Evaluation of maternal anemia in tertiary care centre and its neonatal outcomes

Abstract

Background: Anaemia is the leading cause of maternal mortality and morbidity in India. According to WHO globally, anaemia affects 1.62 billion people. In India, National Family Health Survey 2009, reports that 55% of women in reproductive age group are anaemic. Maternal anaemia can cause many perinatal complications like low birth weight, preterm delivery, low APGAR score, suboptimal infant breast feeding behavior. Methods: This prospective study was conducted in Department of OBG at VIMS and RC for a period of 1 year. Of the total 1863 deliveries during this period, only 412 patients meet the inclusion criteria. Hb% <11gm% were anaemic and with Hb% >11gm% were non anaemic. Haemoglobin estimation was done at time of hospital admission for delivery. Patients background information included education, husband's occupation, monthly family income, urban/rural dwelling. Patients' BMI, obstetric score, number of antenatal visits she has had, if iron tablets taken regularly were all noted. Perinatal parameters recorded were birth weight, gestational age at delivery, perinatal outcome (live birth, intrauterine foetal demise (IUD) and intrauterine growth restriction (IUGR). Results: Out of the total 412 patients examined, 208 were non-anemic and 204 were anemic. Mean age and B.M.I for anemic and non-anemic women were comparable. Most women in both groups were urban dwellers, attended school up to grade 10, were housewives (35.9) and multi gravidas. There was significant difference in household monthly income and husband's employment in both groups. Majority of patients in both groups had taken >3 antenatal checkups, there were significant number of anemic women (15.7%) who had no A.N.C. checkups. Around 50% of women in both groups had taken iron tablets irregularly during pregnancy; around 15.7% and 7.2% of anemic and non-anemic patients respectively did not take iron tablets at all during pregnancy, though this difference was significant. There was significant difference between the groups regarding knowledge of specific diet plan for ante and post-partum period. Only 16.2% in anemic and 22.6% in non-anemic patients knew the correct technique and duration of breast feeding. There is statistically significant increased risk of preterm delivery among anemic women, 27.9% preterm birth in anemic group and 7.2% in non-anemic group. Low birth weight was significantly associated with anemic group, also few babies with increased birth weight >3.5 kg was seen in anemic group. There were 25 IUGR babies (12.3%) in anemic and 12 IUGR babies (5.8%) in non-anemic group, and difference was significant. Conclusions: In our study we found a positive correlation between maternal anaemia and prematurity, LBW babies, Low APGAR score and PNM. . The knowledge regarding nutritious diet and breast feeding was slightly low among anaemic mothers. This compounds the problem and starts the vicious cycle of anaemic malnourished babies & mothers.

Prevalence of maternal anemia and its impact on perinatal outcome in a rural area of Dakshina Kannada

“…Among anemic mothers, the risk of perinatal mortality was high, which was similar to the study conducted by Nair et al [15] and Lone et al [16] The study showed a significant association between maternal anemia and perinatal mortality, which was already established in many studies. Nair et al [17] and Sangeeta and Pushpalatha [18] also showed that the risk of IUGR was more in anemic mothers and the findings are similar to our study. Borah and Agarwalla, [19] showed that LBW baby was 1.93 times more among anemic mothers, which are similar to the findings of our study.…”