ABSTRACT
Iron deficiency anaemia is a prevalent public health issue among pregnant women, particularly in low- and middle-income countries, including Tanzania, where rates range from 47% to 70.9%. This study examines the prevalence, severity, and predictors of iron deficiency anaemia among pregnant women in Iringa Municipality, Tanzania. A quantitative cross-sectional design was conducted from June 12 to July 15, 2024. A total of 545 pregnant women accessing antenatal care were randomly selected from 12 public healthcare facilities. Data were collected from clinic cards and analyzed using the Statistical Package for the Social Sciences (SPSS) version 26. The study found that 13.8% of pregnant women had anaemia, mostly moderate (54.7%) and mild (42.7%).  In univariate analysis, women engaged in petty businesses had a crude odds ratio (cOR) of 0.225 (95% CI: 0.062-0.815, p = 0.023), indicating lower anaemia risk versus formal employment. The first trimester showed a cOR of 0.245 (95% CI: 0.118-0.511, p < 0.001), and the second trimester had a cOR of 0.450 (95% CI: 0.238-0.851, p = 0.014). Multivariate analysis revealed farmers had an adjusted odds ratio (aOR) of 0.175 (95% CI: 0.038-0.811, p = 0.026) while the first and second trimesters had aORs of 0.266 (95% CI: 0.122-0.580, p = 0.001) and 0.494 (95% CI: 0.253-0.967, p = 0.040), respectively. This study notes that anaemia among pregnant women is a mild public health issue, but ongoing monitoring and targeted interventions are crucial to enhance maternal and fetal health outcomes.