Effect of Anemia in Pregnancy and its Perinatal Outcome: A Prospective Cohort Study
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.
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
Copyright (c) 2021 Noora Pradhan
This work is licensed under a Creative Commons Attribution 4.0 International License.
- The Journal of Lumbini Medical College (JLMC) publishes open access articles under the terms of the Creative Commons Attribution (CC BY) License which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- JLMC requires an exclusive licence to publish the article first in its journal in print and online.
- The corresponding author should read and agree to the following statement before submission of the manuscript for publication,
- License agreement
- In submitting an article to Journal of Lumbini Medical College (JLMC) I certify that:
- I am authorized by my co-authors to enter into these arrangements.
- I warrant, on behalf of myself and my co-authors, that:
- the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;
- I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to JLMC are not in breach of any other obligation;
- the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;
- I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.
- I, and all co-authors, agree that the article, if editorially accepted for publication, shall be licensed under the Creative Commons Attribution License 4.0. If the law requires that the article be published in the public domain, I/we will notify JLMC at the time of submission, and in such cases the article shall be released under the Creative Commons 1.0 Public Domain Dedication waiver. For the avoidance of doubt it is stated that sections 1 and 2 of this license agreement shall apply and prevail regardless of whether the article is published under Creative Commons Attribution License 4.0 or the Creative Commons 1.0 Public Domain Dedication waiver.
- I, and all co-authors, agree that, if the article is editorially accepted for publication in JLMC, data included in the article shall be made available under the Creative Commons 1.0 Public Domain Dedication waiver, unless otherwise stated. For the avoidance of doubt it is stated that sections 1, 2, and 3 of this license agreement shall apply and prevail.
Please visit Creative Commons web page for details of the terms.