Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India

Abstract

ObjectivesTo study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes.DesignProspective observational cohort study.SettingCatchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India.Participants72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH’s Global Network, enrolled from 2009 to 2016.Main outcome measuresMode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies.ResultsOver 90% of the women included in the study were anaemic and over a third were underweight (BMI <18 kg/m2) and with both conditions. Mild anaemia at any time during delivery significantly increased the risk (Risk ratio; 95% confidence interval (RR;(95% CI)) of stillbirth (1.3 (1.1–1.6)), neonatal deaths (1.3 (1–1.6)) and LBW babies (1.1 (1–1.2)). The risks became even more significant and increased further with moderate/severe anaemia any time during pregnancy for stillbirth (1.4 (1.2–1.8)), neonatal deaths (1.7 (1.3–2.1)) and LBW babies (1.3 (1.2–1.4)).,. Underweight at anytime during pregnancy increased the risk of neonatal deaths (1.1 (1–1.3)) and LBW babies (1.2;(1.2–1.3)). The risk of having stillbirths (1.5;(1.2–1.8)), neonatal deaths (1.7;(1.3–2.3)) and LBW babies (1.5;(1.4–1.6)) was highest when - the anaemia and underweight co-existed in the included women. Obesity/overweight during pregnancy increased the risk of maternal complications at delivery (1.6;(1.5–1.7)) and of caesarean section (1.5;(1.4–1.6)) and reduced the risk of LBW babies 0.8 (0.8–0.9)).ConclusionMaternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously.Trial registration numberNCT01073475.

Women's and healthcare providers’ perceptions of long‐term complications associated with hypertension and diabetes in pregnancy: a qualitative study

“…This finding is supported by several studies, [27][28][29][30] which have highlighted that >50% of pregnant women in India are anaemic. This finding is supported by several studies, [27][28][29][30] which have highlighted that >50% of pregnant women in India are anaemic.…”

“…Anaemia was identified as the most common and important high-risk condition affecting pregnant women at both study sites. This finding is supported by several studies, [27][28][29][30] which have highlighted that >50% of pregnant women in India are anaemic. 31 The Government of India has recognised the importance of the early recognition and treatment of anaemia throughout a woman's life-course and have recently launched the 'Anemia Mukt Bharat' (Anaemia Free India) campaign.…”

Low birth weight in Bangladesh and associated maternal and socioeconomic factors: results from a recent nationally-representative survey

“…We did not observe a significant association for girls, but it’s not clear why such association can differ among boys and girls. Younger mothers tend to be undernourished and develop anemia during pregnancy – which could be the possible mechanisms for this association [16–18]. We also observed significant adverse effects of maternal undernutrition on low birth weight, independent of socioeconomic status.…”

Spatial distribution and factors associated with low birth weight in Ethiopia using data from Ethiopian demographic and health survey 2016: spatial and multilevel analysis

“…were secondary clusters. The primary clusters' spatial window was located in the North West Amhara and Northeast part of BenishangulGumuz, which was centered at 11.57418N, 36.498123 E with 122.56km radius, and Log-Likelihood ratio (LLR) of 11.82, at p < 0.01. It showed that women within the spatial window had 2.66 times higher risk of LBW as compared to women outside the window.…”