Objective To examine the prevalence and risk factors of anemia among 16 – 40 years old pregnant women living in southern rural area of Guizhou province and to provide references for taking corresponding interventions.

Methods A total of 49 487 pregnant women aged 16 – 40 years were randomly selected with stratified multi-stage sampling from rural Qiannan prefecture of Guizhou province and surveyed with a face-to-face interview, physical examination, and laboratory test between January 2017 and May 2018.

Results Totally 11 857 anemia cases were diagnosed and the crude and standardized prevalence rate of anemia was 23.96% and 22.89% among all the pregnant women surveyed. Multivariate unconditional logistic regression analysis revealed risk factors of anemia among the pregnant women as following: in third trimester of pregnancy (odds ratio OR = 3.798, 95% confidence interval 95% CI: 1.415 – 4.319), Buyi nationality (OR = 3.416, 95% CI: 1.634 – 4.097), Miao nationality (OR = 4.948, 95% CI: 1.865 – 6.126), with the education of primary school and below (OR = 3.412, 95% CI: 1.375 – 4.825), with family annual income per capita of < 5 000 RMB yuan (OR = 4.796, 95% CI: 1.757 – 6.653), menorrhagia (OR = 3.279, 95% CI: 1.234 – 4.657), having three pregnancies or more (OR = 2.995, 95% CI: 1.245 – 4.015), with 2 times of miscarriages or more (OR = 3.385, 95% CI: 1.423 – 4.875), having two deliveries or more (OR = 3.004, 95% CI: 1.249 – 4.235), preference for grain or corn as stable food (OR = 3.895, 95% CI: 1.456 – 5.935), without iron supplementation during pregnancy (OR = 3.887, 95% CI: 1.524 – 5.987), without folic acid supplementation during pregnancy (OR = 3.532, 95% CI: 1.239 – 4.184), without vitamin A supplementation during pregnancy (OR = 4.546, 95% CI: 1.863 – 6.971), tea drinking (OR = 3.916, 95% CI: 1.441 – 3.956), consumption of carbonated drinks (OR = 3.498, 95% CI: 1.432 – 3.973), and living in an area adjacent to a mountain (OR = 3.371, 95% CI: 1.315 – 3.892).

Conclusion The prevalence rate of anemia is at a high level among minority pregnant women in southern rural area of Guizhou province and interventions on risk factors of anemia should be carried out among the women.