Association between anemia and preeclampsia: a case control study in Gorontalo region, Indonesia

Abstract

Background: Preeclampsia is one of the most common health problems in pregnancy that relates to several risk factors leading to an increase in maternal and perinatal mortality. The risk factors for preeclampsia include maternal age ≥35 years old, primigravida, chronic hypertension, obesity, and history of preeclampsia. However, studies investigating anemia as a risk factor for preeclampsia were still limited and showed conflicting results. This study aims to investigate the association between anemia and preeclampsia.Methods: A case-control study was conducted in the department of obstetrics and gynecology Dr. M. M. Dunda public hospital, Indonesia, from December 2020 to May 2021. Secondary data was collected in singleton pregnancy patients aged <35 years, admitted from 2016 to 2020. The number of patients used in this study was 264 consisting of 132 preeclampsia and 132 healthy women. Patient basic characteristics, obstetrics status, urinalysis, and complete blood count were collected and analysed using SPSS 25 for Mac. Kolmogorov-Smirnov test was done to examine data distribution. Chi-square was used to analyse the association between anemia and preeclampsia, p<0.05 is considered to be statistically significant.Results: BMI was found significantly higher in preeclampsia group (p<0.000), and infants born to mothers with preeclampsia had lower birth weight and height compared to the control group with p-value respectively p<0.032 and p<0.001. There was no significant association between anemia and pre-eclampsia (p=0.712; p>0.05).Conclusions: Preeclampsia is significantly associated with higher maternal BMI and lower birth weight/height. However, no association was identified between anemia and preeclampsia.

The Relationship Between Anemia in Pregnant Women and The Incidence of Preeclampsia in Indonesia : A Systematic Review

“…The study by Hamzah categorized pregnant women into age groups of 14-28 years and 29-49 years, with a larger number of subjects falling in the 14-28 age group 14 . Similarly, the study by Nanda & Semarawisma categorized age as 18-34 years and <18 and >34 years, with a higher subject count in the <18 and >34 years age groups 13 . Additionally, the study by Tarisma et al stated that pregnant women aged <20 years and >35 years had a greater risk for preeclampsia, with an odds ratio of 4.03 (CI 1.863-8.725) 12 .…”

“…Table 3 contains four literature published from 2018 to 2022 that showed a relationship between anemia in pregnancy and the incidence of preeclampsia with a p-value less than 0.05 9,11,12,16 . On the contrary, there were four literature that showed an insignificant relationship between anemia in pregnancy and the incidence of preeclampsia with a p-value greater than 0.05 [13][14][15]17 .…”

“…In the study by Nanda & Semarawisma, involving 264 participants, the prevalence of anemia among pregnant women was 50%, with 25.7% in the case group and 24.2% in the control group 13 . The study also categorized anemia severity based on Hb levels into severe (5.3%), moderate (19.7%), and mild (25%) classifications.…”

“…Notably, the study by Ridho et al deviates, with 33.33% of the total sample representing preeclampsia cases 15 . The sample sizes vary across studies, ranging from 49 in Prasetya 11 to 414 in Nanda & Semarawisma 13 .…”