Anemia and pregnancy outcomes: a longitudinal study

To determine the prevalence of anemia at the first antenatal visit and at 32-34 weeks gestational age, and to evaluate perinatal and maternal outcomes.

Venous blood samples were obtained for complete blood counts at both study visits. Maternal and perinatal morbidity and mortality were also recorded. The data were analyzed using SPSS (version 23).

Two thousand pregnant women were recruited. The prevalence of anemia was 42.7% (n = 854/2000) at the first antenatal visit. Thirty-five percent had mild anemia and 68.9% had normocytic normochromic anemia. The prevalence of anemia in HIV infected women was higher than that in the noninfected group and 47.2% of the study population (n = 2000) was HIV infected. At the 32-34 weeks visit, hemoglobin (Hb) levels were available for 1433/2000 (71.7%) of the participants. The prevalence of anemia was 28.1% (n = 403/1433); 19.3% had mild anemia and 65.3% had normocytic normochromic anemia. There was a significant difference in Hb levels between that of the first visit and that at 32-34 weeks (42.7% vs. 28.1%; p = .001; 95% CI: 0.11-0.18). There were significant differences in prematurity, birth weight and hypertensive disorders of pregnancy between the anemic and nonanemic groups.

The prevalence of anemia decreased from 42.7% (booking) to 28.1% (32 - 34 weeks). Normocytic normochromic anemia was the commonest type of anemia. Attention needs to be focused on detailed investigations to establish the exact cause of anemia.