{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:35:26Z","timestamp":1789875326048,"version":"4.0.1"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Anemia remains a critical public health challenge in India, particularly among pregnant women, where its multifactorial etiology is often underappreciated. Despite long-standing supplementation programs, anemia prevalence in Gujarat remains high, necessitating granular, region-specific investigations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the prevalence of anemia among pregnant women across ten districts of Gujarat, and to identify key sociodemographic, nutritional, hematological, and biochemical determinants contributing to anemia and its geographic disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This community-based study included 2,805 pregnant women from diverse settings (tribal\/rural\/urban). Hematological and biochemical assessments included serum ferritin, iron, C-Reactive Protein (CRP), folate, vitamin B12, prealbumin, and hemoglobinopathy screening. A logistic regression analysis was conducted to determine the independent factors associated with anemia, with the findings presented as adjusted odds ratios (aOR) along with their 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall anemia prevalence was 64.2%, with mild anemia comprising 82.1% of cases. Tribal women had 2.21-fold higher odds of anemia than urban counterparts (aOR\u2009=\u20092.21, 95% CI: 1.88\u20132.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Anemia was also associated with illiteracy (aOR\u2009=\u20092.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), underweight status (aOR\u2009=\u20091.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and low dietary diversity (aOR\u2009=\u20092.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Biochemical assessments revealed absolute iron deficiency in 17.2%, folate deficiency in 15.5%, and vitamin B12 deficiency in 60.3% of anemic women. Elevated CRP levels indicated inflammation in 34.7%. Multivariable binary logistic regression revealed five significant and independent predictors of anemia: reduced red blood cell count (aOR\u2009=\u20090.26; 95% CI: 0.22\u20130.31), elevated red cell distribution width (RDW-CV) (aOR\u2009=\u20091.39; 95% CI: 1.33\u20131.46), diminished serum prealbumin (aOR\u2009=\u20090.92;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), lower folate levels (aOR\u2009=\u20090.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and decreased ferritin concentrations (aOR\u2009=\u20090.99;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), each independently contributing to anemia risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anemia in Gujarat's pregnant women is highly prevalent and multifactorial, shaped by overlapping nutritional, inflammatory, and social determinants. Region-specific, integrated strategies targeting biochemical deficits and structural inequities are essential for effective anemia mitigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgwh.2025.1717148","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T06:34:01Z","timestamp":1765521241000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessing anemia burden and multifactorial contributors among pregnant women in Gujarat: a cross-sectional study integrating biochemical, nutritional, and geographic disparities"],"prefix":"10.3389","volume":"6","author":[{"given":"Ashwini","family":"Agarwal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Bakshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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