See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/322598081

Prevalence of Iron Deficiency Anemia in Pregnant Women of District Mardan,

Pakistan

Article · January 2017

DOI: 10.4172/2376-127X.1000356

CITATIONS READS

5 1,171

3 authors, including:

Sulaiman Shams Abdul Wadood

Centre of Excellence in Molecular Biology Abdul Wali Khan University Mardan
34 PUBLICATIONS   293 CITATIONS    209 PUBLICATIONS   1,676 CITATIONS   

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Synthetic green chemistry techniques View project

The methicillin-resistant S. epidermidis strain RP62A genome mining for potential novel drug targets identification View project

All content following this page was uploaded by Sulaiman Shams on 10 February 2018.

The user has requested enhancement of the downloaded file.

 ncy an
gna d Shams et al., J Preg Child Health 2017, 4:6
Journal of P re

Ch
DOI: 10.4172/2376-127X.1000356
Journal of Pregnancy and Child Health
ISSN: 2376-127X ild Health

Research
Research Article
Article OpenAccess
Open Access

Prevalence of Iron Deficiency Anemia in Pregnant Women of District

Mardan, Pakistan
Sulaiman Shams1*, Zarmina Ahmad1,2 and Abdul Wadood1
1
Department of Biochemistry, Abdul Wali Khan University Mardan, Pakistan
2
Department of Biochemistry, Bacha Khan Medical College Mardan, Pakistan

Abstract
Background: Iron depletion is the most common nutrient deficiency worldwide and is the leading cause of anemia.
Anaemia in pregnancy is a common clinical problem contributing to increased maternal and foetal morbidity. Previously
few studies have highlighted this problem in developing country like Pakistan but the situation needs further exploration
in pregnant women of less developed areas. The current study aimed to estimate the prevalence of iron deficiency
anemia (IDA) among pregnant women of district Mardan, Khyber Pakhtunkhwa (KP), Pakistan.
Methods: The study consisted of 300 pregnant women in the age group (18-40) years. Blood samples were
collected from each pregnant woman and a questionnaire was completed at the time of blood collection. Hematological
and biochemical profiles were determined and the collected data was analyzed using SPSS.
Results: In the current study the overall prevalence rate of iron deficiency anemia in pregnant women was
(76.7%). Iron deficiency anemia was most prevalent in the second trimester (45.7%) as compared to first (16.1%) and
third (38.2%) trimester pregnancy. Of the anemic cases, 42.6% have low iron stores and 43.5% have serum ferritin in
a range of 12-30 ng/ml. In 60% of cases CRP was raised and 72.2% were multiparous. Of the study population, 65%
were uneducated and 87% belonged to lower middle class.
Conclusion: This study concluded that anemia is highly prevalent among the antenatal women of this area and
iron deficiency considered to the culprit behind this disease. Multiparty, low socio-economic status and low education
are the contributory factors of iron deficiency anemia. There is a great need for further health education promotional
programs to improve heath of pregnant women.

