Introduction: Gestational anemia remains a major public health concern. This study aimed to identify factors influencing the time to onset of anemia among pregnant women in Parakou in 2025. Methods: A prospective, descriptive, and analytical prospective cohort study was conducted from June to July 2025 among 366 pregnant women attending nine public maternity centers in Parakou. Data were collected through questionnaires and blood tests. Kaplan-Meier survival analysis and Cox regression were used to identify determinants of the time to anemia onset. Results: The mean age of participants was 26.46 ± 5.39 years. The prevalence of anemia was 35.25%. Pregnancy type did not significantly affect the time to onset (p = 0.645). Lack of iron/folic acid supplementation significantly increased the risk (HR = 2.97; p < 0.0001). Urinary tract infections were also associated with earlier anemia onset (p = 0.025). Conclusion: Gestational anemia remains common. Iron/folic acid supplementation and infection prevention are essential to delay its occurrence.
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