Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 2 2019 02 01 338 344 Mohammad Esmaeil MOTLAGH Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Seiyed Davoud NASROLLAHPOUR SHIRVANI Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Farahnaz TORKESTANI Department of Obstetrics and Gynecology, School of Medicine, Shahed University, Tehran, Iran Zahra HASSANZADEH-ROSTAMI Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Seyed-Mozaffar RABIEE Department of Anesthesiology and Intensive Care, Babol University of Medical Sciences, Babol, Iran Hassan ASHRAFIAN AMIRI Internal Medicine, Babol University of Medical Sciences, Babol, Iran Laleh RADPOOYAN Department of Health, Ministry of Health, Tehran, Iran 2019 02 05 Background: Anemia is a common nutritional disorder that is more prevalent in pregnant women than other population groups. This study aimed to assess the frequency of anemia and its association with health care determinants among Iranian pregnant women from provinces with different Maternal Mortality Rate (MMR). Methods: This cross-sectional survey was carried out on 2737 pregnant women referred to public health centers in Iran, 2015. The participants were randomly selected by multistage sampling from six provinces with low, moderate or high MMR. The level of hemoglobin lower than 11 g/dl were defined as anemia in first and third trimester of pregnancy. Results: The rate of anemia in first and third trimester were respectively 8.2 and 26.7%. The most determinants of anemia among women in both first and third trimester of pregnancy were geographical classes with high MMR, no care before pregnancy, and type of house. Moreover, lower number of previous pregnancies (OR, 0.48; 95% CI, 0.27 to 0.85) and adequate care during pregnancy (OR, 0.66; 95% CI, 0.47 to 0.92) were protected women from anemia and high number of children (OR, 2.07; 95% CI, 1.13 to 3.80) enhanced risk of anemia in first trimester of pregnancy. Moreover, higher body mass index had lower odds of anemia in third trimester. Conclusion: The rate of anemia is differed in various parts of Iran, and this disorder gets worse in third trimester of pregnancy than first. Strengthening health care programs may be a useful strategies to prevent and control anemia.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16156 https://ijph.tums.ac.ir/index.php/ijph/article/download/16156/6292