FETOMATERNAL OUTCOMES OF ANEMIA IN PREGNANCY: A COHORT STUDY

Background: Anemia in pregnancy remains one of the most prevalent and critical public health challenges, particularly in low- and middle-income countries like Pakistan. It significantly contributes to adverse maternal and neonatal outcomes. Hemodynamic changes during the second and third trimesters exacerbate the clinical burden of anemia, making early identification and management essential for reducing associated risks. Despite global focus, region-specific data on fetomaternal implications of anemia are still limited and warrant further investigation. Objective: To determine the association of fetomaternal complications with maternal anemia in the second and third trimester of pregnancy. Methods: A prospective cohort study was conducted at the Department of Obstetrics and Gynecology, Imran Idrees Teaching Hospital, Sialkot, over a period of three months from January 26, 2025, to April 26, 2025. A total of 450 pregnant women aged 18–45 years with gestational age >16 weeks were enrolled. Hemoglobin levels were measured and participants were categorized into anemic (Hb <11 g/dL; n=225) and non-anemic (Hb ≥11 g/dL; n=225) groups. Maternal outcomes assessed included pregnancy-induced hypertension and postpartum hemorrhage, while fetal outcomes included preterm birth, intrauterine growth restriction, low birth weight, placental insufficiency, and Apgar score <7 at 5 minutes. Data were analyzed using SPSS version 25, and relative risk (RR) was calculated. Results: Pregnancy-induced hypertension was observed in 121 (53.8%) anemic versus 76 (33.8%) non-anemic women (RR=1.494). Cesarean deliveries occurred in 117 (52.0%) vs. 91 (40.4%) (RR=1.260). Preterm birth was noted in 142 (63.1%) vs. 84 (37.3%) (RR=1.696), postpartum hemorrhage in 126 (56.0%) vs. 78 (34.7%) (RR=1.535), IUGR and low birth weight in 76 (33.8%) vs. 39 (17.3%) (RR=1.486), poor Apgar scores in 86 (38.2%) vs. 57 (25.3%) (RR=1.328), and placental insufficiency in 37 (16.4%) vs. 13 (5.8%) (RR=1.574). Conclusion: Maternal anemia during the second and third trimesters is significantly associated with increased risk of both maternal and fetal complications, highlighting the need for proactive screening and timely intervention.