Association of maternal anemia with other risk factors in occurrence of Great obstetrical syndromes at university clinics, Kinshasa, DR Congo

Abstract

BackgroundMaternal anemia, a common situation in developing countries, provokes impairment of nutrients/oxygen supply to the placenta-fetus unit that leads to Great obstetrical syndromes (GOS). In our setting, however, occurrence of GOS has been found also depending on variables existing prior to pregnancy such as diabetes in family, hypertension in family, previous macrosomia, stillbirth, SGA and pre-eclampsia as well as overweight/obesity. Our study thus aimed to determine the magnitude of maternal anemia and its association with these pre-pregnancy high-risk variables in occurrence of GOS.MethodsThis is a cross-sectional study including women delivered at the University Clinics of Kinshasa, DR Congo, 12. during 18 months. Anemia was stated at hemoglobin blood concentration < 10 g/dL. Sampled women were checked for pregnancy high-risk factors and pregnancy complications. Odds ratios (95 % confidence intervals) were calculated to establish associations of anemia with various variables. Multivariate calculations aimed to isolate variables influencing these associations. The p <0.05 was considered significant.ResultsThe study sample included 412 women, among whom 220 (53.4 %) were diagnosed anemic. Anemia was found significantly linked to malaria, urinary infection, cesarean section, prematurity, SGA and stillbirth whose risk was 1.6 – 6.1 times augmented. Anemia was also found linked to pre-pregnancy high-risk factors such as age < 18 and ≥ 35 years, previous miscarriage, grand multiparity, diabetes in family, previous prematurity, overweight/obesity, previous cesarean section and previous pre-eclampsia, all of them enhancing the link of maternal anemia with complications.ConclusionMaternal anemia is very prevalent among pregnant women of our setting. It strongly contributes to worsening of morbidities that act with pregnancy high-risk factors in raising the risk of cesarean section, prematurity, SGA and stillbirth.

Baseline Iron Status and Indices of Oxidative Stress in a Cohort of Pregnant Women in Kinshasa, DR Congo

“…This is expected to occur when supplementation is initiated irrespective of initial iron status of women concerned. Our study was carried out to assess baseline iron and oxidadive status in a group of pregnant women in order to better appreciate those in actual The rate of anemic pregnant women found in our study (52.2%) has been quite constant in our setting for years [2], meaning endemicity of anemia among pregnant women in our country. This high rate is common in deprived areas [1] [8] [18], although lower rates have been observed in Tanzania (47%) [9] and in Ethiopia (31.7%) [10].…”

“…In order to reduce this maternal and perinatal morbidity/mortality World Health Organization adopted cost-effective preventive interventions during pregnancy including iron-folic acid supplementation, de-hookworming medication and anti-malarial prevention or treatment [1] [2].…”

Epidemiological Aspects of Malaria in Pregnant Women: Prevalence and Risk Factors in Mwene Ditu, DR Congo

“…Children and women are the most exposed [1]. Pregnant women are at high risk of Plasmodium falciparum infection with serious and multiple complications, including placental malaria, fever, maternal anemia, termination of pregnancy, fetal exposure to the parasite Congenital infection, low birth weight, intrauterine growth retardation (IUGR) and infant mortality with anemia [2]- [8]. A Ghanaian study found that pregnant women had 42.6% and 56.4% malaria prevalence in two different settings [9].…”

Rationale of a Cohort Study on Risk of Obstetrical Outcomes Associated with Iron Supplementation during Pregnancy

“…So, supplementation during pregnancy might contribute to huge unabsorbed amount of iron which in turn might induce oxidative stress accountable for in generation of many obstetrical adverse outcomes, most of them being also persistently cited as associated with maternal anemic situation [4]. However, the potential link between oxidative stress resulting from free radicals hyperproduction induced by iron supplementation and harmful maternal/perinatal conditions is rarely questioned by searchers.…”

“…World Health Organization (WHO) estimated the prevalence of anemia in developed and developing countries among pregnant women at 14% and 51%, respectively [3]. In the Democratic Republic of Congo, particularly at University Clinics of Kinshasa, the frequency of anemia during pregnancy is estimated at 53.4% [4]. Causes include iron deficiency as a leading one, parasitic (malaria, hookworms) and bacterial infections (mostly urinary tract infection), micronutrient deficiencies including folic acid, vitamin A, and vitamin B12, and genetically inherited hemoglobinopathies such as drepanocytosis.…”