Clinical and Epidemiological Characteristics of Anemia in Adolescent and Adult Pregnancies in Coastal Ecuador
Underlined: presenting author · Presented by Sofía Chicaiza Erazo
Background
Anemia during pregnancy remains a significant public health concern, particularly in underserved populations. Adolescent pregnancies may involve unique biological and social vulnerabilities, yet clinical and epidemiological characteristics of anemia in adolescent and adult pregnancies remain insufficiently described in Ecuadorian primary care settings. This study compared sociodemographic, anthropometric, hematologic, and antenatal care characteristics among adolescent and adult pregnant women with anemia in coastal Ecuador.
Methods
A retrospective cross-sectional study was conducted using medical records from 23 public primary healthcare centers in Quinindé, Esmeraldas Province, Ecuador. Records from January 2024 to December 2025 were reviewed. The study included pregnant women aged 10–44 years with documented anemia, at least one hemoglobin measurement, and available information on iron–folic acid supplementation and antenatal care visits. Adolescents were defined as women aged 10–19 years and adults as those aged ≥20 years. Anemia was defined as hemoglobin <11 g/dL according to World Health Organization criteria. Sociodemographic, anthropometric, obstetric, and laboratory variables were compared using chi-square, Fisher’s exact, and Mann–Whitney U tests, as appropriate.
Results
Among 2,174 pregnant women with anemia, 810 (37.3%) were adolescents and 1,364 (62.7%) were adults. Adolescents had a higher proportion of rural residence than adults (74.3% vs 68.5%, p=0.005). They also had lower median weight (60.80 vs 67.07 kg) and body mass index (25.25 vs 27.95 kg/m²; both p<0.001). Median hemoglobin was 10.20 g/dL in both groups, although hemoglobin distributions differed significantly (p=0.036). Most participants had mild anemia (67.6%), followed by moderate (32.1%) and severe anemia (0.3%), with no significant difference in anemia severity between groups (p=0.083). Iron–folic acid supplementation was recorded in 86.5% of adolescents and 86.6% of adults (p=0.999). No significant differences were observed in gestational age at evaluation or antenatal care visits.
Discussion & Conclusion
Among pregnant women with established anemia receiving primary care, adolescents were more frequently from rural areas and had lower weight and body mass index than adults. However, anemia severity, median hemoglobin levels, iron–folic acid supplementation, and antenatal care indicators were broadly similar between groups. These findings underscore the importance of incorporating sociodemographic and anthropometric characteristics into adolescent-focused prenatal care strategies in underserved settings. The retrospective cross-sectional design and inclusion of only women with documented anemia limit causal interpretation and the assessment of anemia risk by age. Further research is needed to investigate nutritional and social determinants of anemia among pregnant adolescents.