A study of prevalence of anemia and associated risk factors in pregnant women of tribal community attending antenatal clinic at Trivandrum district, Kerala, India

M. S. Ponny, V. R. Nandini, C. Nirmala, Brahmanandan Mayadevi


Background: Anemia is a major preventable public health concern among the pregnant women worldwide. The present study aims at determining the prevalence of anemia among tribal pregnant women at Trivandrum district, Kerala and identifying its socioeconomic and gynaecological risk factors.

Methods: A cross sectional study was conducted among tribal women attending antenatal clinics of Vithura and Kuttichal Government hospitals at Kerala, India. Sample size was calculated as 117. All consecutive subjects fitting the inclusion criteria were included in the study until the sample size was achieved. Patients were interviewed using a semi structured questionnaire which includes socio demographic, cultural and nutritional factors. Hemoglobin measurement was done while first antenatal visit using semi auto hemo-analyzer. Data obtained were analyzed using SPSS software. Statistical test used was either Chi-square test or student t-test.

Results: The prevalence of anemia among the tribal pregnant women attending primary health care in Trivandrum during the study tenure was 53.33%. The prevalence of mild, moderate and severe anemia was observed as 26.66%, 25% and 1.66% respectively. The mean serum haemoglobin level among the study group was found to be 10.64 gm%. The major risk factors associated with anemia were figured out to be low body mass index, low family income, high parity, joint family, exposure to passive smoking and pan chewing, irregular intake of iron and folic acid supplements, hyperemesis and absence of deworming.

Conclusions: Focus shall be given on creating awareness among tribal women regarding the need for dietary and lifestyle modification to decrease the prevalence of anemia among them.




Anemia, Habit disturbances, Standard of living, Pregnant Women, Prevalence studies, Tribal population

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Donahue Angel M, Berti P, Siekmans K, Tugirimana PL, Boy E. Prevalence of Iron Deficiency and Iron Deficiency Anemia in the Northern and Southern Provinces of Rwanda. Food Nutr Bull. 2017;38:554-63.

Prevalence of Anemia in pregnant women. Available at: indicator-metadata-registry/imr-details/4552. Accessed on 20 February 2021.

Indian Institute for Population Sciences (IIPS) and MoHFW. Available at: NFHS-4Reports/Kerala.pdf). Accessed on 3 March 2021.

Sample registration system, office of the registrar general and census commissioner; 2019. Available at: SRS/Sample_Registration_System.asp x. Accessed on 3 March, 2021

Ortega P, Leal J, Amaya D, Chávez, C. Nutritional evaluation, micronutrient deficiencies and anemia among female adolescents in an urban and a rural zone from Zulia state, Venezuela. Invest Clin. 2010;51:37-52.

Shrinivasa BM, Philip RR, Krishnapali VK, Suraj A, Sreelakshmi P. Prevalence of anemia among tribal women of reproductive age-group in Wayanad district of Kerala. Int J Health Allied Sci. 2014;3:120-4.

Statistics profile of scheduled tribes in India, office of the registrar general andcensus commissioner, government of India. Available at: https://censusindia. Accessed on 3 March 2021.

Corrêa G, Das M, Kovelamudi R, Jaladi N, Pignon C, Vysyaraju K, et al. High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India. Confl Health. 2017;11:10.

Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and mineral nutrition information system. Available at: Accessed on 3 March 2021.

Rohisha IK, Jose TT, and Chakrabarty J. Prevalence of anemia among tribal women. J Family Med Prim Care. 2019;8:145-7.

Perumal V. Reproductive risk factors assessment for anaemia among pregnant womenin India using a multinomial logistic regression model. Trop Med Int Health. 2014;19:841- 51.

Rooney C. Antenatal care and maternal health: how effective is it? A review of the evidence. Available at: Accessed on 3 March 2021.

Al-Farsi YM, Brooks DR, Werler MM, Cabral HJ, Al-Shafei MA, Wallenburg HC. Effect of high parity on occurrence of anemia in pregnancy: a cohort study. BMC Preg Childbirth. 2011;11:7.

Ismail IM, Kahkashan A, Antony A, Sobhith VK. Role of socio-demographic and cultural factors on anemia in a tribal population of North Kerala, India. Int J Community Med Public Health. 2016;3:1183-8.

Agarwal KN, Agarwal DK, Sharma A, Sharma K, Prasad K, Kalita MC, et al. Prevalence of anaemia in pregnant & lactating women in India. Indian J Med Res. 2006;124:173- 84.

Lokare PO, Karajekar VD, Gattani PL, Kulkarni AP. A study of prevalance of anemia and socio demographic factors associated with anaemia among pregnant women in Aurangabad city, India. Ann Nigerian Med. 2012;6:30-4.

Leonardi-Bee J, Britton J, Venn A. Second hand smoke and adverse fetal outcomes in nonsmoking pregnant women: A meta-analysis. Pediatrics. 2011; 127:734-41.

Goel P, Radotra A, Singh I, Aggarwal A, Dua D. Effects of passive smoking on outcome in pregnancy. J Postgrad Med. 2004;50:12-6.

Anlaakuu P, Anto F. Anaemia in pregnancy and associated factors: a cross sectional study of antenatal attendants at the Sunyani Municipal Hospital, Ghana. BMC Res Notes. 2017;10:402.

Kitila KT, Sori LM, Desalegn DM, Tullu KD. Burden of Helicobacter pylori infections and associated risk factors among women of child bearing age in Addis Ababa, Ethiopia. Int J Chronic Dis. 2018;2018: 5183713.

Abiselvi A, Gopalakrishnan S, Umadevi R, Rama R. Anaemia in pregnancy. Int J Community Med Public Health. 2018;5(2):721-7.

World Health Organization, recommendations on antenatal care for a positive pregnancy experience. Available at: handle/ 10665/250796/9789241549912-eng.pdf. Accessed on 3 March 2021.

Mishra V, Verneker R, Gandhi K, Choudhary S, Lamba S. Iron deficiency anemia with menorrhagia: ferric carboxy-maltose a safer alternative to blood transfusion. J Mid-life Health. 2018;9:92-6.

Weldekidan F, Kote M, Girma M, Boti N, Gultie T. Determinants of anemia among pregnant women attending antenatal clinic in public health facilities at Durame Town: unmatched case control study. Anemia. 2018;2018:8938307.

Mohandas S, Amritesh K, Lais H, Vasudevan S, Ajithakumari S. Nutritional assessment of tribal women in Kainatty, Wayanad: a cross-sectional study. Indian J Community Med. 2019;44:58-63.