Iron-deficiency anemia in pregnant women in Bali, Indonesia: a profile of risk factors and epidemiology.

Iron-deficiency anemia in pregnant women is a serious public health problem especially in tropical countries. The aim of this study was to assess the prevalence of iron-deficiency anemia in pregnant women in Bali and determine the risk factors for anemia. A cross-sectional study was conducted among 1,684 pregnant women in 42 villages in Bali that were selected by probabilistic/proportional-to-size sampling technique. Two ml of venous blood were collected for hemoglobin estimation using an automatic hematology analyzer (Technician H-I), and serum ferritin examination using immunolescent technique. The WHO criterion for anemia in pregnancy was applied and serum ferritin < 20 microg/l as cut-off point for iron deficiency. Data regarding risk factors were gathered using pre-designed questionnaires. The prevalence of iron-deficiency anemia in pregnant women was 46.2%; most of the cases of anemia were mild. The risk factors for anemia identified in this study were: length of gestation; level of education; antenatal intake of iron pills. Given the high prevalence of iron-deficiency anemia in pregnant women in Bali, preventive measures, eg iron supplementation, the iron fortification of food, and health education, should be encouraged.