Effect of anemia on pregnancy outcome: a prospective study at tertiary care hospital

Chintan Upadhyay, Nisha Upadhyay


Background: Iron deficiency anaemia during pregnancy leads to preterm birth, low birth weight and small-for-gestational age babies and increases incidence of postpartum haemorrhage (PPH) and the reason for the incidence of PPH is higher in India compared with the rest of the world. The objective of this study was to find association between maternal anaemia and neonatal complications and to find long term morbidity and mortality of babies born to anaemic mothers.

Methods: It is a prospective study done at Obstetrics and Gynecology Department, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore during October 2009 to October 2011. All subjects were analyzed in full details and haemoglobin estimation done during 1st visit, at 30th week and 36th week of gestation.

Results: Study observed moderate anaemia observed in almost 53.0% cases followed by mild (29.5%) and severe (17.5%) respectively. Risk factors present in 58.0% cases and maternal complications in puerperium observed in 14.5% cases. High incidence of adverse foetal outcome in the form of preterm (20%), IUGR (28%), NICU admission (25.5%) and IUD (3%) seen in present study. Study found association between space between pregnancy, LSCS and fetal outcome with severity of anaemia. Ensuring maternal iron sufficiency during gestation is the most cost-effective method of preventing perinatal iron deficiency and related morbidities.

Conclusions: Iron supplementation during pregnancy in iron deficient mothers improves iron status during pregnancy and postpartum period, thus providing some protection against iron deficiency in the subsequent pregnancy. Proper antenatal care is the basic requirement for prevention, early detection and treatment of anaemia.


Anemia, Fetal outcome, IUGR, LSCS, NICU, Space between pregnancies

Full Text:



Kalaivani K. Prevalence and consequences of anemia in pregnancy. Indian J Med Res. 2009;130:627-33.

DeMaeyer, Adiels-Tegman M. The prevalence of anaemia in the world. World Health Statistics Quarterly. 1985;38(3):302-16.

Scholl TO. Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr. 2005;81(5):1218-22.

Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevalence of iron deficiency in the United States. J Am Med Assoc. 1997;277(12):973- 6.

Viteri FE. The consequences of iron deficiency and anaemia in pregnancy on maternal health, the foetus and the infant. SCN News. 1994;11:14-8.

Haider BA, Olofin I, Wang M. Nutrition Impact model study group (anaemia). Anemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Br Med J. 2013;346:f3443.

Kavle JA, Stoltzfus RJ, Witter F, Tielsch JM, Khalfan SS, Caulfield LE. Association between anaemia during pregnancy and blood loss at and after delivery among women with vaginal births in Pemba Island, Zanzibar, Tanzania. J Health Popul Nutr. 2008;26:232-40.

Center for Reproductive Rights. Maternal mortality in India: using International and Constitutional Law to promote accountability and change. New York: Center for Reproductive Rights, 2008.

Shashtri DD. Commom issue in current concepts. Acedemic of Pediatrics, Gujarat. 2013:85-9.

Jaleel R, Khan A. Severe anemia and adverse pregnancy outcome. J Surg Pak. 2008;13:147-50.

Pena-Rosas JP, Viteri FE. Effects of routine oral iron supplementation with or without folic acid for women during pregnancy. Cochrane Database Syst Rev. 2006;(3):CD004736.

Koller O, Sagen N, Ulstein M, Vaula D. Fetal growth retardation associated with inadequate haemodilution in otherwise uncomplicated pregnancy. Acta Obstet Gynecol Scand. 1979;58:9-13.

Mangla M, Singla D. Prevalence of anaemia among pregnant women in rural India: a longitudinal observational study. Int J Reprod Contracept Obstet Gynecol. 2016;5:3500-5.

Alli R, Satyanarayana M. Anemia complicating pregnancy. J Obstet Gynecol India. 1985; 35(2): 335-338.

Bhatt RV. Management of pregnancy anaemia: Obstetrician’s dilemma. J Obstet Gynecol India. 1998;48(6):96-100.

Rangnekar AG, Rashmi D. Fetal outcome in pregnancy anemia. J Obstet Gynecol India. 1993;43(2):172-6.

Awasthi A, Thakur R, Dave A, Goyal V. Maternal and perinatal outcome in cases of Moderate and Severe anemia. J Obstet Gynecol India. 2001;51(6):62-5.

Khandait DW, Ambadikar NN, Zodpey PS. Risk factors for anemia in pregnancy. J Obstet Gynaec India. 2001;51(1):42-4.

Sarin AR. Severe anemia of pregnancy: recent experience. Int J Gynecol Obstet India. 1997;1(1):39-44.

Khalida H, Shah GN, Farooq F. Some obstetric and fetal correlations in association with anemia in pregnancy. Indian J Maternal Child Health. 1997;8(2):48-50.

Angelitta JN, Alkhasawneh E, Seshan V, Raman S. Anemia in pregnancy: consequences and challenges: a review of literature. J South Asian Federation Obstet Gynecol. 2012;4(1):64-70.

Rohilla M, Ravenndran A, Dhaliwal LK, Chopra S, Severe anemia in pregnancy: a tertiary hospital experience from northern India. J Obstet Gynecol. 2010;30(7):694-6.