Severe anemia of pregnancy, recent experience

Abstract

We undertook this study to determine the current prevalence of anemia in pregnancy and its impact on maternal and perinatal mortality and morbidity, and to suggest ways to make the anemia prevention programs more effective. The incidence of pregnancy anemia was determined by a population-based survey (1990-1994) of rural and urban areas using a cluster sample design. Mortality and morbidity data were gathered from our own hospital records (1982-1994). The survey data showed that 86.1% of pregnant women (n = 4752) were anemic (Hb < 11 g/dl); 56.0% had severe anemia (Hb < 7 g/dl); and 1.9% were decompensated (Hb < 4 g/dl). The hospital-based analysis revealed that severe anemia contributed to 34.5% of all maternal deaths (case fatality ratio = 1769). Hypertensive disorders were found in 28.2% of severe anemia cases. The incidence of preterm labor was 31.2% in these cases and the birthweight 2.23 ± 1.13 kg (mean ± SD), while perinatal mortality was 65 compared to overall rates of 7.9%, 2.78 ± 1.32 kg and 46, respectively. We conclude that severe anemia of pregnancy is still rampant and its adverse consequences remain unabated. The risk-care approach is advocated as an alternative strategy.