الفهرس 
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Abstract
Anemia is a global public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. It occurs in all stages of life but it is more prevalent in pregnant women and young children. Anemia is a multi-factorial disorder. At least half of the global burden of anemia in pregnancy is due to iron deficiency. Other contributing factors include nutritional deficiencies of folate, vitamin B12 and vitamin A, chronic inflammation, parasitic infections and inherited disorders. Anemia is associated with multiple adverse outcomes for both mother and infant, including an increased risk of hemorrhage, sepsis, maternal mortality, perinatal mortality, and low birth weight.
The general objective of the study was to assess the prevalence of anemia among pregnant women in Sana’a Governorate, Yemen. The specific objectives were to identify the determinants of anemia among pregnant women and to assess the knowledge of pregnant women regarding anemia.
The study was carried out in the outpatient clinics of four governmental hospitals in Sana’a governorate using a cross sectional design. The study included 360 pregnant women attending these hospitals. A pre-designed structured interviewing questionnaire: was used to collect sociodemographic data, obstetric and gynecological history, medical history (chronic and current diseases), dietary habits, knowledge about signs, symptoms, complication and risk factors of anemia, iron rich foods and enhancers and inhibitors of iron absorption. In addition some laboratory investigations were done to assess the level of hemoglobin.
The study revealed the following main results:
• The prevalence of anemia among pregnant women in Sana’a Governorate was 40.3%. Of these anemic pregnant women, 16.6% had mild anemia, 23.1% had moderate anemia and only 0.6% of them had severe anemia.
• The area under the ROC curve of Hb as a predictor of anemia among pregnant women was the highest of all various red cell indices. Hemoglobin test can predict all cases of anemia (100 %) among pregnant women in Sana’a Governorate.
• The gestational age (second and third trimester), multigravida, spacing between pregnancies, milk drinking, time of tea and coffee drinking, chicken and liver eating and the level of knowledge and income had statistically significant association with anemia among anemic pregnant women than among non anemic pregnant women.
• Logistic regression showed that pregnant women who ate liver weekly, those who drank milk one to six days per week and who were in the third and second trimester of pregnancy had a significant impact on occurrence of anemia than the relevant categories.
• The highest prevalence of anemia (48.8%) was found among pregnant women aged 35- 45 years and among those who had poor income.
• The prevalence of anemia among pregnant women increased with the decrease in nutrition level.
• The prevalence of anemia among pregnant women increased with the decrease in knowledge level, nearly two thirds of anemic pregnant women (63.2%) had poor level of knowledge about anemia.
• Binary logistic regression model indicated a significant impact of the literate and working on the level of knowledge of pregnant women. The area under the curve (AUC) calculated from binary logistic regression model was 0.67 for good knowledge.
The following are the main recommendations of the study:
I. Recommendations for the Ministry of Health:
• Provide nearby primary health care services to all pregnant women.
• Routine early screening of pregnant women for anemia.
• Supply all pregnant women with iron and folic acid tablets free of charge.
• Increase awareness of pregnant females regarding iron rich food, enhancers and inhibitors of iron absorption, importance of iron and folic acid supplements during pregnancy and after delivery and importance of spacing between pregnancies are needed. Mass media such as TV, radio could be used for their education. Also meeting with the health care service providers may be effective.
• Implement easier, accurate and acceptable methods for diagnosing anemia in rural areas in Yemen such as estimation of hemoglobin level.
II. Recommendation for the Ministry of Education:
• Raise awareness of secondary school students about prevention of anemia and special attention should be given to female students.
III. Recommendation for the researchers:
• Implementing intervention studies in females to prevent and control anemia.
• Further studies are also needed to estimate the prevalence of anemia among pregnant women in other areas in Yemen especially the seaboard areas.