Maternal anaemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan.
Adult
Anemia
/ blood
Cohort Studies
Female
Humans
India
/ epidemiology
Infant
Infant Mortality
Infant, Newborn
Maternal Mortality
Pakistan
/ epidemiology
Postpartum Hemorrhage
/ diagnosis
Pregnancy
Pregnancy Complications, Hematologic
/ blood
Pregnancy Outcome
/ epidemiology
Premature Birth
/ epidemiology
Prenatal Care
/ methods
Prospective Studies
Stillbirth
Anaemia
low birthweight
postpartum haemorrhage
stillbirth
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
accepted:
06
12
2018
pubmed:
17
12
2018
medline:
18
4
2019
entrez:
17
12
2018
Statut:
ppublish
Résumé
To describe the association of maternal anaemia with maternal, fetal, and neonatal outcomes. Prospective cohort study. Rural India and Pakistan. Pregnant women residing in the study catchment area. We performed an analysis of a prospective pregnancy registry in which haemoglobin is commonly obtained as well as maternal, fetal, and neonatal outcomes for 42 days post-delivery. Women 40 years or older who delivered before 20 weeks or had a haemoglobin level of <3.0 g/dl were excluded. Our primary exposure was maternal anaemia, which was categorised in keeping with World Health Organization criteria based on a normal (≥11 g/dl), mild (>10-10.9 g/dl), moderate (7-9.9 g/dl) or severe (<7 g/dl). haemoglobin level. The primary maternal outcome was maternal death, the primary fetal outcome was stillbirth, and the primary neonatal outcome was neonatal mortality <28 days. A total of 92 247 deliveries and 93 107 infants were included, of which 87.8% were born to mothers who were anaemic (mild 37.9%, moderate 49.1%, and severe 0.7%). Maternal mortality (number per 100 000) was not associated with anaemia: normal 124, mild 106, moderate 135, and severe 325 (P = 0.64). Fetal and neonatal mortality was associated with severe anaemia: stillbirth rate (n/1000)-normal 27.7, mild 25.8, moderate 30.1, and severe 90.9; P < 0.0001; 28-day neonatal mortality (n/1000)-normal 24.7, mild 22.9, moderate 28.1, and severe 72.6 (P < 0.0001). Severe maternal anaemia was also associated with low birthweight (<2500 and <1500 g), preterm birth, and postpartum haemorrhage. Severe maternal anaemia is associated with higher risks of poor maternal, fetal, and neonatal outcomes but other degrees of anaemia are not. Interventions directed at preventing severe anaemia in pregnant women should be considered. Severe maternal anaemia is associated with adverse fetal and neonatal outcomes in low/middle-income countries.
Identifiants
pubmed: 30554474
doi: 10.1111/1471-0528.15585
pmc: PMC6459713
mid: NIHMS1015227
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
737-743Subventions
Organisme : National Institute of Child Health and Human Development (NICHD)
Organisme : NICHD NIH HHS
ID : U24 HD092094
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD078438
Pays : United States
Organisme : NICHD NIH HHS
ID : UG1 HD078439
Pays : United States
Organisme : Global Network for Women's and Children's Health
ID : NCT01073475
Organisme : NICHD NIH HHS
ID : UG1 HD076457
Pays : United States
Organisme : NICHD NIH HHS
ID : U10 HD076457
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2018 Royal College of Obstetricians and Gynaecologists.
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