Assessment of Nutritional and Nonnutritional Correlates of Anemia in Pregnancy: A Hospital-Based Cross-Sectional Study for Public Health Interventions in the Bono East Region of Ghana.

BACKGROUND AND AIMS: Anemia in pregnancy (AiP) remains a public health concern in Ghana. The Bono East Region is known for a variety of maternal morbidities, yet the association between inadequate intake of iron-rich foods and AiP remains underexplored. This study assessed the prevalence, nutritional, and nonnutritional correlates of anemia among pregnant women in the Bono East Region. METHODS: A hospital-based cross-sectional design was employed. Data were obtained from 1430 pregnant women using hemoglobin (Hb) assessment and a structured questionnaire. AiP was defined using trimester-specific thresholds of < 11.0 g/dL in the first and third trimesters and < 10.5 g/dL in the second trimester. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression using STATA 17. All statistical tests were two-sided, and significance was established a priori at p < 0.05. RESULTS: The study revealed a 63.8% and 72.2% prevalence of kaolin clay consumption and AiP, respectively. Multiple factors were significantly associated with increased odds of AiP, including nonconsumption of selected iron-rich foods such as okra (AOR = 4.49, p = 0.027), fish (AOR = 3.79, p = 0.016), and fermented locust bean seeds (AOR = 3.35, p = 0.012). Frequent consumption of kaolin clay was also strongly associated with AiP, particularly often (AOR = 9.04, p = 0.036) or always (AOR = 8.25, p = 0.046). Other significant correlates included poor household sanitation (AOR = 2.38, p < 0.001), heavy menstrual bleeding before pregnancy (AOR = 1.82, p < 0.001), infrequent deworming (AOR = 1.75, p < 0.001), sickle cell trait (AOR = 1.72, p < 0.001), and short interpregnancy intervals (AOR = 1.69, p = 0.014). CONCLUSION: This study revealed that AiP was shaped by multiple factors. Improving maternal nutrition and strengthening antenatal care services may reduce the burden of AiP in the Bono East Region of Ghana.