title: Anaemia in pregnancy: associations with parity, abortions and child spacing in primary healthcare clinic attendees in Trinidad and Tobago.
abstract: OBJECTIVE
  To determine the prevalence of anaemia in antenatal clinic attendees; to investigate the effects of parity, age, gravidity, previous abortions, child spacing and other factors on the prevalence of anaemia in pregnancy.
  
  
  METHODS
  This was a retrospective and cross-sectional study. Antenatal records of 2287 pregnant women attending 40 public healthcare centres from January 2000 to December 2005 in Trinidad and Tobago were used. Data pertaining to the investigated variables were recorded. The national prevalence of anaemia was calculated and chi-square tests, odds ratios and logistic regression were used to assess the relationship between anaemia and each variable.
  
  
  RESULTS
  The prevalence of anaemia was 15.3% (95% CI 13.4%, 16.6%). No significant difference in the prevalence of anaemia was found among the different clinics or counties. At the first haemoglobin reading, age was inversely related to the presence of anaemia, whereas gestational age at first visit was directly related. At the final haemoglobin reading, parity, gravidity, and previous spontaneous abortions were directly related to the prevalence of anaemia, while the number of visits was inversely related. Age was inversely associated to the severity of anaemia while gravidity was directly related.
  
  
  CONCLUSIONS
  The prevalence of anaemia decreased by 18.7% from 1967. Despite this positive indication, women under 24 years and those commencing antenatal care after the first trimester are still at a higher risk for developing anaemia. Early commencement of antenatal care and close monitoring of the risk groups identified should be strongly advocated.
authors.affiliation: Department of Preclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
authors.forename: E O
authors.initials: EO
authors.lastname: Uche-Nwachi
authors.forename: A
authors.initials: A
authors.lastname: Odekunle
authors.forename: S
authors.initials: S
authors.lastname: Jacinto
authors.forename: M
authors.initials: M
authors.lastname: Burnett
authors.forename: M
authors.initials: M
authors.lastname: Clapperton
authors.forename: Y
authors.initials: Y
authors.lastname: David
authors.forename: S
authors.initials: S
authors.lastname: Durga
authors.forename: K
authors.initials: K
authors.lastname: Greene
authors.forename: J
authors.initials: J
authors.lastname: Jarvis
authors.forename: C
authors.initials: C
authors.lastname: Nixon
authors.forename: R
authors.initials: R
authors.lastname: Seereeram
authors.forename: C
authors.initials: C
authors.lastname: Poon-King
authors.forename: R
authors.initials: R
authors.lastname: Singh
mesh_terms: D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000740:Anemia / Q000145:classification / Q000453:epidemiology*; D001721:Birth Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D010298:Parity; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D015995:Prevalence; D011320:Primary Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D014300:Trinidad and Tobago / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult
chemical_list: D006454:Hemoglobins
references.citation: Tidsskr Nor Laegeforen. 1990 Oct 20;110(25):3222-4
references.pmid: 2256033
references.citation: Eur J Obstet Gynecol Reprod Biol. 2002 May 10;102(2):155-60
references.pmid: 11950483
references.citation: Fam Med. 2005 Oct;37(9):655-62
references.pmid: 16193419
references.citation: Am J Public Health Nations Health. 1967 May;57(5):857-68
references.pmid: 6067210
references.citation: Indian J Med Res. 1979 Apr;69:605-8
references.pmid: 457201
references.citation: Afr J Reprod Health. 2004 Dec;8(3):198-206
references.pmid: 17348336
references.citation: Int J Gynaecol Obstet. 2002 Nov;79(2):93-100
references.pmid: 12427391
references.citation: S Afr Med J. 1997 Nov;87(11):1544-7
references.pmid: 9472280
references.citation: Ethiop Med J. 1993 Oct;31(4):251-8
references.pmid: 8287859