Correlation between Sever Anemia and Pregnancy Complications

Authors

  • Ikram Ullah Department of Gynae and Obs, Zeb Medical and Dental College, Timergara, Dir Lower, KP, Pakistan.
  • Ayesha Iqbal Department of Gynae and Obs, Maqsood Medical Complex, Peshawar, KP, Pakistan.
  • Sana Afridi Department of Gynae and Obs, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
  • Saman Zafar Department of Gynae and Obs, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
  • Nazia Wahid Department of Gynae and Obs, Timergara Teaching Hospital, Dir Lower, KP, Pakistan.
  • Munazza Yousaf Department of Gynae and Obs, Maqsood Medical Complex, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i6.1670

Keywords:

Sever Anemia, Pregnancy Complications, Global Health Issue

Abstract

This prospective observational study aimed to assess the impact of anemia severity on maternal and perinatal outcomes in 200 pregnant women. The participants were categorized into three groups based on their hemoglobin levels: mild anemia (10.0–10.9 g/dL), moderate anemia (7.0–9.9 g/dL), and severe anemia (<7.0 g/dL). The majority of participants (60%) had moderate anemia, followed by 25% with mild anemia and 15% with severe anemia. The study found that as anemia severity increased, maternal and perinatal risks also escalated. Specifically, the incidence of preterm delivery was 8% in the mild anemia group, 20% in the moderate anemia group, and 40% in the severe anemia group. Similarly, postpartum hemorrhage (PPH) occurred in 2% of women with mild anemia, 10% with moderate anemia, and 20% with severe anemia. Cesarean section rates were 20% for mild anemia, 30% for moderate anemia, and 35% for severe anemia. Prolonged hospital stays (more than 7 days) were more common in severely anemic women (20%) compared to 7% in the moderate group and 4% in the mild anemia group. Maternal mortality was observed in one case (3%) in the severe anemia group. Perinatal outcomes showed a marked increase in low birth weight (LBW) with anemia severity. In the severe anemia group, 45% of newborns had a birth weight of less than 2.5 kg, compared to 33% in the moderate anemia group and 16% in the mild anemia group. NICU admissions were required for 30% of neonates in the severe anemia group, 15% in the moderate anemia group, and 8% in the mild anemia group. Perinatal mortality was 3.3% in the severe anemia group, compared to 1.7% in the moderate anemia group and 0% in the mild anemia group. The average birth weight was lowest in the severe anemia group (2.2 kg), followed by 2.4 kg in the moderate group and 2.7 kg in the mild group. Treatment interventions revealed that blood transfusions resulted in the highest increase in hemoglobin levels (3.0 g/dL), followed by intravenous iron (2.5 g/dL) and oral iron supplements (1.5 g/dL). In terms of mode of delivery, 76% of women with mild anemia had normal vaginal deliveries, compared to 60% in the moderate anemia group and 53% in the severe anemia group. Cesarean sections were more frequent in the severe anemia group (35%) than in the mild anemia group (20%). Postpartum hemorrhage rates increased with anemia severity, with 33% of severely anemic women requiring blood transfusions post-delivery, compared to 13% in the moderate anemia group and 4% in the mild anemia group. These findings highlight the significant maternal and neonatal health risks associated with severe anemia, emphasizing the need for early detection, appropriate treatment, and close monitoring to improve pregnancy outcomes.

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References

Agarwal, K., et al. (2010). Prevalence and management of anemia in pregnancy in developing countries. Journal of Obstetrics & Gynaecology Research, 36(4), 444–451.

https://doi.org/10.1111/j.1447-0756.2009.01131.x

Allen, L. H. (2000). Anemia and iron deficiency: effects on pregnancy outcome. The American Journal of Clinical Nutrition, 71(5), 1280S1284S.

https://doi.org/10.1093/ajcn/71.5.1280s

Bakr, A. F., et al. (2009). Impact of maternal anemia on neonatal outcomes in a tertiary care hospital. Journal of Maternal-Fetal & Neonatal Medicine, 22(1), 38–41.

https://doi.org/10.1080/14767050802420456

Balarajan, Y., Ramakrishnan, U., Özaltin, E., Shankar, A. H., & Subramanian, S. (2011). Anaemia in low-income and middle-income countries. The Lancet, 378(9809), 2123–2135.

https://doi.org/10.1016/s0140-6736(10)62304-5

Bharti, P., et al. (2017). The effectiveness of intravenous iron therapy compared to oral iron supplementation in treating anemia in pregnancy. International Journal of Gynaecology and Obstetrics, 136(2), 224–228.

https://doi.org/10.1002/ijgo.12012

Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., de Onis, M., Ezzati, M., Grantham-McGregor, S., Katz, J., Martorell, R., & Uauy, R. (2013). Maternal and Child Undernutrition and Overweight in low-income and middle-income Countries. The Lancet, 382(9890), 427–451.

https://doi.org/10.1016/S0140-6736(13)60937-X

Breymann, C. (2015, October). Iron deficiency anemia in pregnancy. In Seminars in hematology (Vol. 52, No. 4, pp. 339-347). WB Saunders.

https://doi.org/10.1053/j.seminhematol.2015.07.003

Brabin, B. J., et al. (2001). The epidemiology of anemia during pregnancy: A worldwide perspective. Journal of Nutrition, 131(2S2), 604S–615S.

https://doi.org/10.1093/jn/131.2.604S

Froessler, B., et al. (2016). Intravenous iron therapy in pregnancy: A systematic review. BMC Pregnancy and Childbirth, 16, 306.

https://doi.org/10.1186/s12884-016-1092-9

Ghosh, S., et al. (2015). Micronutrient deficiencies and pregnancy outcomes in the Indian context. Indian Journal of Medical Research, 141(5), 596–608.

