Epidemiology and Risk Stratification of Microcytic Hypochromic Anemia in Pregnancy: A Cross-sectional Study in Takoradi, Ghana

Abstract

Anemia in pregnancy is a major public health concern, particularly in low-resource settings, where iron deficiency remains the leading cause. This study investigated the prevalence, determinants, and risk profiling of microcytic hypochromic anemia, a type of anemia characterized by smaller than normal red blood cells (RBCs) with pale coloration due to less hemoglobin, among 360 pregnant women. Haematological indices, including haemoglobin, mean corpuscular volume (MCV), and mean corpuscular haemoglobin concentration (MCHC), were assessed to determine anemia status. Chi-square tests and logistic regression were used to examine associations and predictors of low ferritin, while risk stratification was conducted using quintiles of predicted probabilities. The results showed that 82.5% of women were anaemic, of microcytic hypochromic aneamia accounted for 72.5%. A history of anemia prior to pregnancy was significantly associated with current anemia status. Logistic regression identified prior anemia, smoking, alcohol consumption, being single, and parity of two as significant predictors of low ferritin, whereas supplement use during pregnancy was strongly protective. Risk profiling demonstrated clear model calibration, with prevalence of low ferritin increasing from 1.4% in the lowest risk quintile to 79.2% in the highest. These findings highlight the urgent need for comprehensive antenatal strategies that integrate universal supplementation, behavioural counselling, and socio-economic support to reduce the burden of anemia and improve maternal outcomes.