Prospective study of severity of anemia in pregnancy and its impact on maternal and perinatal outcome

Background: Anemia in pregnancy is a significant global health issue, contributing to adverse maternal and perinatal outcomes. The severity of anemia can influence maternal morbidity, mortality, and fetal health. This study aimed to assess the impact of the severity of anemia on both maternal and perinatal outcomes in a cohort of pregnant women in Bengaluru, India. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynaecology, MVJMC & RH, Bengaluru Rural, between January 2023 and August 2024. A total of 200 pregnant women, between 12-36 weeks of gestation with hemoglobin levels < 10.9g/dL, were recruited. Data were collected using a pre-tested questionnaire, clinical history, general examination, and laboratory investigations, including complete blood picture (CBP) and peripheral smear. Hemoglobin levels were measured during the first visit, at 30 weeks, and at 36 weeks of gestation. Women were classified according to the WHO classification of anemia and treated with oral iron, intravenous iron, or blood transfusion, depending on the severity. Maternal and perinatal outcomes, including modes of delivery, were recorded and analyzed using descriptive statistics. Results: Out of 200 participants, 60% (n=120) had moderate anemia (7.0-9.9 g/dL), while 25% (n=50) had mild anemia (10.0-10.9 g/dL), and 15% (n=30) had severe anemia (<7.0 g/dL). Women with severe anemia had a higher incidence of preterm delivery (40%), low birth weight babies (45%), and increased rates of cesarean sections (35%) compared to those with mild anemia. Perinatal outcomes revealed that babies born to severely anemic mothers had a 30% NICU admission rate, with an average birth weight of 2.2 kg. Maternal outcomes showed that women with severe anemia experienced a higher rate of postpartum hemorrhage (20%) and prolonged hospital stays compared to women with mild or moderate anemia. Hemoglobin levels improved significantly in the treatment groups, with those receiving intravenous iron showing a faster increase in hemoglobin levels by an average of 2.5 g/dL over six weeks. Conclusion: This study provided important insights into the relationship between anemia severity in pregnancy and adverse maternal and perinatal outcomes. The findings highlight the need for timely diagnosis and effective management of anemia in pregnancy to improve maternal and neonatal health outcomes.