Glover, M., et al. (2010). The impact of anemia on pregnancy outcomes: A systematic review. Journal of Obstetrics and Gynaecology, 30(1), 1–5.

https://doi.org/10.3109/01443610903310251

Green, R. (2002). Folate, vitamin B12, and vitamin B6 deficiencies in pregnancy. Obstetrics & Gynecology, 99(5 Pt 1), 760–766.

https://doi.org/10.1016/S0029-7844(02)01887-6

Guyatt, H. L., & Snow, R. W. (2001). Malaria in pregnancy as an indirect cause of infant mortality in sub-Saharan Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95(6), 569–576.

https://doi.org/10.1016/S0035-9203(01)90082-3

Haider, B. A., Olofin, I., Wang, M., Spiegelman, D., Ezzati, M., & Fawzi, W. W. (2013). Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ, 346(jun21 3), f3443–f3443.

https://doi.org/10.1136/bmj.f3443

Kalaivani, K. (2009). Prevalence & consequences of anaemia in pregnancy. Indian Journal of Medical Research, 130(5), 627-633.

https://journals.lww.com/ijmr/abstract/2009/30050/Prevalence___consequences_of_anaemia_in_pregnancy.26.aspx

Kassebaum, N. J., Jasrasaria, R., Naghavi, M., Wulf, S. K., Johns, N., Lozano, R., Regan, M., Weatherall, D., Chou, D. P., Eisele, T. P., Flaxman, S. R., Pullan, R. L., Brooker, S. J., & Murray, C. J. L. (2014). A systematic analysis of global anemia burden from 1990 to 2010. Blood, 123(5), 615–624.

https://doi.org/10.1182/blood-2013-06-508325

Khalafallah, A. A., et al. (2010). Intravenous versus oral iron therapy for moderate iron deficiency anemia in pregnancy: A randomized controlled trial. Obstetrics & Gynecology, 115(2 Pt 1), 188–195.

https://doi.org/10.1097/AOG.0b013e3181cfe4cc

Levy, A., et al. (2005). Severe maternal anemia and the risk of adverse perinatal outcomes. European Journal of Obstetrics & Gynecology and Reproductive Biology, 121(2), 182–186.

https://doi.org/10.1016/j.ejogrb.2004.09.016

Malhotra, M., Sharma, J. B., Batra, S., Sharma, S., Murthy, N. S., & Arora, R. (2002). Maternal and perinatal outcome in varying degrees of anemia. International Journal of Gynecology & Obstetrics, 79(2), 93–100.

https://doi.org/10.1016/s0020-7292(02)00225-4

McLean, E., et al. (2009). Worldwide prevalence of anemia in preschool aged children, pregnant women and non-pregnant women of reproductive age: Estimates of global health burden 1993-2005. Public Health Nutrition, 12(4), 444–454. https://doi.org/10.1017/S1368980008002401

Milman, N. (2011). Iron in Pregnancy – How Do We Secure an Appropriate Iron Status in the Mother and Child? Annals of Nutrition and Metabolism, 59(1), 50–54.

https://doi.org/10.1159/000332129

Peña-Rosas, J. P., De-Regil, L. M., Garcia-Casal, M. N., & Dowswell, T. (2015). Daily oral iron supplementation during pregnancy. Cochrane Database of Systematic Reviews, 7.

https://doi.org/10.1002/14651858.cd004736.pub5

Ramakrishnan, U., Manjrekar, R., Rivera, J., Gonzáles-Cossío, T., & Martorell, R. (1999). Micronutrients and pregnancy outcome: A review of the literature. Nutrition Research, 19(1), 103–159.

https://doi.org/10.1016/s0271-5317(98)00178-x

Roy, C. N., et al. (2010). Anemia in pregnancy. Lancet, 376(9757), 1370–1381.

https://doi.org/10.1016/S0140-6736(10)60571-3

Stoltzfus, R. J., Mullany, L., & Black, R. E. (2004). Iron deficiency anaemia. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors, 1, 163-209.

Van Wyck, D. B., et al. (2005). Intravenous iron vs oral iron supplementation for the treatment of iron deficiency anemia in pregnancy. American Journal of Obstetrics and Gynecology, 193(2), 512–517.

https://doi.org/10.1016/j.ajog.2005.01.011

World Health Organization. (2001). Iron deficiency anaemia: Assessment, prevention and control: A guide for programme managers. Geneva: WHO.

World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO.

Yi, T., et al. (2009). Compliance with iron supplementation in pregnancy: Results from a clinical trial. American Journal of Obstetrics and Gynecology, 200(1), 73.e1–73.e7.

https://doi.org/10.1016/j.ajog.2008.07.050

Zhang, Q., et al. (2011). Association between anemia and maternal and perinatal outcomes in the US population. JAMA, 305(1), 50–59.

https://doi.org/10.1001/jama.2010.1916

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Published

2025-06-30

How to Cite

Ikram Ullah, Iqbal, A., Afridi, S., Zafar, S., Wahid, N., & Yousaf, M. (2025). Correlation between Sever Anemia and Pregnancy Complications. Indus Journal of Bioscience Research, 3(6), 650–655. https://doi.org/10.70749/ijbr.v3i6.1670

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