Fetomaternal Outcomes of Severe Anemia in Pregnancy: A Prospective Observational Study

Introduction Anemia during pregnancy can lead to poor pregnancy outcomes, increasing maternal, fetal, and neonatal morbidity and mortality. Timely detection and management can lead to improved pregnancy outcomes. Objective To study various fetomaternal outcomes in severe anemia during pregnancy. Methods It is a prospective observational study conducted on 102 pregnant females, who presented with severe anemia (hemoglobin (Hb) < 7 gm/dL) between February 2020 and March 2021. Results In this study, 50% of patients presented before term (<37 weeks of gestation). Patients predominantly belonged to the rural population (n = 71, or 69.61%), the majority were multigravidas (81.37%), and 56.86% belonged to the upper-lower socioeconomic class. The mean age at presentation was 26.55 ± 4.99 years. Among maternal outcomes, abruption was seen in 7.84% of patients, post-partum hemorrhage (PPH) in 14.71%, sepsis in 3.92%, prolonged hospitalization in 48.04%, intensive care unit (ICU) admission in 4.90%, and maternal mortality in one patient. Additionally, 82.35% of patients went into spontaneous labor, and 76.47% of patients delivered vaginally. Among fetal and neonatal outcomes, 50% of neonates were premature, 62.75% were low birth weight (LBW), 42.16% were small for gestational age (SGA), and 22.55% of neonates were admitted to the neonatal ICU, of which two neonates expired. Stillbirth was noted in six (5.88%) babies. When the studied population was divided on the basis of the severity of anemia into two groups (Group A: very severe anemia with Hb < 4 gm/dL and Group B: severe anemia with Hb ≥ 4 gm/dL but <7 gm/dL), most of the outcomes were much worse for group A, with a statistically significant difference.  Conclusion Not only can very severe anemia (Hb < 4 gm/dL), but also severe anemia (Hb ≥ 4 gm/dL but <7 gm/dL), adversely affect both maternal and fetal outcomes if not diagnosed and optimized on time.