobin concentrations cutoffs of <12 g/dL and <11 g/dL, respectively. Logistic regression was used to obtain unadjusted and adjusted prevalence odds ratios (aOR). All analyzes were adjusted for multi-stage sampling, stratification and clustering.

The study population included a subset of 7415 non-pregnant WRA. Mean hemoglobin concentration was 12.84 g/dL (95% CI = 12.8-12.9). The overall prevalence of anemia and moderate-severe anemia was 16.8% and 5.0%, respectively. Some factors were associated with an increase in anemia prevalence odds: living in Guayaquil (aOR 1.82, 95% CI 1.16-2.84) and Quito (aOR 1.84, 95% CI 1.17-2.90) compared to living in the rural Amazon, having given birth to more than four alive children compared with being nulliparous (aOR 1.85, 95% CI 1.00-3.43), currently taking contraceptives compared with former use (aOR 1.46, 95% CI 1.09-1.97). In addition, moderate-severe anemia was associated with age and region of residence.

In 2012, the prevalence of anemia among Ecuadorian WRA was considered a mild public health concern. However, we identified groups with higher anemia prevalence. Thus, emphasizing the importance of analyzing the prevalence in sub-populations of WRA and identifying populations where more frequent surveillance may be helpful.