Keywords: Pregnancy; Haematological and biochemical profiles; and Multan (76%) [10-12]. Although the differences among the
Mardan; Anemia; Iron deficiency reported prevalence rates in the studies might be due to variations in
the main characteristics of their target population, methodological
Introduction differences such as laboratory tests. But Despite its known effect on
Anaemia from Greek Anaimia, “meaning without blood” is as the population, very limited data is available on the biochemical
a condition in which either the number of red blood cells (RBCs) deficiency of micronutrient like iron in pregnant women of the studied
decreased or their oxygen-carrying capacity reduce to meet the body region of Khyber Pakhtunkhwa (KP). Identifying the prevalence of
normal physiologic functions. Anemia is especially common in women anaemia and determining its causes in individuals of high-risk groups,
of reproductive age and particularly during pregnancy. Anemia is a such as in pregnant women is a dire need of the day particularly in
well-studied and well known risk factor in pregnancy for both mother developing countries like Pakistan, where the social conditions pose
and fetus life. Anaemia is associated with increased pre-term labour serious challenges to women. Therefore, this study was carried out to
(28.2%), pre-eclampsia (31.2%) and maternal sepsis [1,2]. Three types determine the prevalence of anemia and true iron deficiency in the
of anemia during pregnancy are severe anemia when hemoglobin pregnant women of district Mardan and to compare it with previously
concentration is less than 7.0 g/dL, moderate when hemoglobin falls done studies.
between 7.0-9.9 g/dL and mild anemia when hemoglobin level range Materials and Methods
from 10.0 to 11.0 g/dL [3,4]. Anemia has a variety of converging
contributing factors including nutritional, genetic, frequent labour, Study design, study population and sampling size
multiparity, abortions and infectious disease, however, iron deficiency
This was a descriptive, cross sectional type of study. The study
is the cause of 75% of anemia cases [1,5,6]. The major causes of
population comprised 300 women aged 18-40 years, at various stages of
iron deficiency include insufficient intake of iron-rich foods and
poor bioavailability of consumed iron in relation to the need during
pregnancy [7]. The demand for iron increases about six to seven times
*Corresponding author: Sulaiman Shams, Department of Biochemistry,
from early pregnancy to the late pregnancy [8]. Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan, Tel:
+923339202865; E-mail: [email protected]
Iron deficiency anemia (IDA) is a well-reported problem during
pregnancy in both developed and developing countries including Received: October 16, 2017; Accepted: November 01, 2017; Published:
November 08, 2017
Pakistan. In the world the number of anaemic people around 1.62
billion among which 56 million are pregnant women [5]. Prevalence Citation: Shams S, Ahmad Z, Wadood A (2017) Prevalence of Iron Deficiency
Anemia in Pregnant Women of District Mardan, Pakistan. J Preg Child Health 4:
of iron deficiency anemia among women in developing countries was 356. doi:10.4172/2376-127X.1000356
calculated from 40% to 88%. In Pakistan the prevalence of anemia
among pregnant women living in urban areas was reported from 29% to Copyright: © 2017 Shams S, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
50% [9]. Some studies have shown that the frequency of Iron deficiency use, distribution, and reproduction in any medium, provided the original author and
anemia varies in the pregnant women of Karachi (64%), Lahore (73%) source are credited.

J Preg Child Health, an open access journal

ISSN: 2376-127X Volume 4 • Issue 6 •1000356
Citation: Shams S, Ahmad Z, Wadood A (2017) Prevalence of Iron Deficiency Anemia in Pregnant Women of District Mardan, Pakistan. J Preg Child
Health 4: 356. doi:10.4172/2376-127X.1000356

Page 2 of 5

pregnancy belonging to different socioeconomic backgrounds. A total ANTECH Diagnostics. Add 50 ul of the sample and one drop each of
of 300 apparently healthy pregnant women were studied attending the positive (Human serum with CRP concentration >20 mg/L Sodium
out patient department of Gynae and Obstetric Unit of Mardan Medical azide 0.95 g/L) and negative controls (Animal serum sodium azide
Complex. 0.95 g/L) into separate circles on the test slide. The CRP latex reagent
was swirled gently before using. Then 50 μl of the reagent was added
Inclusion and exclusion criteria to the samples. The drops mixed and spread over the entire surface
Healthy pregnant women, aged 18-40 years at different stages with a stirrer. Different stirrers were used for different samples. The
of pregnancy belonging to district Mardan were selected, whose slide was put on a mechanical rotator at 80-100 rpm for 2 min. Then
Haemoglobin level were below 11 g/dl. While excluded pregnant women the slide examined macroscopically for the presence or absence of any
with any acute illnesses, gestational diabetes mellitus, hypertension, visible agglutination. The presence of agglutination showed a CRP
obesity, women with other chronic diseases, women over age 40 and concentration of equal to or greater than 6 mg/L. CRP concentrations
women with a history of blood loss/blood transfusion in the present were determined in triplicate and the mean was used for analysis.
pregnancy.
Care manager
Ethical consideration Five care managers were working in the office and Clinic of
This study was approved by the ethics committee of the Abdul Zarmina Ahmad at Bacha Khan Medical College And in office of Dr.
Wali Khan University Mardan KP and performed in accordance with Sulaiman Shams in Biochemistry Department AWKUM. The central
the principles of Committee. To ensure their voluntary participation, aim of the care managers was to empower pregnant females living with
inform consent was obtained from all the participants. iron deficiency to take a more active role in their health.

