The association of maternal anaemia with adverse maternal and foetal outcomes in Somali women: a prospective study

Abstract

Background Anaemia in pregnant women is one of the most common public health problems, especially in low- and middle-income countries, such as Somalia. This study aimed to examine the association between the severity of anaemia during pregnancy and the risk of adverse maternal and foetal outcomes in Somali women. Methods We prospectively enrolled pregnant women who had deliveries from May 1 to December 1, 2022, at Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital. Blood haemoglobin levels were measured for each participant at admission for delivery. Anaemia was defined as a haemoglobin level of less than 11 g/dL, with mild (10 to 10.9 g/dL), moderate (7 to 9.9 g/dL), and severe (< 7 g/dL) forms. The associations between maternal anaemia and maternal-foetal outcomes were investigated. Results The study included 1186 consecutive pregnant women (mean age 26.9 years, range 16–47). The incidence of maternal anaemia at delivery was 64.8%, with 33.8%, 59.8%, and 6.4% of women having mild, moderate and severe forms, respectively. Anaemia at delivery was associated with increased oxytocin administration to prompt labour (OR, 2.25, 95% CI, 1.34–3.78). Both moderate and severe anaemia were associated with increased risks for postpartum haemorrhage (moderate, OR, 4.93; severe, OR, 41.30) and the need for maternal blood transfusions (moderate, OR, 9.66; severe, OR, 301.50). In addition, severe anaemia was associated with increased risks for preterm delivery (OR, 2.50, 95% CI, 1.35–4.63), low birth weight (OR, 3.45, 95% CI, 1.87–6.35), stillbirths (OR, 4.02, 95% CI, 1.79–8.98), placental abruption (OR, 58.04,95% CI, 6.83–493.27) and maternal ICU admission (OR, 8.33, 95% CI, 3.53–19.63). Conclusion Our findings suggest that anaemia in pregnancy is associated with adverse maternal and foetal outcomes, with moderate or severe anaemia leading to increased risks for peri-, intra- and postpartum complications and that treatment of severe anaemia in pregnant women should be given particular consideration in our efforts to prevent preterm births, LBW and stillbirths.

Anemia during pregnancy and adverse maternal outcomes in Georgia – a birth registry-based cohort study

“…In contrast to previous studies [3, 8, 10, 35, 36], we found no increased odds for preterm delivery among mothers with anemia in the third trimester, and this is a good message for decisionmakers of the Georgian national healthcare. In fact, we observed an inverse linear trend, suggesting that women with anemia have lower odds of preterm delivery than women without anemia ( P for trend =0.01).…”

“…The proportion of women with mild (28.3%), moderate (11.9%), and severe (0.5%) anemia in Georgia was consistent with pooled estimates from Canada and China [8, 9, 12, 18], and lower than that the reported values for some African and Asian countries, such as Somalia, India, and Pakistan [10, 35]. The low prevalence of severe anemia suggests that implemented national public health measures for anemia prevention, such as free screening and treatment among pregnant women, are efficient.…”

Prevalence of Low Birth Weight and its Association With Anemia in White Nile State, Sudan: A Cross-Sectional Study

“…Another notable finding of the current study was that maternal anemia increased the risk of LBW by 4.7 times. Several studies have also reported similar findings for other regions of Sudan and Africa—Wad Mani in Central Sudan ( Elhassan et al, 2010 ), Kassala in Eastern Sudan ( Ali et al, 2011 ), Darfur in Western Sudan ( Haggaz et al, 2010 ), Ethiopia ( Deriba and Jemal, 2021 ; Tadesse et al, 2023 ), Somalia ( Barut and Mohamud, 2023 ), Sierra Leone ( Kargbo et al, 2021 ), Uganda ( Odongkara et al, 2022 ), and Ghana ( Mohammed et al, 2019 ). This association was further corroborated by several meta-analyses that have shown that anemic pregnant women are at a higher risk of delivering newborns with LBW ( Rahman et al, 2016 ; Young et al, 2019 , 2023 ).…”

“…Despite continuing preventive measures, there is still a high prevalence of LBW in different countries in the sub-Saharan African region, including Sudan ( Adam et al, 2008 ; Ahenkorah et al, 2022 ; Ahmed, 2022 ; Barut and Mohamud, 2023 ; Elhassan et al, 2010 ; Haggaz et al, 2010 ; Kamala et al, 2018 ; Kargbo et al, 2021 ; Odongkara et al, 2022 ; Tadesse et al, 2023 ; Wondemagegn et al, 2022 ). Several maternal factors, such as age ( Odongkara et al, 2022 ), parity, level of antenatal care (ANC; Kamala et al, 2018 ), anemia ( Barut and Mohamud, 2023 ; Kargbo et al, 2021 ; Odongkara et al, 2022 ; Tadesse et al, 2023 ), malarial infection ( Odongkara et al, 2022 ), and malnutrition ( Ahmed, 2022 ; Wondemagegn et al, 2022 ), as well as the neonate's gestational age ( Ahenkorah et al, 2022 ; Ahmed, 2022 ), are reportedly associated with LBW in sub-Saharan Africa.…”

The Effect of PENEMIA (Prevention of Anemia) Video-Based Education on Anemic Pregnant Women on Changes in Knowledge and Attitudes

“…Anemia is a multifactorial disease. Maternal anemia is associated with maternal and child morbidity and mortality such as an increased risk of miscarriage, stillbirth, prematurity, and low birth weight in infants (6,7). Other impacts will affect the physical health and cognitive development of individuals leading to low productivity and poor economic development of a country (4).…”