Geographic Inequalities and Determinants of Aneamia among Preeclamptic Women in Bangladesh

Abstract

Abstract Background Anaemia is among preeclamptic women's main health problems in Bangladesh. Aneamia affects pregnant women and women of reproductive age who have hemoglobin levels below 11.0 g/dl. In Bangladesh, the prevalence of aneamia among pregnant women is 42.2%, compared to a global incidence of 38.2%, which raises a major public health concern. Methods Information from 180 respondents was gathered from the Department of Gynecology and Obstetrics, Preeclampsia (PE) ward at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, between September 2021 and August 2022 [Ethical approval Ref: Memo No. ERC-DMC/ECC/2022/31]. Factors associated with aneamia were explored using the chi-square test, and then we performed multinomial logistic regression (MLR) to determine the level of association with the risk factors. We further conducted cluster analysis, Global Moran’s I, and Anselin local Moran’s I to check the geographical distribution of anaemia cases from our sample. Results Early and late PE onset were recorded and classified into two categories; 28.9% of respondents reported an early onset of PE, while 71.1% reported a late onset of PE. A total of 38.9% of subjects had normal hemoglobin counts, whereas 38.3% had mild aneamia. A total of 17.8% had moderate aneamia, and 5.0% had severe aneamia. By performing MLR, anaemia had a statistically significant association with several underlying factors, e.g., recreational substance use (RR = 83.093, 95% CI- 3.351 to 2060.315), gestational age (RR = 10.235, 95% CI- 1.478 to 70.879), gestational diabetes mellitus (RR = 4.906, 95% CI- 1.920 to 12.532), pregnancy interval (RR = 4.374, 95% CI- 1.338 to 4.303), education (RR = 3.448, 95% CI- 1.542 to 7.709), profession (RR = 0.263, 95% CI- 0.109 to 0.635), parity (RR = 0.117, 95% CI- 0.026 to 0.529), and respondent age (RR = 0.160, 95% CI- 0.032 to 0.802). Higher incidence rates for all kinds of aneamia were observed in the Dhaka, Narayanganj, and Munshiganj districts. The global Moran’s I value ranged from 0.14 to 0.44, and high-high cluster regions were detected in the central region. Conclusions The risk factors indicated in this study and geographical inequalities will help policymakers take necessary steps. The geographical distribution of the incidence rate raises concern for further research, including sociodemographic and environmental factors. This will assist in determining the determinants of aneamia and suggest possible measures.