Prevalence of iron deficiency anaemia among microcytic anaemic premenopausal patients at tertiary care hospital, Karachi

Ghulam Abbas Memon, Tooba Jawed Khan, Shabnam Abbas, Ghulam Abbas Shaikh, Nusrat Shah, Hammad Afzal Kayani, Muhammad Atif Habib


Background: Iron deficiency anaemia (IDA) is the prevalent form of anaemia which has become a major public health problem, globally. Women in the reproductive age group (15–49 years of age) are at increased risk, especially in the South Asian population. It is of paramount importance to identify these micronutrient deficiencies in this age group as it adversely affects the birth outcomes, but the mother and the child at risk of morbidity and mortality during pregnancy.  

Methods: A cross-sectional study was conducted at Civil Hospital, Karachi for 12 months i.e. October, 2018 to December, 2019. Data was prospectively collected from patients after obtaining written informed consent. 377 patients were included who met the diagnostic criteria. Descriptive statistics were used and qualitative data analysis; mean, standard deviation, frequency, and percentages were respectively calculated. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. For post-stratification, the chi-square test was applied with a p value of≤0.05.

Results: A total of 377 patients with microcytic anaemia were enrolled from Civil Hospital, Karachi. Mean age, duration of anaemia, haemoglobin, height, weight and BMI in our study was 29.28±6.14 years, 1.41±0.26 months, 9.27±0.86 mg/dl, 26.72±1.56 kg/m2, 138±7.28 cm and 78.7±9.87 kg. Out of 377 patients with microcytic anaemia, 144 (38.2%) and 233 (61.8%) had and did not have iron deficiency anaemia.  

Conclusions: IDA is frequently found in microcytic anaemia patients. Thus, it is important to screen premenopausal in female patients for iron deficiency presenting with microcytic anaemia to prevent adverse outcomes.  


Microcytic anaemia, Iron deficiency anaemia, Premenopausal patients, Tertiary Care Hospital, Karachi

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World Health Organization. The prevalence of anaemia in women: a tabulation of available information. 2015. Geneva, WHO 1992.

Eisenstaedt R, Penninx BW, Woodman RC. Anaemia in the elderly: Current understanding and emerging concepts. Blood Rev. 2006;2:213-26.

World Health Organization. The Global Prevalence of Anaemia in 2011. Geneva, Switzerland: World Health Organization; 2015. Available at: Accessed on 15 June 2020.

Basturk A, Kutlucan L, Kutlucan A, Pekin AT, Akinci S, Dagli M, et al. Evaluation of pregnant women awareness about anaemia and factors affecting the development of anaemia. Eur J Health Sci. 2016;2(1):1-4.

Karakus V, Giden A, Ersil SD, Bozkurt S, Kurtoglu E. Evaluation of anaemia in terms of etiology, risk factors, and relapse in adult patients. Mugla Med J. 2016;3:1-6.

Massawe SN, Urassa EN, Nyström L, Lindmark G. Anaemia in women of reproductive age in Dar-es-Salaam, Tanzania. East Afr Med J. 2002;79(9):461-6.

Erdem O, Bucaktepe EG, Kara IH. Family medicine clinic women attending the iron deficiency anaemia and gestation story relations. J Dicle Med. 2009;36:123-6.

Bhandari S, Sayami JT, Thapa P, Sayami M, Kandel BP, Banjara MR. Dietary intake patterns and nutritional status of women of reproductive age in Nepal: findings from a health survey. Arch Public Health. 2016;74:2.

Gereklioglu C, Asma S, Korur A, Erdogan F, Kut A. Medication adherence to oral iron therapy in patients with iron deficiency anaemia. Pak J Med Sci. 2016;32(3):604-7.

Fraser IS, Mansour D, Breymann C, Hoffman C, Mezzacasa A, Petraglia F. Prevalence of heavy menstrual bleeding and experiences of affected women in a Europeanpatientsurvey. Int J Gynaecol Obstet. 2015;128(3):196-200.

Sekhar DL, Murray-Kolb LE, Kunselman AR, Weisman CS, Paul IM. Differences in risk factors for anaemia between adolescent and adult women. J Women's Health. 2016;25(5):505-13.

Bodnar LM, Scanlon KS, Freedman DS, Siega-Riz AM, Cogswell ME. High prevalence of postpartum anaemia among low-income women in the United States. Am J Obstet Gynecol. 2001;185(2):438-43.

Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Nutrition Impact Model Study Group (Anaemia). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011:a systematic analysis of population-representative data. Lanc Glob Heal. 2013;1(1):16-25.

Nguyen PH, Casanova-Gonzalez I, Pharm H, Truong TV, Nguyen S, et al. Multicasual etiology of anaemia among women of reproductive age in Vietnam. Euro J Clin Nutr. 2015;69(1):107-13.

Lone FW, Qureshi RN, Emanuel F. Maternal anaemia and its impact on perinatal outcome. Trop Medic Int Heal. 2004;9(4):486-90.

Lone FW, Qureshi RN, Emmanuel F. Maternal anaemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan. East Medit Heal J. 2004;10(6):801.

Baig-Ansari N, Badruddin SH, Karmaliani R, Harris H, Jehan I, Pasha O, et al. Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food Nutrit Bullet. 2008;29(2):132-9.

Unicef data. Maternal mortality. 2020. Available at: . Accessed on 22 June 2020.

Alvarez-Uria G, Naik PK, Midde M, Yalla PS, Pakam R. Prevalence and severity of anaemia stratified by age and gender in rural India. Anaemia. 2014;2014:176182.

Zhao L, Zhang X, Shen Y, Fang X, Wang Y, Wang F. Obesity and iron deficiency: A quantitative meta-analysis. Obes Rev. 2015;16(12):1081-93.

Kara IH, Baltaci D, Sayin S, Yilmaz A, Çeler A, Karaçam MS, et al. Investigation of haematological and biochemical parameters in obese women of reproductive age. J Konuralp Med. 2012;4:1-7.

Gebre A, Mulugeta A. Prevalence of Anaemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethiopia: A Cross-Sectional Study. J Nutr Metabol. 2015:1-7.

Taha A, Azhar S, Lone T, Murtaza G, Ali Khan S, et al. Iron deficiency anaemia in reproductive age women attending obstetrics and gynaecology outpatient of the university health centre in Al-Ahsa, Saudi Arabia. Afr J Tradit Complement Altern Med. 2014;11(2):339-42.

Camaschella C. Iron-deficiency anaemia. N Engl J Med. 2015;372:1832-43.

Republic of Turkey State Planning Organization of the National Food and Nutrition Strategy Working Group Report. 2003. s:43. DPT:2670.

Wintrobe MM, Lukens JN, Lee GR. The approach to the patient with anaemia. In: Lee GR, Bithell TC, Foerster J, Athens JW, Lukens JN, editors. Wintrobe's Clinical Hematology. 8th ed. Philadelphia, PA: LeaandFebiger; 1993.

Kulnigg S, Gasche C. Systematic review: managing anaemia in Crohn’s disease. Aliment Pharmacol Ther. 2006;24(11-12):1507-23.

Gasche C. Anaemia in IBD: the overlooked villain. Inflamm Bowel Dis. 2000;6(2):142-50.

De Nicola L, Minutolo R, Chiodini P et al. SIN-TABLE CDK Study Group. Prevalence and prognosis of mild anaemia in non-dialysis chronic kidney disease: a prospective cohort study in outpatient renal clinics. Am J Nephrol. 2010;32(6):533-40.

Saydam BK, Genc RE, Sarac F, Turfan EC. Prevalence of anaemia and related factors among women in Turkey. Pak J Med Sci. 2017;33(2):433-8.

Liao QK. Prevalence of iron deficiency in pregnant and premenopausal women in China: a nationwide epidemiological survey. Zhonghua Xue Ye Xue Za Zhi. 2004;25(11):653-7.

Gautam S, Min H, Kim H, Jeong H-S. Determining factors for the prevalence of anaemia in women of reproductive age in Nepal: Evidence from recent national survey data. PLoS ONE. 2019:14(6): e0218288.

Mawani M, Ali SA, Bano G, Ali SA. Iron Deficiency Anaemia among Women of Reproductive Age, an Important Public Health Problem: Situation Analysis. Reprod Syst Sex Disord. 2016:5:187.

Borch-Iohnsen B, Meltzer HM, Stenberg V, Reinskou T. Iron status in a group of Norwegian menstruating women Eur. J. Clin. Nutr. 1990:44:23-8.