Questionnaire interview Statistical analysis of the data

A questionnaire based interview was done from all the participants. All data are presented as mean ± SD. Significant differences were
All interviews were conducted face to face by the researcher’s their self. determined by using ANOVA in SPSS 16.0. P<0.05 was considered
During the survey the researcher explained a question that was not statistically significant.
clear. The questionnaire included questions on socio-demographic data
(age, education and family income/month), medical history (previous Results
pregnancy, complications in previous pregnancy), clinical data From different localities of district Mardan, 300 pregnant women
(complications during this pregnancy, any blood loss and treatment were selected, for the purpose of this study. Detailed medical and
received, (if any) food and drink intake. obstetric history was recorded. Out of 300 women, 230 fulfilled the
criteria and further studies were carried out.
Specimen collection and determination of hemoglobin
Blood samples were collected from 300 pregnant women who Socio-demographic data of the study population
were at various stages of pregnancy. The blood samples were collected The study population comprised of 300 pregnant women, aged
in Ethylenediaminetetraacetic acid (EDTA) tubes. Hemoglobin 18-40 years. Table 1 summarizes their socio-demographic details. It
determinations of 300 females were done. Hemoglobin was measured showed that out of total, 60% women were in age group 30-40 years
by hematology analyzer (BC 3000 Plus Auto hematology analyzer, while 40% were in age range 18-29 years. Almost 65% were not educated
MINDRAY: Bio-medical Electronics company Ltd., Shenzhen China) (never attended school or have education less than class 5) and 35%
at the pathology and hematology laboratory Bacha Khan medical had some educational background (have completed education up to
college Mardan. Blood samples were withdrawn and collected in EDTA class 5 and above). Most of these pregnant women belonged to lower
tubes, labeled and processed in the laboratory. The samples were then (annual house hold income US$<500) and middle class (annual house
inserted into the analyzer and automated measurement was initiated. hold income US$500-1000) that comprised 87% of the whole group
Participant’s results were recorded in laboratory information system. and 13% belonged to upper class (annual house hold income U$>1000.
The results compared with the previous data and any variations such Regarding their residence, 70% of the females came from rural areas
as abnormal drop in hemoglobin, flagged. The procedure was repeated while 30% were living in the urban areas of district Mardan (Table 1).
three times.
Status of pregnancy in iron deficient women
Measurements of blood iron stores
Out of the total, almost half (45.7%) of the pregnant women were in
The blood iron stores were measured by estimation of serum
ferritin in those anemic females whose hemoglobin level was less than
Characteristics Range/Group Number %
11 g/dl. Blood samples were collected in EDTA tubes and stored at
2-8°C for 3-5 days. Estimation of serum ferritin was done collectively of 18-29 years 92 40%
Age Group
5-10 samples. Serum ferritin estimation was done by using Elecsys and 30-40 years 138 60%
COBAS e (Trade mark of Rosche) immunoassay analyzer. The results Educated 80 35%
then collected. A few cases were seen to have raised serum ferritin so in Education
Non educated 150 65%
those cases further estimation of CRP was done. Lower class 92 40%
Socio-economic status Middle class 108 47%
Estimation of C-reactive protein (CRP)
Upper class 30 13%
CRP was estimated by latex agglutination method. The CRP latex Urban Areas 69 30%
Residence
is a slide agglutination test for the qualitative and semi-quantitative Rural areas 161 70%
detection of C-Reactive protein in human serum. The kit was used of Table 1: Socio-demographic distribution of studies population.

J Preg Child Health, an open access journal

ISSN: 2376-127X Volume 4 • Issue 6 •1000356
Citation: Shams S, Ahmad Z, Wadood A (2017) Prevalence of Iron Deficiency Anemia in Pregnant Women of District Mardan, Pakistan. J Preg Child
Health 4: 356. doi:10.4172/2376-127X.1000356

Page 3 of 5

their 2nd trimester of pregnancy, followed by 3rd trimester (38.2%) and Serum Ferritin No. of
Category Percentage
the rest of females (16.1%) were in their 1st trimester. The current study Level (ng/mL) Participants
also reflected that most of the women (72.2%) were multi gravida, while Category 1 <12 ng/mL 98 42.6%
19.1% were having their first pregnancy and 8.7% were grand multi- Category 2 12-30 ng/ml 100 43.5%
parous women as shown in Table 2. Category 3 31-300 ng/ml 27 11.7%
Category4 >300 ng/ml 5 2.2%
Prevalence of anemia in study population
Table 5: Serum ferritin level in study population.
Estimation of hemoglobin level of 300 women was done. Out of
total studies population, 230 women have hemoglobin level less than No. & % of No. & % of No. & % of
Type of anemia &
participants S. participants S. Participants S.
11 g/dl. The current study showed the prevalence of anemia (defined No. of Patients
ferritin <12 ng/ml ferritin 12-30 ng/ml ferritin 30-300 ng/ml
by the World Health Organization as hemoglobin <11.0 g/dL) in these Mild Anemia 157 68 (43.3%) 30 (19.1%) 59 (37.6%)
subjects was 76.7% (Table 3). Moderate anemia 67 22 (32.8%) 26 (38.8%) 19 (28.4%)

