Exploring the socio-economic, nutritional anthropometric and dietary factors associated with anemia in pregnancy

Nutritional inadequacies and anemia during pregnancy pose significant risks to maternal and foetal health. This study aimed to assess the socio-economic, nutritional anthropometric and dietary factors associated with anemia in pregnancy. A cross-sectional survey was conducted among 300 pregnant women receiving antenatal care at the State Hospital, Ijaiye, Abeokuta. Data were collected on socio-demographic characteristics, anthropometric measurements (pre-pregnancy (kg) and pregnancy weight (kg), height (m), MUAC (cm), dietary intake (nutrient adequacy, dietary diversity) and supplement use using validated questionnaires.​ ​​Anaemia preva​lence in pregnancy was analyzed using standard procedure. Anaemia in pregnancy was defined as​ ​< 11 g/dl Hb​ for women in their first and third trimester, and < 10.5 g/dL for women in their second trimester. Body mass index (BMI) was calculated and classified as underweight (< 18.5 kg/m 2 ), normal weight (18.5–24.99 kg/m 2 ), overweight (25.0–29.99 kg/m 2 ) and obese (>= 30.0 kg/m 2 ). Data were subjected to medians, frequencies, and percentages. Binary logistic and multiple linear regression analyses were performed to determine associations and relationships between socio-economic and dietary factors with anemia. More than half (56%) of the population were predominantly young women aged 19–30 years with almost all (93.3%) earning low monthly income (< $125), and 86.3% in their third trimester. Pre-pregnancy body mass index (BMI) indicated a high prevalence of overweight/obesity, which increased during pregnancy. Only 10.3% of respondents with normal pre-pregnancy weight had expected weight gain during pregnancy. Nutrient intake was inadequate for energy, carbohydrates, fiber, fat, and several micronutrients (vitamins C, B6, folate, calcium, sodium, potassium, and magnesium). More than one-quarter (29.7%) of the pregnant women did not achieve minimum dietary diversity. Anemia prevalence was 72.3%, despite iron and folic acid supplementation. Binary logistic regression showed that secondary educational level (AOR = 2.24, 95% CI = 1.28–4.59), and high consumption of nuts/seeds (AOR = 1.80, 95% CI = 1.04–3.11) increased the risk of anemia while low household income (AOR = 0.44, 95% CI = 0.24–0.81), and low vitamin A-rich fruit/vegetable intake (OR = 0.48, 95% CI = 0.24–0.96) ​increased the risk of anemia. The high prevalence of anemia in this study highlights a nutritional-poverty nexus, where inadequate dietary diversity is fundamentally constrained by systemic socioeconomic barriers. Since low maternal education and financial instability are the primary drivers of this burden, clinical iron supplementation alone is insufficient. A multifaceted strategy that integrates socioeconomic empowerment with culturally tailored nutritional counseling is essential to effectively disrupt the cycle of maternal malnutrition.