DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180903

Severe anemia in late pregnancy: a retrospective study at a tertiary care rural medical college in Gujarat, India

Shilpa A. Sapre, Nitin S. Raithatha, Rumi S. Bhattacharjee

Abstract


Background: Anaemia in pregnancy is the commonest medical disorder in developing countries like India. It has multifactorial etiology and is associated with increased maternal and perinatal morbidity and mortality. The study aimed at analyzing the socio-demographic variables and also the maternal and perinatal outcome of pregnant women admitted to labour room with severe anaemia (Hb <7 gm%) late in pregnancy.

Methods: This is a retrospective observational study done at a tertiary care rural medical college in Gujarat over a 3 year period from January 2014 to December 2016.

Results: Results of the study were analyzed. Out of 3963 deliveries during the study period 225 (5.6%) patients were severely anaemic. There were 177 (78.6%) unbooked patients and 169 (75.1%) were multigravidas. Majority of patients belonged to under 24 yr age group. Maternal complications were in form of preterm labour (44%), pre-eclampsia-ecclampsia (24.8%), cardiac failure (2.2%), PPH (2.2%) maternal death (0.4%). Neonatal outcome was analyzed in terms of prematurity (44%), LBW (24.8%), NICU admission (15.1%), still birth (4.4%), neonatal death (11.5%).

Conclusions: Severe anaemia during pregnancy is associated with adverse maternal and perinatal outcome. It is also one of the preventable indirect cause of maternal mortality. Imparting health education to adolescent girls, regular antenatal check-ups, early diagnosis and treatment along with active participation of ASHA workers at grass-root level might help in bringing down the prevalence. A more focused approach is warranted towards pregnant women in rural and underdeveloped areas of India.


Keywords


Late pregnancy, Maternal outcome, Perinatal outcome, Rural area, Severe anemia

Full Text:

PDF

References


Baig-Ansari N, Badruddin SH, Karmaliani R, Harris H, Jehan I, Pasha O et al Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food Nutr Bull. 2008 Jun;29(2):132-9.

Tolentino K, Friedman JF. An update on anemia in less developed countries. Am J Trop Med Hyg. 2007;77:44-51.

Cyril C. Dim, Hyacinth E. Onah. The prevalence of anemia among pregnant women at booking in Enugu, South Eastern Nigeria. Med Gen Med. 2007;9(3):11.

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

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.

Sharma JB, Shankar M. Anemia in Pregnancy. JIMSA. 2010;23(4)

Kaur K. Anaemia ‘a silent killer’ among women in India: Present scenario. Euro J Zool Res. 2014;3(1):32-6.

Abiselvi A, Gopalakrishnan S, Umadevi R, Rama R. Anaemia among pregnant women in a rural area of Kancheepuram district, Tamil Nadu. Int J Community Med Public Health. 2017;4:2400-5.

Gupta SK, Agarwal SS, Kaushal R, Jain A ,Gupta VK, Khare N. Prevalence of rural population living in and around of rural health and training center, Ratua Village of Madhya Pradesh. Muller J Med Sci Res. 2014;5:15-8.

Toteja GS, Singh P, Dhillon BS, Saxena BN, Ahmed FU, Singh RP, Prakash B, Vijayaraghavan K, Singh Y, Rauf A, Sarma UC. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull. 2006 Dec;27(4):311-5.

Gautam VP, Bansal Y, Taneja DK, Saha R. Prevalence of anaemia amongst pregnant women and its socio-demographic associates in a rural area of Delhi. Ind J Com Med. 2002;27(4):157-60.

Virender PG, Yogesh B, Taneja DK, Renuka S. Prevalence of anemia amongst pregnant women and its socio-demographic associates in a rural area of Delhi. Indian J Comm Medicine. 2002;27:157-60.

Bisoi S, Haldar D, Majumdar T, Bhattacharya N, Sarkar G, Ray S. Correlates of anemia among pregnant women in a rural area of West Bengal. J Fam Welfare. 2011;57(1):72-8.

Ghimire RH, Ghimire S. Maternal and fetal outcome following severe anaemia in pregnancy: results from Nobel Medical College Teaching Hospital, Biratnagar, Nepal. J Nobel Med Coll. 2013;2(1):22-6.

Brabin BJ, Hakimi M, Pelletier D. An analysis of anemia and pregnancy-related maternal mortality. J Nutrition. 2001;131:604-14.

Ali AA, Rayis DA, Abdallah TM, Elbashir MI, Adam I. Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan. BMC Res Notes. 2011;4:311.

VanderJagt DJ, Brock HS, Melah GS, El-Nafaty AU, Crossey MJ, Glew RH. Nutritional factors associated with anaemia in pregnant women in northern Nigeria. J Health Popul Nutr. 2007 Mar;25(1):75-8.

Van den Broek NR, Letsky EA. Etiology of anemia in pregnancy in south Malawi. Am J Clin Nutr. 2000;72:247S-56S.

Ghimire N, Pandey N. Knowledge and practice of mother regarding the prevention of anaemia during pregnancy, in teaching hospital Kathmandu. J Chitwan Med Coll. 2013;3(5):14-7.

Sabina S, Iftequar S, Zaheer Z, Khan M, Khan S. An overview of anemia in pregnancy. JIPBS. 2015;2(2):144-51.

Karaoglu L, Pehlivan E, Egri M, Deprem C, Gunes G, Genc MF et al. The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey. BMC Public Health. 2010 Dec;10(1):329.

Munasinghe S. Anaemia in pregnancy in Malawi-a review. Malawi Med J. 2006;18(4):160-75.

Geelhoed D, Agadzi F, Visser L, Ablordeppey E, Asare K, O'rourke P et al. Maternal and fetal outcome after severe anemia in pregnancy in rural Ghana. Acta Obstet Gynecol Scand. 2006;85(1):49-55.

Nirmala Devi B, Varalaxmi B, Jyothirmayi T, Lahari N. Maternal outcome in pregnancy with severe anaemia: Prospective study in a tertiary care hospital in Andhra Pradesh. JDMS. 2015;14(4):06-10.