Prevalence of anemia based on severity of anemia Severe anemia 6 5 (83.3%) 1 (16.7%) Nil
Table 6: Comparison of anemia with S. ferritin in study population.
Of the total anemic cases, 68.3% had mild anemia and 29.1% had
moderate anemia and 2.6% were severely anemic as shown in Table 4. No. of patients Hb in g/dl S. ferritin in ng/ml CRP levels
Grading of anemia is done on WHO classification of anemia (Table 4). 1 10.2 460 Raised
2 10.8 320 Normal
Serum ferritin level in study population
3 9.8 304 Normal
To determine the actual prevalence of iron deficiency anemia in the 4 10.0 502 Raised
study population, further analysis was carried out of those participants 5 10.1 330 Raised
who had hemoglobin concentration of less than 11 g/dl. Category Table 7: Comparison of raised S. ferritin with CRP levels.
1 (<12 ng/ml), requires active intervention. Category 2 (12-30 ng/
ml) level which still signifies low iron stores. Category 3 (31-100 ng/ ferritin in study population. Out of severely anemic cases, 83.3% had
ml) indicates a normal level. As serum ferritin is also an acute phase low S. ferritin (Table 6).
reactant so its level rises in response to infections. Category 4 showed
levels >300 ng/ml. The current study showed as in Table 5 that out CRP relative to raised S. ferritin
of total 230 participants, 42.6% had Serum ferritin level below12 ng/ We performed CRP on those 5 women with raised positive S.
ml. while 43.5% had serum ferritin level in the range of 12-30 ng/ml Ferritin, i.e., >300 ng/ml. The result showed that 3 out of these 5 women
which is a range that still signifies the low iron stores in almost half the had raised CRP as shown in Table 7.
population. 11.7% have S. ferritin level in 31-300 ng/ml rang and the
rest of 2.2% of the participants have a high level of S. Ferritin, i.e., >300 Discussion
ng/ml (Table 5).
The single most prevalent micro nutrient i.e., iron deficiency
Co- relation of anemia with low S. ferritin coupled with anemia in a pregnant woman has serious health threats.
The prevalence of IDA in developing countries including Pakistan
Table 6 determines the Comparison of anemia with positive serum remains high. Pakistan, with its vital geopolitical importance, is
still a long way off from its goal to overcome IDA among vulnerable
Status No. of Participants %
population groups. According to a report of national health survey of
Pakistan, 50-60% of expectant mothers are affected by IDA [13]. In
1st Trimester 37 16.1%
Pregnancy Status 2nd Trimester 105 45.7%
an effort to combat this seemingly benign problem, we first aimed to
3rd Trimester 88 38.2%
get the prevalence of anemia generally in the pregnant population of
Parity Status Primigravida 44 19.1% district Mardan. This study showed the prevalence of anemia in these
Multigravida 166 72.2% subjects to be quite high (76.7%) as sown in Table 3, of these 68.3%
Grand multi 20 8.7% had mild anemia and 29.1% had moderate anemia. 2.6% were severely
Total participants 230
anemic. Secondly the results were compared with other studies done in
Pakistan and especially in KP. It showed that in a study done in district
Table 2: Status of pregnancy in iron deficient women. Karak, the percentage of anemia in pregnant women was 67.6%, while
a study done in Kohat showed the prevalence of anemia to be 66.6%
Hb level No. of Women Percentage
[14,15]. Studies done in Peshawar showed the prevalence to be 53.0%
Patients <11 g/dl 230 76.7% [16] (Table 4).
Normal >11 g/dl 70 23.3%
Total 300 100% The anemia association with education in the present study was
that 65% were un-educated (never Attend school) and 35% had some
Table 3: Prevalence of anaemia in study population.
educational background. The study demonstrated that less education
Severity of Haemoglobin No. of was associated with high prevalence of anemia. This is similar to
Group Patients (%)
Anemia Levels (g/dL) patients studies carried out in Korangi Karachi and district Karak that showed
1 Mild 10-10.9 157 68.3% high incidence of anemia in illiterate pregnant females (55.6% and
2 Moderate 7-10 67 29.1% 88.0%, respectively) [10,14]. From the above information it is evident
3 Severe Less than 7 6 2.6% that lower the level of education in women, the more probability of
Table 4: Prevalence of anemia based on severity of anemia. anemia during. Most of these pregnant women in the current study

