PREVALENCE OF MATERNAL ANEMIA AND CLINICAL EFFICACY OF IRON SUPPLEMENTATION STRATEGIES IN RESOURCE-CONSTRAINED SETTINGS

Prof. Sophie Dubois; MD; Dr. Pierre Laurent; MD

Abstract

Maternal anemia remains a formidable global health challenge, disproportionately affecting pregnant women in resource-constrained environments. This cross-sectional and interventional study examines the prevalence of gestational anemia and evaluates the therapeutic efficacy of standardized oral iron supplementation programs in low-income regions. By tracking 950 pregnant subjects, the research identifies critical barriers to hematological optimization, including late-term presentation and gastrointestinal intolerability of supplements. The findings underscores a significant prevalence rate of 48.2% at the first trimester, which climbs to 56.4% without structured intervention. Through a rigorous comparative analysis of treatment arms, the study demonstrates that while oral ferrous sulfate remains the standard of care, adherence remains the primary determinant of clinical success. The data suggests that targeted nutritional education combined with routine iron-folic acid (IFA) distribution can significantly reduce the incidence of severe anemia (Hb < 7.0 g/dL), although moderate anemia persists in nearly a third of the cohort. These insights are vital for refining maternal health protocols and directing public health resources toward high-risk demographic clusters to improve neonatal outcomes and maternal survival rates.

Keywords: Maternal Anemia, Iron-Folic Acid Supplementation, Gestational Health, Low-Income Regions, Hemoglobin Concentration, Prenatal Care, Public Health Intervention, Nutritional Deficiency

This research addresses a cornerstone of the Sustainable Development Goals (SDGs) by targeting maternal mortality and morbidity. In low-income regions, maternal anemia is not merely a clinical condition but a manifestation of systemic socioeconomic disparities, including food insecurity and inadequate healthcare infrastructure. Reduced oxygen-carrying capacity in the blood significantly increases the risk of postpartum hemorrhage—the leading cause of maternal death globally—as well as intrauterine growth restriction and preterm birth. By providing empirical data on the efficacy of current supplementation programs, this study identifies specific failure points in existing public health frameworks. The evidence generated allows policymakers to transition from generic intervention strategies to evidence-based, localized protocols. Furthermore, understanding the quantitative impact of adherence on hematological recovery provides a basis for developing better patient education materials, ultimately aiming to reduce the global burden of maternal anemia and enhance the health trajectory of the next generation.

To determine the point prevalence of gestational anemia among expectant mothers in low-income regions and evaluate the clinical efficacy of routine iron-folic acid supplementation on maternal hemoglobin concentrations.

A prospective cohort study was conducted involving 950 pregnant women (ages 18–42) across three rural primary health centers over an 18-month period. Participants were screened for anemia at their initial prenatal visit using automated hematology analyzers. Successive follow-ups were conducted at 24 and 36 weeks of gestation. The intervention group (n=475) received daily oral iron-folic acid (60 mg elemental iron/400 μg folic acid), while the control group (n=475) represented those with late-stage registration or irregular access to supplies. Hemoglobin (Hb) levels, serum ferritin, and mean corpuscular volume (MCV) were measured. Adherence was assessed via pill counts and self-reported surveys. Data were analyzed using Chi-square tests for prevalence and independent t-tests for longitudinal Hb changes. Multivariate logistic regression was employed to identify independent predictors of anemia, adjusting for maternal age, parity, and socioeconomic status. All P-values were two-sided with significance set at

80% adherence showed an OR of 4.2 (95% CI: 2.8–6.3, p

11.0 g/dL compared to the low-adherence group. Despite supplementation, 28.4% of the intervention group remained moderately anemic at delivery. Adverse gastrointestinal effects were reported by 42.1% of participants, which was the most cited reason for non-compliance. Multivariate analysis identified maternal parity >3 (AOR 2.1, 95% CI: 1.4–3.2) and lack of secondary education (AOR 1.8, 95% CI: 1.2–2.7) as significant risk factors for persistent anemia.

The study confirms that maternal anemia is a critical public health burden in low-income regions, with prevalence rates exceeding the WHO threshold for high significance. While standardized iron supplementation is efficacious in elevating hemoglobin levels among adherent patients, the high rate of non-compliance due to side effects limits its population-level impact. The findings suggest that current supplementation strategies are insufficient to fully eradicate moderate anemia, likely due to multifactorial etiologies including parasitic load and micronutrient deficiencies. Therefore, clinical protocols should move beyond simple distribution toward integrated care models that include nutritional counseling, early screening in the first trimester, and potentially, the introduction of intravenous iron formulations for high-risk individuals. Addressing these gaps is essential for reducing maternal morbidity and improving birth weights across impoverished demographics.