Global profile of anemia during pregnancy versus country income overview: 19 years estimative (2000-2019)

Abstract

Anemia is a worldwide public health problem that is worst in low- and middle-income countries (LMICs), reaching 60% of prevalence. The etiology of anemia is diverse and multifactorial, with iron deficiency being the most prevalent, and often found in pregnant women. Iron is indispensable for the production of red blood cells and approximately 80% of the available heme iron is used for hemoglobin synthesis in mature erythroblasts. Iron deficiency affects oxygen transport, compromising energy and muscle metabolism and can occur with depletion of iron storage, defective erythropoiesis, and low hemoglobin levels. We analyzed anemia prevalence in pregnant women from 2000 to 2019 worldwide correlating them with current (2022) country income, with especial attention to LMICs using WHO dataset. Our analysis indicates that pregnant women from LMICs had a higher probability (40%) of anemia during pregnancy especially those from Africa and South Asia. Africa and the Americas showed a higher decrease in the prevalence of anemia from 2000 to 2019. The Americas and Europe have a lower prevalence, concentrated in 57% of most upper-middle- and high-income countries. Black women are also more prone to develop anemia during pregnancy, especially if they are from LMICs. However, the prevalence of anemia appears to decrease with an increase in educational level. In conclusion, anemia prevalence fluctuated from 5.2 to 65.7% worldwide in 2019, validating it as a public health problem.

Keywords: Africa; Anemia; Iron deficiency; Low-middle income countries; Pregnant women.

Fig. 1

Economies distributions among continents by county incomes from World Bank classification for the fiscal year of 2022. Low-income economies are defined as gross national income (GNI) per capita less or equal as $1045; lower middle-income economies are those with a GNI per capita between $1046 and $4095; upper middle-income economies are those with a GNI per capita between $4096 and $12,695; high-income economies are those with a GNI per capita of $12,696 or more. Numbers in each column represent countries in each income. Data analysis by Excel

Fig. 2

a Fluctuation of anemia prevalence in pregnant women among continents in 19 years (2000–2019). b–g Continent profiles showing anemia prevalence by their tendency in increasing or decreasing prevalence among each 5-year analysis. Abscissa axis shows the percentage of decrease/increase in anemia (%) and the ordinate axis shows how many countries achieved each tendency by 5-year analysis. Data analysis by Excel

Fig. 3

a–f Prevalence of anemia among continents subdivided from each 5-year period, from 2000 to 2019 in pregnant women. Abscissa axis shows 5-year analysis, and the ordinate axis shows how many countries achieved increased/decreased tendency. Data analysis by Excel

Fig. 4

Comparison between GDHx and WHO datasets that drawn attention to fluctuations in anemia among countries. Data analysis by Excel. a Seven LMICs experienced annualized decreases in mean anemia prevalence in all of their districts over the 2000–2018 period according to the GHDx dataset. This graph describes the same trend, modeling with the WHO dataset. b Nine LMICs showed increases in overall anemia prevalence in the majority of districts according to GHDx. Our analysis using the WHO dataset showed a tendency to decrease in prevalence, at least until 2010, when Gambia and Tajikistan presented annual increases