J Preg Child Health, an open access journal

ISSN: 2376-127X Volume 4 • Issue 6 •1000356
Citation: Shams S, Ahmad Z, Wadood A (2017) Prevalence of Iron Deficiency Anemia in Pregnant Women of District Mardan, Pakistan. J Preg Child
Health 4: 356. doi:10.4172/2376-127X.1000356

Page 4 of 5

belonged to lower middle class that comprised 87% of the whole pregnancy, nutritional education and counseling should as a part of
group 13% belonged to upper class. This is similar to the study done anemia eradication plan. Researchers should concentrate on preventive
in District Karak where 80% of anemic pregnant females belonged to supplements and food fortification approaches. A detailed health data
lower class [14]. Regarding their residence in the present study, 70% of could be acquired such as parity, menstrual characteristics, infections,
the females came from rural areas while 30% were living in the urban previous iron or blood transfusions, etc. The Government needs to take
areas of district Mardan. The Table 2, determine that the incidence of solid steps to improve the quality of education and socioeconomic status
anemia was high in the second trimester (45.7%) and the rest of females of females, increase the number of health care providers and intensify
were either in their 1st trimester (16.1%) or 3rd trimester (38.2%). The public education. Health behavior’s need to be changed and adherence
fact that every 2nd pregnant woman is anemic requires some serious to the prescribed programs by the government is needed. Providing
measures to be taken towards improvement. This study also reflected long term iron supplementation and dietary modification starting from
that most of the women (72.2%) were multi gravida, while 19.1% were adolescence may improve the hemoglobin levels and later on prevent
having their first pregnancy. 8.7% were grand multi parous women as anemia in pregnancy.
shown in Table 2. This is in conformity with the results of other similar Acknowledgement
studies which also signify that multiparity and short birth spacing lead
to anemia in women [17] (Tables 1 and 2). We thank all the pregnant women of district Mardan who participate in this
study. Sulaiman Shams and Zarmina Ahmad participated in all steps of the study
Another focus of the current study was to know the prevalence of from its design to write up. Dr. Sulaiman Shams, Zarmina Ahmad and Dr. Abdul
Wadood critical review the manuscript and wrote the manuscript and performed
actual iron deficiency in these anemic patients. Serum ferritin levels statistical analysis.
were estimated in the blood samples of these anemic subjects. While
interpreting the levels of serum ferritin, the cases were divided into four References
categories as shown in Table 5. This study showed that in almost half 1. Sharma JB (2003) Nutritional anaemia during pregnancy in non-industrialized
the population of pregnant females (42.6%) S. ferritin level was below countries. In: Studd J (Edtr), Progress in obstetrics and gynecology. New Delhi:
Churchill Livingstone, pp: 103-122.
12 ng/ml establishing iron deficiency as the main cause of anemia in
pregnant females as shown in Table 5. In the current study, 43.5% have 2. Buzyan LO (2015) Mild anaemia as a protective factor against pregnancy loss.
Int J Risk Saf Med 27: 7-8.
serum ferritin in the range of 12-30 ng/ml which is a range that still
signifies low iron stores. Only 11.7% had a normal value of S. Ferritin, 3. Salhan S, Tripathi V, Singh R, Gaikwad HS (2012) Evaluation of hematological
i.e., 31-300 ng/ml. Although women with acute or chronic infections parameters in partial exchange and packed cell transfusion in treatment of
severe anaemia in pregnancy. Anaemia.
were excluded from the study to get a clear picture regarding levels of
iron stores, still in 2.2% cases the value of serum ferritin was >300 ng/ 4. Esmat B, Mohammad R, Behnam S (2010) Prevalence of iron deficiency
anaemia among Iranian pregnant women, a systematic review and meta-
ml as shown in Table 5. For better interpretation of the results, the cases analysis. J Reprod Infertil 11: 17-24.
were tested for CRP levels. It turned out that 60% of cases, i.e., 3 out of
5. Balarajan Y, Ramakrishnan U, Ozaltin E, Shankar AH, Subramanian SV (2011)
5 had raised CRP as shown in Table 7. An important strength of the Anaemia in low-income and middle-income countries. Lancet 378: 2123-2135.
current study is that the study population was homogeneous in terms
