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Background  Anemia in pregnancy is associated with higher risk of low birth weight and both maternal and perinatal mortality. While previous studies in Ethiopia have examined factors associated with anemia, which factors are the most important determinants of anemia in this population remain unclear. The objective of this study was to examine the association between anemia status in pregnant women with different health, behavioral, and socioeconomic factors in Oromiya province of Ethiopia.    Methods  This study used pregnancy enrollment data from a longitudinal birth cohort study conducted in Ethiopia. Survey data on maternal and household characteristics were collected at enrollment and maternal hemoglobin levels were measured. The analysis includes 4600 pregnant women. Logistic regression models were used to identify factors associated with maternal anemia in pregnancy.    Results  Controlling for geographic location and religion, low maternal MUAC and previous pregnancies were associated with increased odds of anemia, with odds ratios of 1.30 ( p  < 0.001, CI 1.12–1.51), and 1.50 ( p  = 0.002, CI 1.16–1.95), respectively. For each additional point on the handwashing score scale, the odds of being anemic were reduced by 12% ( p  < 0.001, CI 0.82–0.94). Numerate women compared to non-numerate women had 30% lower odds ( p  < 0.001, CI 0.57–0.85).    Conclusion  Controlling for woreda and religion, low maternal MUAC, and previous pregnancy increased odds of anemia while numeracy and better handwashing practices significantly reduced the odds of anemia in pregnancy. Further investigation is needed to determine the cause of anemia in pregnant women in Oromiya and to determine the effects of maternal anemia on birth outcomes.

Predictors of anemia in pregnant women residing in rural areas of the Oromiya region of Ethiopia