BackgroundAnaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes.MethodsThis is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb) < 7 g/dl, n = 303) who delivered from January 2008 to December 2010 were reviewed. Socio-demographic and obstetric data were analysed and compared with a similar number of women with mild/moderate anaemia (Hb = 7-10.9 g/dl, n = 303) and with no anaemia (Hb > 11 g/dl, n = 303). Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW) and stillbirth.ResultsThere were 9578 deliveries at Kassala hospital, 4012 (41.8%) women had anaemia and 303 (3.2%) had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, P = 0.007). Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7), and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0). The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia). The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, P < 0.001).ConclusionsThe greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.

The prevalence and possible risk factors for anaemia were investigated in 744 pregnant Sudanese women attending the antenatal clinic of New Halfa teaching hospital, eastern Sudan between October 2003 and April 2004. Of those, 466 (62.6%) had anaemia (haemoglobin [Hb]: <11 gm/dl); 52.4% had mild anaemia (Hb: 9.0-10.9 gm/dl); 8.1% had moderate anaemia (Hb: 7.0-8.9 gm/dl); and 2.2% had severe anaemia (Hb: <7 gm/dl), respectively. The prevalence of anaemia (73.2%) was significantly high in grandmultigravidae. Univariate and multivariate analysis showed that age and parity were not significantly associated with anaemia. Malaria (OR = 4.5, 95% CI 2.5-8.1; P < 0.0001) and pica (OR = 1.6, 95% CI 1.05-2.6; P = 0.03) were the risk factors for anaemia. Thus, preventive measures against malaria (chemoprophylaxis and insecticide-treated bednets) may be needed for all pregnant women irrespective of their age or parity.

The findings of this trial, which need to be verified in a large multicenter study, suggest that omega-3 fatty acids can be an effective, safe, and affordable therapy for sickle cell anemia. This trial was registered with Current Controlled Trials as ISRCTN80844630.

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Viral sequences analyzed indicate recent virus movement and support the need for surveillance.

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This study was carried in New Halfa Hospital, eastern Sudan from October 1997 to February 2001. Twenty-eight pregnant Sudanese women infected with Plasmodium falciparum were treated with intramuscular artemether (six injections, 480 mg) after failure of chloroquine and quinine therapy. The patients were followed-up until delivery; the babies were followed-up until the age of 1 year. Artemether was given to one patient in the tenth week of gestation, to 12 during the second trimester, and to 15 during the third trimester. It was well tolerated, the parasitaemia was cleared and the patients were symptom-free within three days. One patient (3.5%) delivered at 32 weeks and the baby died six hours after delivery. The other 27 (96.5%) delivered full-term live babies. None of the pregnant women died and there was no abortion, stillbirth or congenital abnormalities in the newborn babies.

A hospital-based study was carried out in Gedarif town, eastern Sudan, an area of markedly unstable malaria transmission. Among the 2488 diagnosed malaria patients, 4.4% fulfilled the WHO criteria for severe malaria, and seven died of cerebral malaria. The predominant complication was severe malarial anemia (45.4%), followed by convulsions (21%), cerebral malaria (16. 4%) and hypotension (11.8%). Severe malaria was recognized in all age groups, but 44.5% of patients were aged 2 to 4 years. The mean ages of patients with severe anemia (5.6 years) and convulsions (5.9 years) were significantly lower than the mean ages of patients with cerebral malaria (14.1 years) or hypotension (35.2 years). Patients with convulsions and cerebral malaria had significantly higher mean parasite count (69972 and 56110 parasites/microL, respectively) than patients with severe anemia (24637 parasites/microL) or hypotension (13667 parasites/microL). The mean blood glucose level was higher in patients with cerebral malaria than in patients with anemia, and higher in patients who died than in patients who survived. In this setting, the clinico-epidemiological pattern of severe malaria varies considerably from that of hyperendemic regions in sub-Saharan Africa, and there is considerable variation between the individual complications of severe malaria.