of race. Determination of hemoglobin with the help of auto analyzer 6. Masukume G, Khashan AS, Kenny LC, Baker PN, Nelson G (2015) Risk factors
and birth outcomes of anaemia in early pregnancy in a nulliparous cohort. PLoS
done was performed during the study for the first time in this region. ONE 10: 1-15.
This is the first study that examines the of anemia in the population
7. De-Benoist B, McLean E, Egli I, Cogswell M (2008) Worldwide prevalence of
of Pashtuns women during pregnancy using serum ferritin in addition anaemia 1993-2005: WHO global database on anaemia. Geneva: World Health
to CRP to account for infection. The rate of low birth weight babies Organization.
was high in mothers who were anemic in their third trimester. Preterm
8. Christensen RD, Ohls RK (2004) Anaemia’s unique to pregnancy and the
deliveries occurred highly in mothers who were anemic in their second perinatal period. Wintrobe’s clinical hematology, USA. Lippincott Williams and
and third trimesters [18]. Therefore, the government needs to take Wilkins. 11: 1467-1486.
action to improve the quality of education and socioeconomic status of 9. Lone FW, Qureshi RN, Emmanuel F (2004) Maternal anaemia and its impact
females and to increase the number of health care providers. on perinatal outcome in a tertiary care hospital in Pakistan. East Mediterr
Health J 10: 801-807.
Conclusion 10. Karim SA, Khurshid M, Memon AM, Jafarey SN (1994) Anaemia in pregnancy-
its cause in the underprivileged class of Karachi. J Pak Med Assoc 44: 90-92.
It can be concluded from this study that anemia due to iron deficiency
is highly prevalent in district Mardan. The results of the current study 11. Sohail R, Zainab S, Zaman F (2004) Prevalence of anaemia in obstetrical
were found in conformity with the work of other researchers in our population. Ann King Edward Med Coll 10: 146-148.
country. It was observed that the etiology of iron deficiency remains 12. Awan MM, Akbar MA, Khan MI (2004) A study of anaemia in pregnant women
the same over the decades. Multiparity, short birth spacing, poor socio of railway colony, Multan. Pak J Med Res 43: 11-14.
economic status, lack of education were responsible for high prevalence 13. Mohyddin M (1995) National health survey of health profile of peoples of
of IDA. Besides this, it was observed that majority of women attended Islamabad, Pakistan. Pak Medical Research Council and Federal Bureau of
statistics, pp: 27-44.
clinic during the 2nd trimester of pregnancy. So they had lack of iron intake
at the time of conception. Non-compliance of iron supplementation 14. Irfan U, Muhammad Z, Muhammad IK, Mudassir S (2013) Prevalence of
was also observed to be an important contributory factor. Almost all anaemia in pregnant women in district Karak, Khyber Pakhtunkhwa, Pakistan.
Int J Biosci 3: 77-83.
the South Asian countries including Pakistan has national level anemia
control programs but this problem still persists. This study will provide 15. Riaz U, Ayaz S, Khader JA, Abdelslam NM, Anwar M (2013) Prevalence and
detection of anaemia (Iron Deficiency) in women population in Kohat Khyber
a base upon which strategies against the eradication of IDA will be Pakhtunkhwa, Pakistan. Life Sci J 10: 812-815.
made. Intervention only with iron and folic acid supplements is not
adequate to combat this problem but this issue requires a multi-faceted 16. Paracha PI, Hameed A, Simon J, Jamil A, Nawab G (1997) Prevalence of
anaemia in semi-urban areas of Peshawar, Pakistan: A challenge for health
approach. Besides regular screening of hematological parameters during professionals and policy makers. J Pak Med Assoc 47: 49-53.

J Preg Child Health, an open access journal

ISSN: 2376-127X Volume 4 • Issue 6 •1000356
Citation: Shams S, Ahmad Z, Wadood A (2017) Prevalence of Iron Deficiency Anemia in Pregnant Women of District Mardan, Pakistan. J Preg Child
Health 4: 356. doi:10.4172/2376-127X.1000356

Page 5 of 5

17. Woldemariam G, Timotiows G (2002) Determinants of nutritional status of 18. Kumar KJ, Asha N, Murthy DS, Sujatha MS, Manjunath VG (2013) Maternal
women and children in Ethiopia, Calverton, Maryland, USA, pp: 49-57. anaemia in various trimesters and its effect on newborn weight and maturity:
An observational study. Int J Prev Med 4: 193-199.

Citation: Shams S, Ahmad Z, Wadood A (2017) Prevalence of Iron Deficiency

Anemia in Pregnant Women of District Mardan, Pakistan. J Preg Child Health
4: 356. doi:10.4172/2376-127X.1000356

J Preg Child Health, an open access journal

ISSN: 2376-127X Volume 4 • Issue 6 •1000356

View publication stats