Prevalence and determinants of anaemia during the second or third trimester of pregnancy in Bangladesh: a cross-sectional study protocol

Background Anaemia in pregnancy remains a critical global health problem and has long-term adverse health outcomes for both the mother and child. In developing countries like Bangladesh, there has been limited progress in reducing the burden of anaemia in pregnancy. This community-based survey will provide insight into the prevalence and determinants of anaemia during the second and third trimesters of pregnancy. Methods This cross-sectional survey will be conducted in three Upazilas (sub-districts) in rural Bangladesh. A total of 1,500 pregnant women will be recruited in second and third trimester, calculated from last menstrual period. The primary outcome is to determine the prevalence of anaemia (Hb<11 g/dL); haemoglobin will be measured in venous blood by HemoCue. The association between iron deficiency and anaemia will be determined, and the role of drinking water iron level in anaemia aetiology will be explored. Key secondary outcomes include the prevalence of moderate (Hb <10 g/dL) and severe anaemia (Hb <7 g/dL), iron deficiency (ferritin <15 mg/L), and iron deficiency anaemia (concurrent iron deficiency and anaemia). Detailed information on socioeconomic status, current and past pregnancies, knowledge on nutrition and anaemia, water-sanitation-hygiene and maternal mental health status will be collected. Conclusions This study will provide comprehensive information on the prevalence and determinants of anaemia in second and third trimester of pregnancy, and inform anaemia intervention strategies to improve maternal and child health outcomes. Ethics and dissemination This study has been approved by the Ethical Review Committee of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) and the Human Research Ethics Committee of the Walter and Eliza Hall Institute of Medical Research (WEHI), Melbourne, Australia. The results will be actively disseminated through reports and presentations to stakeholders, symposiums and scientific publications. Registration The protocol is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000982819; 26/07/2021).