Prevalence and predictors of anaemia in pregnancy: the role of birth spacing, educational status and awareness levels in Meerut City

Authors

  • Prem Kumar Department of Liberal Arts & Humanities, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
  • Sartaj Ahmad Department of Liberal Arts & Humanities, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India https://orcid.org/0009-0006-1020-8982
  • Anuradha Davey Department of Community Medicine, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India https://orcid.org/0000-0003-4391-4665
  • Komal Saxena Department of obstetrics and Gynaecology Nursing Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India https://orcid.org/0000-0002-9185-8672

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20260683

Keywords:

Birth spacing, Anaemia, Awareness, Educational status, Maternal health, Meerut city, Pregnancy

Abstract

Background: Anaemia during pregnancy remains a major public health challenge in India and is a leading contributor to maternal and neonatal morbidity. Understanding its determinants is essential for designing targeted interventions. Evidence from urban areas such as Meerut City is limited, despite rapid urbanisation and shifting socioeconomic patterns. To assess the prevalence and predictors of anaemia among pregnant women in Meerut City, with specific focus on birth spacing, educational status and awareness related to anaemia.

Methods: A cross-sectional study was conducted among 904 pregnant women attending antenatal clinics in Meerut City. Data were collected using a structured, interviewer-administered questionnaire along with haemoglobin estimation based on WHO criteria. Logistic regression analysis was performed to identify significant predictors of anaemia.

Results: Anaemia prevalence was 59.6%, comprising 22.9% mild, 34.5% moderate and 2.2% severe cases. Short interpregnancy interval (<24 months) showed a strong association with anaemia (p<0.05). Women with lower educational attainment and poor awareness of anaemia were significantly more likely to be anaemic, indicating a prominent role of reproductive, educational and informational factors.

Conclusions: Anaemia among pregnant women in Meerut City remains alarmingly high. Short birth spacing, low maternal education and inadequate awareness emerged as key predictors. Strengthening ANC counselling, enhancing women’s health literacy and promoting optimal birth spacing are critical strategies to reduce the burden of anaemia in similar urban populations.

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References

Zhu BP, Rolfs RT, Nangle BE, Horan JM. Effect of the interval between pregnancies on perinatal outcomes. N Engl J Med. 1999;340(8):589–94. DOI: https://doi.org/10.1056/NEJM199902253400801

Conde-Agudelo A, Belizán JM, Lammers C. Maternal morbidity and mortality associated with interpregnancy interval: cross-sectional study. BMJ. 2000;321:1255. DOI: https://doi.org/10.1136/bmj.321.7271.1255

King JC. The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies. J Nutr. 2003;133(5):1732–6. DOI: https://doi.org/10.1093/jn/133.5.1732S

Rutstein SO. Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. Int J Gynaecol Obstet. 2005;89:7–24. DOI: https://doi.org/10.1016/j.ijgo.2004.11.012

Anorlu RI, Oluwole AA, Abudu OO. Sociodemographic factors in anaemia in pregnancy at booking in Lagos, Nigeria. J Obstet Gynaecol. 2006;26(8):773–6. DOI: https://doi.org/10.1080/01443610600963846

World Health Organization. Report of a WHO technical consultation on birth spacing: Geneva, Switzerland 13–15 June 2005. Geneva: World Health Organization. 2007.

Dewey KG, Cohen RJ. Does birth spacing affect maternal or child nutritional status? A systematic literature review. Matern Child Nutr. 2007;3(3):151–73. DOI: https://doi.org/10.1111/j.1740-8709.2007.00092.x

Conde-Agudelo A, Rosas-Bermudez A, Castano F, Norton MH. Effects of birth spacing on maternal, perinatal, infant and child health: a systematic review of causal mechanisms. Stud Fam Plann. 2012;43(2):93–114. DOI: https://doi.org/10.1111/j.1728-4465.2012.00308.x

Wendt A, Gibbs CM, Peters S, Hogue CJ. Impact of increasing inter-pregnancy interval on maternal and infant health. Paediatr Perinat Epidemiol. 2012;26(1):239–58. DOI: https://doi.org/10.1111/j.1365-3016.2012.01285.x

Uche-Nwachi EO, Odekunle A, Jacinto S, Burnett M, Clapperton M, David Y, et al. Anaemia in pregnancy: associations with parity, abortions and child spacing in primary healthcare clinic attendees in Trinidad and Tobago. Afr Health Sci. 2010;10(1):66–70.

