Postpartum anemia and associated factors among caesarean section women in West Gojjam zone Ethiopia 2023

Postpartum anemia is a significant public health concern, particularly among women who have undergone caesarean sections, which increases the risk of maternal mortality and morbidity in the postpartum period. While prenatal anemia is extensively studied, the literature on post-caesarean section anemia is limited, and the characteristics of women who are at the highest risk of developing postpartum anemia after caesarean section are unknown. Therefore, this study aimed to assess the prevalence and determinants of postpartum anemia among women who had caesarean section in West Gojjam zone hospitals, Ethiopia. A cross-sectional study was conducted at public hospitals in the West Gojjam zone from April 15 to June 15, 2023, involving 414 women who underwent caesarean sections. To select study participants, a systematic random sampling technique was employed. Data were collected through face-to-face interviews and maternal chart reviews. Data were entered with EPIDATA-4.6 and analyzed with STATA-14. A binary logistic regression analysis was done to identify factors associated with postpartum anemia. Bi-variable analysis at p-value < 0.25 was used to select the candidate variables for multivariable logistic regression to control confounding effects. Finally, adjusted odds ratios with 95% confidence intervals were used to report results. Statistical significance was declared at p-values < 0.05. The overall prevalence of postpartum anemia among caesarean-section women was 32.85% (95% CI: 28.3-37.6%). The multivariable binary logistic regression analysis showed that having a history of blood loss [AOR: 6.12; 95% CI: (2.23-10.9)], had pre-delivery hemoglobin level < 11 g/dl [AOR: 2.51; 95% CI: (1.21-5.23)], lack of iron-folate supplementation during pregnancy [AOR: 4.21(1.32-9.23)], and non-adherence to iron-folate [AOR: 1.49; 95% CI: (1.12-3.02)] were factors associated with higher odds of postpartum anemia. In this study, the prevalence of anemia among post-caesarean section women was moderate. Blood loss, pre-delivery anemia, lack of iron-folate supplementation, and non-adherence to iron-folate supplementation were factors associated with postpartum anemia.