Social relationships and empowerment as risk factors for anemia among anxious pregnant women in Pakistan

Background: Empowered women with social support are more likely to seek healthcare services, leading to better health outcomes. This study investigated spousal relationships, social support, and women's empowerment in relation to anemia in pregnant women living in urban areas of Rawalpindi, Pakistan. Subjects and Method: A cross-sectional study enrolled 1,200 pregnant women at ≤ 22 weeks of gestation from Holy Family Hospital, Pakistan. The anxiety component of the Hospital Anxiety and Depression Scale (HADS) was used to assess eligibility, with a cutoff score of > 8. The quality of marital relationships, social support, and women's empowerment were evaluated using the MacArthur Relationship Questionnaire (MRQ), the Multidimensional Scale of Perceived Social Support (MSPSS), and an empowerment scale, respectively. Blood samples were collected to assess anemia in the participants. Descriptive statistics, risk ratios and bivariate analysis were conducted to explore the association. Results: At enrollment, 29.7% of pregnant women exhibited mild anemia, 14.6% exhibited moderate anemia, and 0.3% exhibited severe anemia. Having a strong spousal relationship was significantly associated with decreased risk of anemia (RR=0.87; 95% CI= 0.82 to 0.93, p