Factors associated with anaemia among lactating mothers up to six months postpartum in a selected medical officer of health area in Colombo

Abstract

The severity of postpartum anaemia (PPA) is classified according to haemoglobin (Hb) concentration; mild (110-119 g/L), moderate (80-109 g/L) and severe (<80 g/L). However, no consensus has been established on the duration of the postpartum period. Generally, it is considered as up to 6 months post-delivery and is divided into three phases as acute (first 6-12 hours), sub-acute (2-6 weeks) and delayed (up to 6 months). The aim of the present study is to assess selected factors associated with anaemia among lactating mothers up to 6 months postpartum. This cross-sectional analytical study was conducted in the Dehiwala Medical Officer of Health area in Colombo from September 2020 to May 2021. Lactating mothers (n=67), 1-6 months post-delivery, were selected via a community-based convenience sampling method. Data were collected via a self-administered questionnaire and Hb counts were recorded according to their clinical records. The proportion of anaemia among lactating mothers was 30.6% including mild (16.7%) and moderate (13.9%) anaemia. However, cases of severe anaemia were not encountered. PPA was associated with low Hb count at first antenatal clinic visit (p=0.020). Nevertheless, PPA was not associated with socio-demographic parameters, duration of pregnancy, type of delivery, birth order, birth interval, 6-month exclusive breast feeding, attendance to pre pregnancy, antenatal and postnatal clinics, intake of iron, folic acid and other supplements in postpartum period, and nature of dietary iron intake. Majority of lactating mothers (92.5%) in the study population had either satisfactory or good knowledge on iron and folic acid intake in pregnancy and postpartum period. In conclusion, nearly one third had mild or moderate anaemia even though a majority were aware on iron and folic requirement during pregnancy and postpartum. More attention on incidence of PPA will pave the way to reduce its burden.