ABSTRACT
Objective. To estimate the effect of the severity of maternal anaemia on various perinatal outcomes. Design. A cross-sectional study. Setting. Labour Ward; Muhimbili National Hospital; Dar es Salaam; Tanzania. Methods. The haemoglobin of eligible pregnant women admitted for delivery between 15 November 2002 and 15 February 2003 was measu- red. Data on socio-demographic characteristics; iron supplementation; malaria prophylaxis; blood transfusion during current pregnancy; and current and previous pregnancy outcomes were collected and analysed. Anaemia was classified according to the World Health Organization (WHO) standards: normal - Hb =11.0 g/dl; mild - Hb 9.0 - 10.9 g/dl; moderate - Hb 7.0 - 8.9 g/dl; and severe - Hb 7.0 g/dl. Logistic regression analysis was performed to estimate the severity of anaemia. The following outcome measures were used: preterm delivery (37 weeks); Apgar score; stillbirth; early neonatal death; low birth weight (LBW) (2 500 g) and very low birth weight (VLBW) (1 500 g). Results. A total of 1 174 anaemic and 547 non-anaemic women were enrolled. Their median age was 24 years (range 14 - 46 years) and median parity was 2 (range 0 - 17). The prevalence of anaemia and severe anaemia was 68and 5.8; respectively. The risk of preterm delivery increased significantly with the severity of anaemia; with odds ratios of 1.4; 1.4 and 4.1 respectively for mild; moderate and severe anaemia. The corresponding risks for LBW and VLBW were 1.2 and 1.7; 3.8 and 1.5; and 1.9 and 4.2 respectively. Conclusion. The risks of preterm delivery and LBW increased in proportion to the severity of maternal anaemia