Prevalence and factors associated with anemia among pregnant women in East Lombok district during the COVID-19 pandemic

Abstract Background Maternal anemia is a major public health problem that has detrimental effects on pregnancy and birth outcomes. The threat of food insecurity and nutritional deficiencies is growing as a result of the COVID-19 pandemic. The aim of this study was to determine the prevalence and risk factors of anemia among pregnant women in East Lombok during the pandemic. Methods This community-based cross-sectional study is part of an observational cohort study entitled “UKRI-GCRF Action Against Stunting Hub (AASH)” in rural areas of East Lombok, Indonesia, from August 2021 to February 2022. Data were collected from women (18-40 years) in their third trimester pregnancy (N=446). Data collection included hemoglobin, mid-upper arm circumference, intestinal helminth infections, and structured questionnaires for sociodemographic, dietary diversity, pregnancy-related, reduced coping strategy index and COVID-19-related variables. The association between anemia and its determinants was analyzed using binary logistic regression model. Results Anemia was found in 40.8% of pregnant women. During the pandemic, 74.7% and 28.9% of women reported a decrease in household income and food expenditure whereas 47% of them reported having medium-to-high coping strategies against the pandemic. Higher RCSI scores (≥5) was associated with food insecurity, decrease in household income, older age (>35 years), low education level, multiparity, receiving government assistance targeted for poor families, but with contraceptive use. In logistic regression, anemia was significantly associated with chronic energy deficiency (CED, AOR=1.92; 95%CI: 1.06-3.48), inadequate dietary diversity (AOR=1.58; 95%CI: 1.02-2.45), and non-use of contraception (AOR=1.58; 95%CI: 1.02-2.45). Conclusions CED, inadequate dietary diversity, and non-use of contraception were major contributors to anemia in pregnancy in the area. The findings highlight the importance of improving anemia control program among pregnant women in rural areas like East Lombok and improving policy to strengthen their resilience to natural phenomenon such as COVID-19.