Pre-conceptional anemia and iron deficiency in South Indian women: A community-based cross-sectional study

Women with pre-conceptional anemia and iron deficiency have a higher risk of developing anemia during pregnancy leading to adverse outcomes. This community-based cross-sectional study aimed to estimate the prevalence of anemia, iron deficiency, and their associations among young (18-35 years) pre-conceptional women married for less than 2 years duration.

Multistage cluster random sampling of primary health subcenters from four sociogeographic regions (urban, rural, hilly, and coastal) of Thiruvananthapuram district in South India was done to get a representative sample. All newly married women planning to have their first child were met at their homes and invited for the study. Demographic details, clinical history, and anthropometric measurements were noted. Blood sample was taken for a complete hemogram, ferritin, renal, and liver function tests.

A total of 1377 women were enrolled, the majority belonging to the middle class, mean body mass index (BMI) was 23.47 kg/m². Anemia was detected in 335 (24.4%) participants and 777 (56.4%) participants suffered from iron deficiency. Iron intake was less than the recommended daily allowance in 1332 (96.7%) participants and less than the estimated average requirement in 1077 (78.2%). A higher BMI was found to be protective against anemia.

One out of every four pre-conceptional women in the Thiruvananthapuram district of South India suffer from anemia and one in two suffer from iron deficiency. A large nutritional gap exists with regard to iron intake in pre-conceptional women. There is a need to bridge the gap in community interventions targeting iron deficiency during adolescence and pregnancy to include the pre-conceptional period.