Open Access Highly Accessed Research article

The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey

Leyla Karaoglu1*, Erkan Pehlivan2, Mucahit Egri3, Cihan Deprem4, Gulsen Gunes2, Metin F Genc2 and Ismail Temel5

Author Affiliations

1 Public Health Department, Medical School, Rize University, Rize, Turkey

2 Public Health Department, Medical School, Inonu University, Malatya, Turkey

3 Public Health Department, Medical School, Gaziosmanpa┼ča University, Tokat, Turkey

4 Enfectious Diseases Department, Ankara Health Directorate, T.R.Ministry Of Health, Ankara, Turkey

5 Department of Biochemistry, Medical School, Inonu University, Malatya, Turkey

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BMC Public Health 2010, 10:329  doi:10.1186/1471-2458-10-329

Published: 10 June 2010



Anemia is considered a severe public health problem by World Health Organization when anemia prevalence is equal to or greater than 40% in the population. The purpose of this study was to determine the anemia prevalence with the associated factors in pregnant women and to determine the serum iron, folate and B12 vitamin status in anaemic pregnants in Malatya province.


This is a cross-sectional survey. A multi-sage stratified probability-proportional-to-size cluster sampling methodology was used. A total of 823 pregnant women from sixty clusters were studied. Women were administered a questionnaire related with the subject and blood samples were drawn. Total blood count was performed within four hours and serum iron, folate and B12 vitamin were studied after storing sera at -20 C for six months.


Anemia prevalence was 27.1% (Hb < 11.0 gr/dl). Having four or more living children (OR = 2.2), being at the third trimester (OR = 2.3) and having a low family income (OR = 1.6) were determined as the independent predictors of anemia in pregnancy. Anemia was also associated with soil eating (PICA) in the univariate analysis (p < 0.05). Of anaemic women, 50.0% had a transferrin saturation less than 10% indicating iron deficiency, 34.5% were deficient in B12 vitamin and 71.7% were deficient in folate. Most of the anemias were normocytic-normochromic (56.5%) indicating mixed anemia.


In Malatya, for pregnant women anemia was a moderate public health problem. Coexisting of iron, folate and B vitamin deficiencies was observed among anaemics. To continue anemia control strategies with reasonable care and diligence was recommended.