Marked reduction of anemia during pregnancy over a 10-year period in Montserrat.

Anemia during pregnancy is associated with adverse outcomes including maternal and perinatal mortality. However, health education and other public health strategies seeking to reduce its prevalence have usually met with only limited success. The study reported here surveyed anemia of pregnancy on the island of Montserrat in 1980, 1985, and 1990. This involved examination of clinic and hospital records for over 90% of all women giving birth on Montserrat in 1980 and 1985, as well as 80% of those giving birth in 1990. This examination showed a dramatic reduction in the prevalence of anemia at the time of the first prenatal visit (a drop from 82% of the study women in 1980 to 23% in 1985 and 19% in 1990) and also a marked drop at three days postpartum (from 91% in 1980 to 41% in 1985 and 39% in 1990). Logistic regression analyses indicated that after controlling for three possible confounding factors (maternal age, parity, and weeks of gestation at first prenatal visit) the difference between the risk of developing anemia during pregnancy in 1980 as compared to 1985 or 1990 was still highly significant. The reasons for the observed drop in anemia's prevalence during the survey period are not entirely clear, partly because of the retrospective nature of the study. However, better nutrition resulting from improvement in the standard of living on Montserrat during the survey period could have been important, as could changes in health education and food supplementation activities.