MATERNAL AND PERINATAL MORBIDITY AND MORTALITY ASSOCIATED WITH ANEMIA COMPLICATING PREGNANCY IN A TERTIARY CARE CENTRE - A PROSPECTIVE STUDY

Abstract

Background and Objectives-Maternal anaemia during pregnancy, defined as haemoglobin (Hb) levels <11 g/dL, adversely impacts maternal and fetal health. It is a prevalent condition in both developing and industrialized nations, with iron deficiency as the leading cause. Multiparity, short inter-pregnancy intervals, and physiological haemodilution during pregnancy further exacerbate the risk. This study aims to assess maternal and perinatal outcomes associated with anaemia during pregnancy.

Methods- This prospective descriptive study was conducted over 18 months (November 2022–May 2023) in a tertiary care center in Tamil Nadu. A total of 100 antenatal women with Hb <11 g/dL were enrolled based on predefined inclusion and exclusion criteria. Participants underwent detailed history taking, physical and systemic examinations, and serial investigations, including serum ferritin and complete blood counts, over four antenatal visits. Standard prophylactic and therapeutic iron and folic acid supplementation were provided. Maternal and neonatal outcomes were recorded, including haemoglobin trends, infection history, comorbidities, postpartum hemorrhage (PPH), NICU admissions, and lengths of stay.

Results- The mean age of participants was 25.2 ± 3.05 years, with a gestational age of 13.9 ± 4.6 weeks at the first visit. Multiparous women comprised 63% of the study population. Haemoglobin levels showed an initial decline from 9.3 ± 1.2 g/dL at <14 weeks to 8.4 ± 1.2 g/dL at 14–32 weeks, followed by improvement to 10.0 ± 0.9 g/dL by the final visit. Infections peaked during 14–32 weeks, with 12% having urinary tract infections and 10% having multiple infections. Pre-eclampsia was the most frequent comorbidity, rising to 28% by the last visit. NICU admissions were primarily due to mild asphyxia (44%) and low birth weight. PPH occurred in 54% of cases, with 14% requiring medical management for severe PPH. The mean neonatal and maternal lengths of stay were 4.4 ± 2.0 days and 6.1 ± 1.9 days, respectively.

Conclusions- Anaemia during pregnancy is associated with significant maternal and perinatal morbidity. Early detection, timely iron supplementation, and adequate antenatal care can improve outcomes. Strategies to address nutritional deficiencies, inter-pregnancy intervals, and infection control are essential in managing anaemia and mitigating its adverse effects on pregnancy.