Birth outcomes and associated risk factors of anaemia in early pregnancy in a nulliparous cohort
Date
2015-09-08
Authors
Masukume, Gwinyai
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Abstract
Background
Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality. Clinical manifestations of anaemia in pregnancy include fetal growth restriction, preterm delivery, low birth weight, impaired lactation, poor maternal/infant behavioural interactions and post partum depression.
Objective
The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of ‘low risk’ women participating in a large international multicentre prospective study (n = 5 609), to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation.
Methods
The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints (SCOPE) study. Anaemia was defined according to the World Health Organization’s definition of anaemia in pregnancy (haemoglobin < 11g/dL). Binary logistic regression with adjustment for potential confounders (country, maternal age, having a marital partner, ethnic origin, years of schooling, and having paid work) was the main method of analysis.
Results
The hallmark findings were the low prevalence of anaemia (2.2%), that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78), and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score < 7 at one and five minutes). Adverse pregnancy outcomes were however more common in those with anaemia than in those without.
Conclusion
The absence of a marital partner is an important non-modifiable factor that should be added to the conceptual framework of anaemia’s determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.
Description
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Epidemiology & Biostatistics.
Johannesburg, February 2015