Abstract:

Introduction: Iron deficiency anemia is one of the physiological changes that occur during pregnancy. Among the causes of iron deficiency in pregnancy is the increase in plasma volume during pregnancy which does not correspond with the increase in red blood cell mass. There is the highest pica use in Africa (44.8%) as related to the rest of the world. By 2014 about 45.6% of pregnant women from small scale gold mining communities in Tanzania had soil eating behavior. Geophagia has different side effects to the consumers such as malabsorption of different micronutrients, increased risk of anemia, worm infestation, consumption of different metals in high quantities arsenic, copper, iron, manganese, nickel, chromium and many others

Objectives: To determine the prevalence of iron deficiency anemia and geophagia in pregnancy, pregnancy outcomes associated with iron deficiency anemia and geophagia as well as the association between iron deficiency anemia and geophagia in pregnancy in women at BMC from January 2023 to March 2023.

Methodology: A retrospective cross – sectional study was conducted at BMC among post-delivery women within puerperal period from March 2023 to July 2023. The candidates were randomly selected from mothers who delivered on Wednesdays, Fridays and Saturdays from March to July 2023. Data was collected using questionnaires. The statistical analysis of the data was performed through the Statistical Program SPSS version 20.0.

Expected results: It is expected that results from this study will reveal the prevalence of iron deficiency anemia and geophagia among pregnant women at BMC as well as the association between iron deficiency anemia and geophagia in pregnancy.

Budget: This study is estimated to cost TZS 331,000/= which was covered by the researcher.

Results: The study included a total of 393 post-delivery women who delivered from March 2023 to July 2023. 311 participants (79.1%) claimed to know about soil eating behavior (geophagia) and upon enquiring 212 (53.9%) participants admitted to have a soil eating behavior. 43% practiced during pregnancy, followed by 25% who practiced monthly while only 17% ate soil every day. About 50% of those practicing geophagia had more episodes during the second trimester as compared to other trimesters, 33% of them had no change in frequency of Geophagia during pregnancy. From the full blood pictures results of the participants in which they took during the visits. During the 1st trimester the mean Hemoglobin level ranged from 8 – 13 g/dl. (69%) had HB level between 10 – 11g/dl and 25% had HB levels of less than 10g/dl during the first trimester. During the second trimester majority of the participants (45%) had HB levels of 10g/dl and about 37% had HB levels of less than 11g/dl. MCV levels throughout the pregnancies ranged from 70 – 90fl and during the second trimester majority of the participants (51%) had lowest values with MCV values of less than 80fl. Hematocrit levels had the same trend as MCV values, majority of the participants having a hematocrit level of 35% in first trimester, 30% in the second trimester. Only 38.6% of the babies were born before 37 completed weeks and only 5.6% were post term deliveries while the rest were born at term. leading delivery abnormality was neonatal infection affecting 41 babies, birth asphyxia in 15 babies, macrosomia in 10 babies, 11 syndromic babies and 6 babies with hydrocephalus.

Conclusion: This study has shown that more than half of the women have low levels of hemoglobin during pregnancy and these levels are even lower during the second trimester. This is attributed to increased demands during the second trimester and inadequate iron and folic acid supplementations during the antenatal visits. Geophagia practices have been seen in more than half of the participants, and more than half of them started during pregnancy. There is increased frequency of geophagia during the second trimester as compared to the rest of trimesters, however, about 33% of the pregnant women did not notice any change in frequency among the trimesters. Due to the association between geophagia and iron deficiency Geophagia can be classified as iron seeking behavior because it is more pronounced during the episodes of iron deficiency and the vice versa is also true. About 80 babies were born with complications of pregnancy and birth. About half of them had neonatal infections while a few of them had congenital malformations like hydrocephalus and some were syndromic babies. This can be attributed to inadequate folic acid supplementations during pre-conception and first trimester because most of them started antenatal visits late in the first trimester of early in the second trimester.