Optimizing maternal and neonatal health: a review of anemia at term pregnancy

Santosh S. Arakeri; Trupti K. Nadkarni; Pooja M. Shah

doi:10.18203/2320-1770.ijrcog20250874

Authors

Santosh S. Arakeri Department of Obstetrics and Gynecology, Seth G. S. Medical College and KEM Hospital, Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra, India
Trupti K. Nadkarni Department of Obstetrics and Gynecology, Seth G. S. Medical College and KEM Hospital, Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra, India
Pooja M. Shah Department of Obstetrics and Gynecology, Seth G. S. Medical College and KEM Hospital, Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20250874

Keywords:

Adherence to oral hematinics, Anemia at term, Maternal outcomes, Neonatal outcomes, Pregnancy

Abstract

Background: Anemia in pregnancy remains a critical global health issue, particularly in developing countries, leading to significant maternal and fetal complications. The study aimed to identify factors contributing to anemia at term and its impact on maternal and neonatal outcomes.

Methods: A prospective observational study was conducted at a tertiary hospital in (Mumbai), including 100 pregnant women with hemoglobin <11 gm/dl at term (≥37 weeks) who fulfilled the inclusion and exclusion criteria. Demographics, antenatal care practices, and outcomes were analyzed using a predesigned case record proforma.

Results: The prevalence of mild anemia was 79%, while 21% had moderate anemia. Poor dietary intake, non-compliance with oral iron therapy, and low socioeconomic status were significant contributors. Anemia at term predisposed women to increased risks of labor complications, including prolonged hospital stays and a higher need for parenteral iron therapy or blood transfusions. Neonatal complications, including low APGAR scores and NICU admissions, were higher among moderately anemic mothers.

Conclusions: Anemia at term leads to adverse maternal and neonatal outcomes. Strengthening antenatal care, improving dietary practices, and ensuring adherence to supplementation can mitigate the risks associated with anemia.

Metrics

Metrics Loading ...

References

CDC. CDC criteria for anemia in children and childbearing-aged women. MMWR Morbidity and mortality weekly report. 1989;138(22):400-4.

WHO. Iron deficiency anemia: assessment, prevention and control. WHO/NHD/01.3, Geneva: World Health Organization, Switzerland; 2001. Available at: https://www.who.int/publications/m/item/iron-children-6to23--archived-iron-deficiency-anaemia-assessment-prevention-and-control. Accessed on 2 March 2025.

WHO. Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011. Available at: https://www.who.int/publications/i/item/WHO-NMH-NHD-MNM-11.1. Accessed on 2 March 2025.

Sharma JB, Shankar M. Anemia in pregnancy. JIMSA. 2010;23(4):253-60.

Vijayaraghavan K, Brahmam GN, Nair KM, Akbar D, Pralhad Rao N. Evaluation of national nutritional anemia prophylaxis programme. Indian J Pediatr. 1990;57:183-90.

WHO/CDC. Worldwide prevalence of anemia 1993-2005. WHO Global Database on Anemia. World Health Organization. 2008. Available from: https://www.who.int/publications/i/item/9789241596657. Accessed on 1 December 2012.

Press Information Bureau, 2022. PM inaugurates 25th National Youth Festival in Puducherry. Press Information Bureau, Government of India. Available at: https://pib.gov.in/PressReleasePage.aspx?PRID=17954. Accessed on 2 December 2024.

WHO. Guideline: Daily iron and folic acid supplementation in pregnant women. Geneva, World Health Organization, 2012. Available at: https://apps.who.int/iris/handle/10665/77770. Accessed on 2 December 2024.

Sifakis S, Pharmakides G. Anemia in Pregnancy. Ann New York Acad Sci. 2000;900:125-36.

Sarala V, Gopalan U. A study on prevalence of anemia in pregnancy in South India. Int J Reprod Contracept Obstet Gynecol. 2020;9(1):34-8.

Kaur M, Chauhan A, Manzar MD, Rajput MM. Maternal anaemia and neonatal outcome: a prospective study on urban pregnant women. J Clin Diagn Res. 2015;9(12):QC04-8.

Kumari S, Garg N, Kumar A, Guru PK, Ansari S, Anwar S, et al. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: a cross sectional study from Jharkhand, India. One Health. 2019;8:100098.

Stephen G, Mgongo M, Hussein Hashim T, Katanga J, Stray-Pedersen B, Msuya SE. Anaemia in pregnancy: prevalence, risk factors, and adverse perinatal outcomes in Northern Tanzania. Anemia. 2018;2018(1):1846280.

Churchill D, Nair M, Stanworth SJ, Knight M. The change in haemoglobin concentration between the first and third trimesters of pregnancy: a population study. BMC Pregnancy Childbirth. 2019;19:1-6.

Col Madendag I, Eraslan Sahin M, Madendag Y, Sahin E, Demir MB, Acmaz B, et al. The effect of iron deficiency anemia early in the third trimester on small for gestational age and birth weight: a retrospective cohort study on iron deficiency anemia and fetal weight. BioMed Res Int. 2019;2019(1):7613868.

Tandon R, Jain A, Malhotra P. Management of iron deficiency anemia in pregnancy in India. Indian J Hematol Blood Transfus. 2018;34:204-15.

Miglani U, Bhangadia P, Kadam VK, Laul P. Anemia in term pregnancy: influence on maternal and perinatal outcome and role of demographic factors. Int J Reprod Contracept Obstet Gynecol. 2018;8(1):251-7.

Kapur D, Agarwal AD. Good clinical practice recommendations for iron deficiency anemia in pregnancy (IDA) in pregnancy in India. J Obstet Gynecol India. 2011;61:569-71.

Miner L, Bolding P, Hilbe J, Goldstein M, Hill T, Nisbet R, et al. Socioeconomic status- an overview. ScienceDirect Topics. 2015. Available at: https://www.sciencedirect.com/topics/medicine-and-dentistry/socioeconomic-status. Accessed on 2 March 2019.

Jasti S, Siega-Riz AM, Cogswell ME, Hartzema AG, Bentley ME. Pill count adherence to prenatal multivitamin/mineral supplement use among low-income women. J Nutr. 2005;135:1093-101.

Suitor CW, Gardner JD. Supplement use among a culturally diverse group of low-income pregnant women. J Am Diet Assoc. 1990;90(2):268-71.

Yu SM, Keppel KG, Singh GK, Kessel W. Preconceptional and prenatal multivitamin-mineral supplement use in the 1988 National Maternal and Infant Health Survey. Am J Public Health. 1996;86:240-2.

Ministry of Health and Family Welfare, Government of India. Anemia Mukt Bharat- Operational guidelines for programme managers: Intensified national iron plus initiative (I-NIPI). Government of India. 2018. Available from: https://anemiamuktbharat.info/wp-content/uploads/2019/09/Anemia-Mukt-Bharat-Operational-Guidelines-FINAL-1.pdf. Accessed on 2 March 2019.