Anaemia during Pregnancy and its Association with Adverse Maternal and Foetal Outcomes

ABSTRACT

Nutritional iron deficiency is the main cause of anemia throughout the world. It is especially common in women of reproductive age and particularly during pregnancy. Anemia during pregnancy is associated with adverse perinatal outcomes in the form of preterm birth, stillbirth, small for gestational age babies and increased perinatal mortality. There is persistently high prevalence of anemia in Indian mothers despite a national program in place. Objective: To assess the prevalence of anaemia, its different types and their association with maternal and perinatal outcomes. Methods: This study was conducted on 100 pregnant patients with severe anemia. The study population was divided into 3 groups based on basis of peripheral smear picture i.e. microcytic, macrocytic and dimorphic anemia. These pregnant mothers were followed up until their time of delivery and associations between anaemia types and maternal as well neonatal adverse outcomes were explored. All the data collected was analyzed using statistical computer software (STATA Version 13.0). Result: Microcytic hypochromic anemia was most commonly present (45 patients, 45%). Intrauterine growth restriction was seen in 20% of total study population and out of these, majority were born to mother with macrocytic anemia (32.5%). The same trend was also seen for gestational hypertension with 8.9%. 32.5% and 6.7% patients having gestational hypertension in microcytic, macrocytic and dimorphic anemia groups respectively (p=0.009). A total of 23 patients had low birth weight babies; 65.2% patients with low birth weight babies had macrocytic anemia and this difference was statistically significant (p=0.024). Overall 15% of babies were small for gestational age, out of which 66.7% babies were in macrocytic anemia group. Low Apgar score at one minute after birth was seen in four babies born to mothers having macrocytic anemia and this was a statistically significant relationship (p=0.044). Conclusion: Anemia is increasingly becoming prevalent and is associated with poor maternal and perinatal outcomes. Public health interventions should be made by way of appropriate food fortifications to reduce prevalence of anemia Early diagnosis should be made by appropriate investigations and proper therapy should be started as soon as possible according to type of anemia, in order to prevent adverse maternal and foetal outcomes.