Effect of Anemia in Pregnancy and its Perinatal Outcome: A Prospective Cohort Study

  • Noora Pradhan Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal. https://orcid.org/0000-0001-6076-967X
  • Suman Raj Tamrakar Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.
  • Shailendra Bir Karmacharya Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Keywords: Anemia, Birth outcomes, Mortality, Perinatal, Pregnancy


Introduction: Anemia is a major risk factor for poor maternal health status. Anemia during pregnancy leads to poor birth outcomes such as fetal anemia, low birth weight, preterm birth, stillbirth, and neonatal mortality. This study aimed to assess the effect of anemia in pregnancy and its perinatal outcome. Methods: A prospective study was conducted among 370 pregnant women in Dhulikhel Hospital, Kavre from June 2017 to December 2017. Descriptive statistics were used to represent the socio-clinical characteristics. Bivariate analysis was performed to analyze the effect of anemia. Results: The study found that all the participants were anemic out of which mild anemia was observed in 352 (95.4%), moderate anemia in 17 (4.6%), and severe anemia in one (0.3%) participants respectively. Women aged 17 to 24 years and multiparous women had higher odds of having moderate anemia (Hb 7.0-8.9 g/dL). Women with moderate anemia had more odds of having neonates with less Apgar scores. Women with moderate anemia had nine times higher odds of having newborn mortality. Conclusion: Anemia during pregnancy not only affects the health status of the mother but also impacts the birth outcomes. This study highlighted the emphasis on the active participation of governmental and non-governmental organizations to prevent adverse effects of anemia during pregnancy and birth outcomes.


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Author Biographies

Noora Pradhan, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.


Department of Obstetrics and Gynecology.

Suman Raj Tamrakar, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.

Professor and Head,

Department of Obstetrics and Gynecology.

Shailendra Bir Karmacharya, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal

Senior Consultant Pediatrician,

Department of Neonatology.


Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019;1450(1):15-31. PMID: 31008520 DOI: https://doi.org/10.1111/nyas.14092

World Health Organization. Iron Deficiency Anemia: Assessment, Prevention and Control [Internet]. World Health Organization. Report number: WHO/NHD/01.3, 2001. https://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf

World Health Organization. Anaemia [Internet]. Geneva: WHO; 2021. Available from: https://www.who.int/health-topics/anaemia [Accessed 28 March, 2021]

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013;382(9890):427-51. DOI: https://doi.org/10.1016/S0140-6736(13)60937-X

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(0):1846280. PMID: 29854446 DOI: https://doi.org/10.1155/2018/1846280

Osman MO, Nour TY, Bashir HM, Roble AK, Nur AM, Abdilahi AO. Risk Factors for Anemia Among Pregnant Women Attending the Antenatal Care Unit in Selected Jigjiga Public Health Facilities, Somali Region, East Ethiopia 2019: Unmatched Case-Control Study. J. Multidiscip Healthc. 2020;13(0):769-777. PMID: 32848406 DOI: https://doi.org/10.2147/jmdh.s260398

Sukrat B, Wilasrusmee C, Siribumrungwong B, McEvoy M, Okascharoen C, Attia J, et al. Hemoglobin Concentration and Pregnancy Outcomes: A Systematic Review and Meta- Analysis. Biomed Res Int. 2013;2013(0):769057. DOI: https://doi.org/10.1155/2013/769057

Ministry of Health Nepal, New ERA, ICF. Nepal Demographic Health Survey 2016. Ministry of Health, Nepal: Kathmandu, Nepal; 2017. Available from: https://www.dhsprogram.com/pubs/pdf/fr336/fr336.pdf

Helmy ME, Elkhouly N, Ghalab RA. Maternal anemia with pregnancy and its adverse effects. 2018;31(1):7-11. Available from: https://www.mmj.eg.net/text.asp?2018/31/1/7/234258

Kumari S, Garg N, Kumar A, Guru PKI, 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(0):100098. PMID: 31485474 DOI: https://doi.org/10.1016/j.onehlt.2019.100098

Upadhyay C, Upadhyay N. Effect of anemia on pregnancy outcome: a prospective study at tertiary care hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(12):5379-83. DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20175246

Mulepati S, Chaudhary TK. Determinants of Anemia Among Pregnant Women Attending in a Tertiary Level Hospital, Kathmandu. Med Phoenix. 2017;2(1):24-33. DOI: https://www.jnmc.com.np/index.php/jnmc/article/download/20/17/93

Ghimire N, Pandey N. Knowledge and Practice of Mothers Regarding the Prevention of Anemia during Pregnancy, in Teaching Hospital, Kathmandu. Journal of Chitwan Medical College. 2013;3(5):14-17. DOI: https://doi.org/10.3126/jcmc.v3i3.8631

Lamichhane A, Gurung S, Panthee K, Shrestha D. Prevalence of Maternal Anemia in a tertiary care hospital in Western Nepal. J Nepal Med Assoc. 2019;57(218):238-42. PMID: 32323654

Ahmad MO, Kalsoom U. Effect of Maternal Anaemia on APGAR Score of Newborn. Journal of Rawalpindi Medical College. 2015;19(3):239- 42. https://www.journalrmc.com/index.php/JRMC/article/view/246

Sharma D, Amgain K, Panta PP, Pokhrel B. Hemoglobin levels and anemia evaluation among pregnant women in the remote and rural high lands of mid-western Nepal: a hospital based study. BMC Pregnancy Childbirth. 2020;20(0):182. DOI: https://doi.org/10.1186/s12884-020-02870-7

Cakmak BD, Turker UA, Oztas S, Arik M, Ustunyurt E. The effect of first trimester hemoglobin levels on pregnancy outcomes. Turk J Obstet Gynecol. 2018;15(3):165-170. PMID: 30202626 DOI: https://doi.org/10.4274/tjod.87269

Lone FW, Qureshi RN, Emanuel F. Maternal anaemia and its impact on perinatal outcome. Tropical Medicine & International Health. 2004;9(4):486-90. DOI: https://doi.org/10.1111/j.1365-3156.2004.01222.x

Malhotra M, Sharma JB, Batra S, Sharma S, Murthy NS, Arora R. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynaecol Obstet. 2002;79(2):93-100. PMID: 12427391 DOI: https://doi.org/10.1016/s0020-7292(02)00225-4

How to Cite
Pradhan N, Tamrakar SR, Karmacharya SB. Effect of Anemia in Pregnancy and its Perinatal Outcome: A Prospective Cohort Study. J Lumbini Med Coll [Internet]. 17Nov.2021 [cited 5Jun.2023];9(2):6 pages. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/445
Original Research Article