Severe maternal anemia presenting in late gestation: Its influence on delivery in a tertiary care centre in South-East Rajasthan

Abstract

Background: Anaemia is the most common nutritional deficiency in the world. Globally, anaemia affects 1.62 billion people which constitute to 24.8% of the total population and the group with the greatest number of individuals affected being pregnant women (41.8%). The condition is prominent in Southeast Asian countries where about half of all global maternal deaths are due to anemia and India contributes about 80% of the maternal death due to anaemia in South Asia. There is marginally decrease in prevalence of anemia in pregnant women in India from 58% in NFHS-3 (National Family Health Survey-2005-06) to 50% in NFHS-4 survey (2015-16). Material and Methods: This is a prospective study conducted for six months from February 2021 to July 2021 in the Department of Obstetrics and Gynaecology at a tertiary care hospital, Jhalawar. Data was collected from bedside medical records. A total of 190 women were studied who fulfilled the inclusion and exclusion criteria. Results: A total of 4911 deliveries occurred during the study period, of which 190 (3.87%) women had severe anemia. Most women (59.5%) were younger than 25 years. A majority were of low socioeconomic status, illiterate, unbooked, and multiparous. LSCS was the commonest mode of delivery (58.4%). Maternal complications were reported in 98 women (51.6%). Preterm labour was most common (35.8%), preeclampsia occurred in 14.2%, antepartum hemorrhage in 10.5%, postpartum hemorrhage in 8.9%, abruptio placentae in 8.9%, IUGR in 7.4%, sepsis in 2.6%, and placenta previa in 6.3%. Neonatal complications occurred in 87 cases (45.8%). NICU admission was required in 41.6%, prematurity occurred in 21.6%, respiratory distress in 12.1%, meconium-stained liquor in 9.5%, and intrauterine fetal demise in 4.2%. Conclusion: Severe anemia in pregnancy significantly increases the risk of complications during labour and delivery. Improving antenatal care coverage, promoting iron-folic acid supplementation, raising nutritional awareness, addressing parasitic infections, and strengthening rural healthcare infrastructure can reduce maternal and neonatal morbidity. Preventive strategies, timely interventions, and public health initiatives targeting women of reproductive age are essential to reduce the impact of severe anemia on fetomaternal health.