Impact of different grades of anaemia severity during pregnancy on maternal and neonatal outcomes: a prospective study

Authors

  • Sonia Dahiya Department of Obstetrics and Gynaecology, Pt. B.D Sharma PGIMS, Rohtak, Haryana, India
  • Nisha Malik Department of Obstetrics and Gynaecology, Pt. B.D Sharma PGIMS, Rohtak, Haryana, India
  • Kiran Pandey Department of Obstetrics and Gynaecology GSVM Medical College, Kanpur, Uttar Pradesh, India
  • Renu Gupta Department of Obstetrics and Gynaecology GSVM Medical College, Kanpur, Uttar Pradesh, India
  • Vanamail Perumal Department of Statistics & Demography, All India Institute of Medical Sciences, New Delhi, India
  • Vikram Singh Department of General Surgery, Pt. B.D Sharma PGIMS, Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20192409

Keywords:

Anaemia, Pregnancy, Maternal, Neonatal outcome

Abstract

Background: Anaemia in pregnancy is a universal health problem that may cause a number of obstetrical and neonatal complications. This prospective observational study aims to evaluate and compare maternal and neonatal outcomes in different grades of anaemia severity.

Methods: A total of 400 pregnant women with anaemia in third trimester were classified into three groups according to haemoglobin (Hb) levels-group I with Hb:10-10.9 g/dl, group II with Hb:7-9.9g/dl and group III with Hb<7 g/dl. Maternal and neonatal outcomes of women with different severity of anaemia were analyzed and compared. Two groups means were compared by Student’s t-independent test and more than two groups means by one way analysis of variance test followed by post-hoc pairwise comparison using Bonferroni test.

Results: The prevalence of anaemia in the study population was 35.2%. Mild, moderate and severe anaemia were found in 58% (n=232), 29.0% (n=116) and 13% (n=52) women respectively. A statistically significant difference in maternal outcomes such as Preterm labor (p=0.001), Prelabor premature rupture of membranes (p=0.044), Intrauterine growth restriction (p=0.002) and postpartum hemorrhage (p=0.001) was observed amongst the three groups. Cardiac failure occurred in 26.9% (n=14) and mortality in 13.4% (n=7) women with severe anaemia. Amongst the neonatal morbidities, the rate of low birth weight, preterm birth, respiratory distress syndrome, septicaemia, pneumonitis and jaundice revealed an increasing trend with rising severity of anaemia which was statistically significant.

Conclusions: Targeted interventions addressing early detection and appropriate treatment in early pregnancy can prevent and avoid dismal maternal and neonatal consequences.

References

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

International Institute of Population Sciences and ORC Macro. National Family Health Survey - 3. International Institute of Population Sciences, Mumbai. Available at: http://www.iipsindia.org/ nfhs3.html. Accessed on 3 January 2019.

WHO, Iron deficiency anaemia: assessment, prevention and control. WHO/NHD/ 01.3, Geneva, 2001.

Malagi U, Reddy M, Naik R. Evaluation of national nutritional control programme in Dharward (Karnataka). J Hum Ecol. 2006;20(4):279–81.

Kumar A, Jain S, Singh NP, Singh T. Oral versus high dose parenteral iron supplementation in pregnancy. Int J Gynecol Obstet. 2005;89:7–13.

Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr. 2016;103(2):495-504.

Perumal V. Reproductive risk factors assessment for anaemia among pregnant women in India using a multinomial logistic regression model. Trop Med Int Health. 2014;19(7):841-51.

Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Peña-Rosas JP, Bhutta ZA, Ezzati M. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1:e16–25.

Rao S, Joshi S, Bhide P, Puranik B, Kanade A. Social dimensions related to anaemia among women of childbearing age from rural India. Public Health Nutr. 2011;14(2):365-72.

Allen LH. Biological mechanisms that might underlie iron’s effects on fetal growth and preterm birth. J Nutr 2001;131:581s-89s.

Zhang Q, Ananth CV, Li Z, Smulian JC. Maternal anaemia and preterm birth: a prospective cohort study. Int J Epidemiol. 2009;38(5):1380-9.

Kozuki N, Lee AC, Katz J Moderate to Severe, but Not Mild, Maternal Anemia, Is Associated with Increased Risk of Small-for-Gestational-Age Outcomes. J Nutr. 2012;142(2):358-62.

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

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(2):232-40.

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Published

2019-05-28

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Original Research Articles