Anaemia and iron deficiency in pregnant women attending an antenatal clinic in a Teaching Hospital in Southern Sri Lanka

Abstract

Introduction In Sri Lanka the current prevalence of anaemia during pregnancy is estimated to be less than 20%. Objectives To determine the rate of anaemia defined as hemoglobin concentration < 11 g/dl, and the rate of iron deficiency using the best cut off level of serum ferritin, in women presenting for antenatal care. Methods Three hundred and fifty consecutive pregnant women with gestations between 12 to 20 weeks, presenting to the Academic Obstetric Unit at the Teaching Hospital Mahamodera, Galle, Sri Lanka from 10.11.2014 to 13.01.2015 had their heamoglobin and hematocrit measured by flowcytometry and hydro-dynamic focusing methods using a Sysmex- XS-500i System and serum ferritin measured by electro-chemiluminescence method using a Cobas-e411 Analyzer. The rate of anaemia was calculated. The best cut off level of serum ferritin for the detection of anaemia was obtained using a Receiver Operator Characteristics (ROC) curve, and using this cut off, the rate of iron deficiency was calculated. Results The rate of anaemia was 16.6%. The best cut off level of serum ferritin for the detection of anaemia was < 30 μg/L (the area under the ROC curve was 0.77; 95% CI -0.72 to0.81), with a sensitivity of 78.3% (95% CI 65.8 - 87.9) and a specificity of 74% (95% CI 68.6 -79.0) in detecting anaemia. Using this cut off, 36.9% of the pregnant women had iron deficiency. Conclusions Rates of anaemia (16.6%) and iron deficiency (36.9%) in pregnancy are at levels of mild to moderate public health significance respectively.