This study showed that the overall magnitude of anemia among the study participants was 19.8% (95% CI 16.00-23.70). This result is Similar with the findings from previous studies conducted in, Gondar (16.6%)(11), Shire,Tigray (16.3%)(12),MizanTepi (23.5%)(13) and Nigeria (16.8%)(14). It is considerably lower than the national average (29.1%)(15) and other previous study reports from North West Tigray (36.1%)(16), Ilu Abba Bora Zone, South West Ethiopia: (31.5% (17),west Arsi (36.6%,)(18) Gilegle Gibe (53.9%),(19) and southern Ethiopia 65%(20).
The possible reasons for the difference may be resulted from geographical variation of factors across different areas. In addition, lower magnitude can be attributed to gradual improvement of life style and living standards, using the iron supplementation ordered by the physician during follow up.
This study finding showed a slightly higher magnitude than studies conducted in Hawassa (15.3%) (21) ,Tikur Anbesa Specialized Hospital (14.1%)(22) , Adama town (11.3%)(23), North Shoa zone (9.7%)(9) and Adigrat General Hospital 7.9%(24). This variation might be due to differences in sample size, study design, study period, study setting, and socio-demographic characteristics.
This study also showed that being HIV positive, parasitic infestation and women with history of not taking fruits as significant determinants of anemia during pregnancy.
Pregnant women having parasitic infestation were nearly 12 times AOR= 11.886(95% CI 5.606, 25.204) more likely to be anemic than their counterparts. This finding is consistent with studies conducted in Gondar(25), Shire(12), Adigrat (24), and North Shoa (9). This might be due to the reason that parasites attach and injure upper intestinal mucosa and ingest blood. This brings gastrointestinal blood loss and induces depletion of iron, folic acid, and vitamin B12 that ultimately results in anemia (26).
This study also showed that HIV positive pregnant women were six times (AOR= 6.126 (95% CI 2.197, 17.084) more likely to develop anemia during pregnancy than those who are not infected
with HIV. Studies conducted in Mizan (13),Gondar (11) and Shire (12) showed a similar association between anemia and HIV infection. This increased prevalence of anemia among HIV seropositive pregnant women might be explained by the fact that HIV infection is associated with lower serum folate, vitaminB12, and ferritin in pregnancy. In addition, Anemia in HIV/AIDS patients may arise from a number of causes, including deregulation of the host immune system leading to destruction or inhibition of hematopoietic cells (27).
Women who did not have the habit of taking fruits were found to be three times (AOR 3.128 (95% CI 1.723, 5.679) more likely be anemic than those who have the habit of taking fruits. This finding is similar with a study conducted in South West Arisi zone(18). This might be due to the fact that taking fruits before and after meal may facilitate iron absorption in gastro intestinal system. good knowledge about basic nutrients and adequate well balanced diet usually resulting in positive dietary practices which are important determinants of optimum health (28).