An analysis of the determinants of anaemia in pregnant women in rural Malawi : a basis for action

Haematological data are presented on 4104 pregnant women attending the antenatal-care facilities of two hospitals in a rural area in southern Malawi. In this area, malaria transmission is perennial and there is a high prevalence of HIV infection. The local women are exposed to drought and food shortages but experience high fertility rates.Mean (s.d.) haemoglobin (Hb) concentration was significantly lower in the primigravidae [8.7 (1.6) g/dl] than in the secundigravidae [9.1 (1.5) g/dl; P< 0.0001] or multigravidae [9.2 (1.5) g/dl; P < 0.0001] Primigravidae also experienced significantly more iron deficiency and malaria than secundi- or multi-gravi-dae. For all parity groups, the lowest mean Hb levels were observed between 26–30 weeks' gestation. In primigravidae peak prevalence of malaria occurred between 16–20 weeks' gestation (38.6%) and peak prevalence of moderately severe anaemia (<8gHb/dl) between 26–30 weeks' (35.7%). Multigravidae showed little variation in the prevalence of anaemia, iron deficiency...