The Prevalence and Causes of Anemia during Pregnancy in Maharaj Nakorn Chiang Mai Hospital
Bunyarit Sukrat MD*, Supatra Sirichotiyakul MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : To determine the prevalence and causes of anemia during pregnancy in Maharaj Nakorn Chiang
Mai Hospital.
Materials and Methods : The pregnant women were screened with hemoglobin, hematocrit, osmotic fragility
test, hemoglobin E test and serology for hepatitis B, syphilis and HIV at first antenatal visit. In anemic cases,
serum ferritin, serum iron/total iron binding capacity, or therapeutic trial with iron supplementation were
performed to assess the iron status. The cases of abnormal thalassemia screening were followed by hemoglo-
bin A2 level, PCR for alpha-1(SEA type) and hemoglobin electrophoresis. Additional tests were stool exam,
stool occult blood and red blood cell indices. Anemia was defined as a hemoglobin level less than 11.0 g/dl in
the first and third trimester or less than 10.5 g/dl in the second trimester of pregnancy. The data was presented
as mean, standard deviation and percentage.
Results : Six hundred and forty eight pregnant women were recruited. The prevalence of anemia was 20.1
percent(128 cases). Classified in each trimester, the prevalence was 17.3%, 23.8% and 50.0% in the first,
second and third trimester, respectively. Thalassemia carriers and diseases were detected in 56 from 102
anemic pregnant women (54.9%). Iron status was assessed in 58 cases and iron deficiency anemia was found
in 25 cases (43.1%). Other causes of anemia were parasitic infection (8.7%) and anemia of chronic disease
(2.7%). In 37 anemic pregnant women (33.0%), the causes of anemia were not found.
Conclusion : The prevalence of anemia in pregnant women who first attended at the antenatal clinic was
20.1%. The main causes of anemia were thalassemia carriers/diseases and iron deficiency anemia.
Keywords : Anemia, Pregnancy, Prevalence, Thalassemia, Iron-deficiency anemia
