Background: Maternal anaemia is one of the most common complications of pregnancy and is associated with adverse outcomes such as preterm delivery, impaired fetal development, and increased risks of morbidity and mortality in the perinatal period. The high prevalence of anaemia in pregnancy and its impact on fetal development represents a significant public health issue. The aim of this study was to analyze the influence of maternal anaemia on neonatal outcomes.

Patients and Methods: In a two-year prospective study conducted at the Clinic of Gynecology and Obstetrics and the Clinic of Children’s Diseases of the University Clinical Center Tuzla, 177 newborns and their mothers were analyzed—127 in the experimental group (mothers with anaemia) and 50 in the control group (without anaemia). Sociodemographic and clinical data of the mothers and newborns were collected. Data were processed using conventional statistical techniques. Ethical approval was obtained from the relevant institutional review board.

Results: Of the 120 (70.58%) mothers with anaemia included in the study, 106 (88.3%) were between 18 and <35 years of age. Working mothers had lower odds of anaemia (p = 0.025), while mothers who did not use supplements during pregnancy had higher odds (p = 0.001). Maternal anaemia was significantly associated with smoking or tobacco use (p = 0.015). Mothers living outside of marriage were more likely to be anaemic. A higher percentage of vaginal bleeding (p = 0.0001), uncontrolled pregnancies (p = 0.011), and caesarean section as the mode of delivery (p = 0.000) were recorded among anaemic mothers. Babies born to anaemic mothers had lower birth weight compared to those born to non-anaemic mothers (p = 0.004). Maternal anaemia significantly affected gestational age (p = 0.024) and Apgar scores in the 1st (p = 0.006) and 5th minutes (p = 0.0031). In this study, maternal anaemia during pregnancy had a statistically significant impact on perinatal outcomes including perinatal asphyxia, respiratory distress syndrome, neonatal infections, icterus neonatorum, intracranial hemorrhage, and hypoxic-ischemic encephalopathy.

Conclusion: In developing countries, current strategies for the prevention of anaemia in pregnancy have had limited success. Programs for careful monitoring and management of anaemia during pregnancy need to be developed in order to prevent poor perinatal outcomes.

 

neonatal outcome, anaemia, pregnancy

 

1. Auerbach M, Landy HL. Anemia in pregnancy. UpToDate. Available at https://www.uptodate.com /contents/anemia-in-pregnancy. Accessed on 19 September 2024.
2. World Health Organization. Guideline on haemoglobin cutoffs to define anaemia in individualsand populations. 2024. Available at: https://www.who .int/publications/ i/item/9789240088542.
3. World Health Organization. Anaemia in women and children. Available at: https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children. Accessed on 19 September 2024.
4. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Obstetrics. Anemia in Pregnancy: ACOG Practice Bulletin, Number 233. ObstetGynecol 2021; 138: e55.doi: 10.1097/AOG.0000000000004477. PMID: 34293770
5. Pavord S, Daru J, Prasannan N, Robinson S, Stanworth S, Girling J et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2020;188(6):819-30. doi: 10.1111/bjh.16221.
6. Bone JN, Bellad M, Goudar S, Mallapur A, Charantimath U, Ramadurg U, et al. Anemia and adverse outcomes in pregnancy: subgroup analysis of the CLIP cluster-randomized trial in India. BMC Pregnancy Childbirth. 2022;22(1):407. doi: 10.1186/s12884-022-04714-y.
7. Shi H, Chen L, Wang Y, Sun M, Guo Y, Ma S, et al. Severity of anemia during pregnancy and adverse maternal and fetal outcomes. JAMA Netw Open. 2022;5(2):e2147046. doi: 10.1001/jamanetworkopen.2021.47046.
8. Mehta VR, Parmar HR, Khandwala AB, Kakkad KM, Vekaria VV, Bhatt JV. A study of postnatal assessment of gestational age of neonates by new Ballards and Parkins score. Int J Contemp Pediatr. 2022;9(1):32-8. doi: 10.18203/2349-3291.ijcp20214849.
9. Simon LV, Shah M, Bragg BN. APGAR Score. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
10. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. doi: 10.1001/jama.2013.281053.
11. Hsieh TT, Liou JD, Hsu JJ, Lo LM, Chen SF, Hung TH. Advanced maternal age and adverse perinatal outcomes in an Asian population. Eur J Obstet Gynecol Reprod Biol. 2010;148(1):21-6. doi: 10.1016/j.ejogrb.2009.08.022. .
12. Park JH, Lee BE, Park HS, Ha EH, Lee SW, Kim YJ. Association between pre-pregnancy body mass index and socioeconomic status and impact on pregnancy outcomes in Korea. J Obstet Gynaecol Res. 2011;37(2):138-45. doi: 10.1111/j.1447-0756.2010.01332.x.
13. Bansal R, Bedi M, Kaur J, Kaur K, Shergill HK, Khaira HK, et al. Prevalence and factors associated with anemia among pregnant women attending antenatal clinic. Adesh Univ J Med Sci Res. 2020;2(1):42-8. doi:10.25259/AUJMSR_8_2020
14. Bhaware GM, Muneshwar SN, Pundkar RD. Anaemia in pregnancy: a cross-sectional study. Int J Comm Med Public Health. 2021;8(10):4876-9. doi:10.18203/2394-6040.ijcmph20213786
15. Mistry R, Jones AD, Pednekar MS, Dhumal G, Dasika A, Kulkarni U, et al. Antenatal tobacco use and iron deficiency anemia: integrating tobacco control into antenatal care in urban India. Reprod Health. 2018;15(1):1-8.doi: 10.1186/s12978-018-0516-5.
16. Adhikari J, Belbase M, Rijal S. Effects of maternal anemia on neonatal outcome. J Nepalgunj Med Coll. 2021;19(1):30-3.doi: https://doi.org/10.3126/jngmc.v19i1.40091.
17. Bakhtiar UJ, Khan Y, Nasar R. Relationship between maternal hemoglobin and perinatal outcome. RMJ. 2007;32(2):102-4.
18. Stangret A, Wnuk A, Szewczyk G, Pyzlak M, Szukiewicz D. Maternal hemoglobin concentration and hematocrit values may affect fetus development by influencing placental angiogenesis. J Matern Fetal Neonatal Med. 2017;30(2):199-204. doi: 10.3109/14767058.2016.1168395.