Riyanto DL. Short interpregnancy interval as a risk factor for anaemia in pregnancy: a retrospective cohort study in Duren Sawit, Jakarta, 2014–2016. Adv Sci Lett. 2017;23(7):6828–30. DOI: https://doi.org/10.1166/asl.2017.9408

Schummers L. Association of short interpregnancy interval with pregnancy outcomes according to maternal age. JAMA Intern Med. 2018;178(12):1661–71. DOI: https://doi.org/10.1001/jamainternmed.2018.4696

Hutcheon JA, Moskosky S, Ananth CV, Basso O, Briss PA, Ferré CD, et al. Good practices for the design, analysis and interpretation of observational studies on birth spacing and perinatal health outcomes. Paediatr Perinat Epidemiol. 2019;33(1):15–24. DOI: https://doi.org/10.1111/ppe.12512

Sanga LA, Mtuy T, Philemon RN, Mahande MJ. Inter-pregnancy interval and associated adverse maternal outcomes among women who delivered at Kilimanjaro Christian Medical Centre in Tanzania, 2000–2015. PLoS ONE. 2020;15(2):228330. DOI: https://doi.org/10.1371/journal.pone.0228330

Yaya S, Uthman OA, Ekholuenetale M, Bishwajit G, Adjiwanou V. Effects of birth spacing on adverse childhood health outcomes: evidence from 34 countries in sub-Saharan Africa. J Matern Fetal Neonatal Med. 2020;33(20):3501–8. DOI: https://doi.org/10.1080/14767058.2019.1576623

Sinha M. Awareness regarding anaemia among antenatal women. medRxiv. 2021;3:658.

International Institute for Population Sciences (IIPS). National Family Health Survey (NFHS-5): India report. 2021.

Gebremedhin AT, Regan AK, Ball S, Betrán AP, Foo D, Gissler M, et al. Interpregnancy interval and hypertensive disorders of pregnancy: a population-based cohort study. Paediatr Perinat Epidemiol. 2021;35(4):404–14. DOI: https://doi.org/10.1111/ppe.12668

Mishra R, Gupta S. Knowledge and practices regarding anaemia in pregnancy: a KAP study. J Clin Health Res. 2021.

Agrawal S, Chaudhary M, Das V, Agarwal A, Pandey A, Kumar N, et al. Association of long and short interpregnancy intervals with maternal outcomes. J Family Med Prim Care. 2022;11(6):759. DOI: https://doi.org/10.4103/jfmpc.jfmpc_2231_21

Kausar Z. Effect of interpregnancy interval on maternal anaemia in current pregnancy and its obstetric outcome. Int J Pharm Clin Res. 2022;14(8):889–97.

Mruts KB. Interpregnancy interval and maternal anaemia in 21 sub-Saharan African countries. Reprod Health. 2022;4:74-9. DOI: https://doi.org/10.1371/journal.pone.0275155

Varma G. Awareness about anaemia among antenatal mothers in tertiary settings. Academic Med J. 2022;2:65.

Mehta S, Roy P. Prevalence of anaemia in urban slum antenatal women in Mumbai. J Community Med. 2022;6:822-8.

Rahman M. The prevalence of anaemia during pregnancy and its consequences: systematic review. BMC Pregnancy Childbirth. 2022;1:729.

Ni W. Birth spacing and risk of adverse pregnancy and birth outcomes: a systematic review and dose–response meta-analysis. Acta Obstet Gynecol Scand. 2023;2:82-8. DOI: https://doi.org/10.1111/aogs.14648

Talin IA. Exploring factors influencing the severity of pregnancy-associated anaemia in India: DHS 2019–21 analysis. Sci Rep. 2023;4:87.

Dhamrait G. Interpregnancy interval and adverse birth outcomes: population-based cohort study of twins. BMC Pregnancy Childbirth. 2023;4:119. DOI: https://doi.org/10.1186/s12884-023-06119-x

Purakayastha R. Prevalence and determinants of anaemia among pregnant women in rural Bihar: a cross-sectional analysis. Indian J Public Health. 2023;5:454.

Mohapatra A. A cross-sectional knowledge, attitude and practice study for copper IUCD in a tertiary care centre in New Delhi. International J Reprod, Contrac, Obst Gynecol. 2023;12(6):1623. DOI: https://doi.org/10.18203/2320-1770.ijrcog20231525

Ahmed K. Anaemia prevalence: NFHS review. Reprod Epidemiol Rev. 2023;5:368.

Let S, Singh P, Sharma R. Prevalence and determinants of anaemia among reproductive age women in India. BMC Public Health. 2024;5:925-9.

Kannaujiya AK, Kumar K, McDougal L, Upadhyay AK, Raj A. Interpregnancy interval and child health outcomes in india: evidence from three recent rounds of national family health survey. Mat Child Health J. 2023;27(1):126-41. DOI: https://doi.org/10.1007/s10995-022-03559-3

Jha NI, Mahida SJ, Parmar MM, Limbani TR. Prevalence and Socioeconomic Determinants of Iron Deficiency Anemia among Adolescent Girls in Rural India. Europ J Cardiovas Med. 2025;15:231-4.

Das M, Verma M, Barman P, Behera DK. Prevalence of anaemia among married women with recent birth history and high-risk fertility behaviour: secondary data analysis of the National Family Health Survey-India (2019–21). BMJ Open. 2024;14(1):73395. DOI: https://doi.org/10.1136/bmjopen-2023-073395

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Published

2026-02-27

How to Cite

Kumar, P., Ahmad, S., Davey, A., & Saxena, K. (2026). Prevalence and predictors of anaemia in pregnancy: the role of birth spacing, educational status and awareness levels in Meerut City. International Journal Of Community Medicine And Public Health, 13(3), 1294–1302. https://doi.org/10.18203/2394-6040.ijcmph20260683

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Original Research Articles