Effects of Maternal Anemia on Neonatal Outcome

Introduction: Anemia is one of the most prevalent nutritional deficiency problem affecting pregnant women. It is defined by World Health Organization as hemoglobin (Hb) level of less than 11 g/dl. Hemoglobin level of 9.0- 10.9 g/dl is mild, 7.0-8.9 g/dl is moderate and less than 7 g/dl is severe anemia respectively. Maternal anemia in pregnancy is commonly considered as a risk factor for poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus. Aims: To find out neonatal outcome delivered to anemic mothers. Methods: A prospective case control study was carried out among 75 newborns delivered to pregnant women with hemoglobin below 10.9g/dL. Another 75 newborns were taken delivered at the same time, matched age and sex wise as a control group to mothers whose hemoglobin was more than 11g/dl. Results: Out of total 75 cases 35(46.7%) mothers had mild, 32(42.6%) had moderate and 8(10.7%) had severe anemia respectively. Similarly, the risk of having preterm baby among anemia group was 4.42 times higher than that in control group (p 0.033). The risk of having low birth weight in anemia group was 3.9 times higher than that in control group (p 0.04). The mean of head circumference (HC) among the anemia group was 33.9cm +1.40 (Mean+SD) and among the control group was 34.4cm+1.24(Mean+SD) with a mean difference of 0.5cm (p 0.032). The mean of length among anemia group was 45.3cm+1.97 (Mean+ SD) and among the control group was 46.2cm+1.69 (Mean+ SD) with a mean difference of 0.9 cm (p 0.003). Conclusion: Maternal anemia in pregnancy is associated with increased risk of adverse neonatal outcome. Efforts must be made to reduce the prevalence of anemia especially during pregnancy to reduce neonatal morbidity and mortality.

The Effect of HSV-1 Seropositivity on the Course of Pregnancy, Childbirth and the Condition of Newborns

The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.

An evidence-based definition of anemia for singleton, uncomplicated pregnancies

Background The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970’s to 1980’s. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed. Objective To define anemia in pregnancy in a United States population including a large county vs. private hospital population using uncomplicated patients. Materials and methods Inclusion criteria were healthy women with the first prenatal visit before 20 weeks. Exclusion criteria included preterm birth, preeclampsia, hypertension, diabetes, short interval pregnancy (<18 months), multiple gestation, abruption, and fetal demise. All women had iron fortification (Ferrous sulfate 325 mg daily) recommended. The presentation to care and pre-delivery hematocrits were obtained, and the percentiles determined. A total of 2000 patients were included, 1000 from the public county hospital and 1000 from the private hospital. Each cohort had 250 patients in each 2011, 2013, 2015, and 2018. The cohorts were compared for differences in the fifth percentile for each antepartum epoch. Student’s t-test and chi-squared statistical tests were used for analysis, p-value of ≤0.05 was considered significant. Results In the public and private populations, 777 and 785 women presented in the first trimester while 223 and 215 presented in the second. The women at the private hospital were more likely to be older, Caucasian race, nulliparous, and present earlier to care. The fifth percentile was compared between the women in the private and public hospitals and were clinically indistinguishable. When combining the cohorts, the fifth percentile for hemoglobin/hematocrit was 11 g/dL/32.8% in the first trimester, 10.3 g/dL/30.6% in the second trimester, and 10.0 g/dL/30.2% pre-delivery. Conclusions Fifth percentile determinations were made from a combined cohort of normal, uncomplicated pregnancies to define anemia in pregnancy. Comparison of two different cohorts confirms that the same definition for anemia is appropriate regardless of demographics or patient mix.

Undiagnosed Wilson’s disease masquerading as hemolytic anemia in pregnancy: a case report

Successful pregnancy is a rare phenomenon in women with Wilson’s disease. We report a case of a primigravid 19 -years old woman who presented with hemolytic anemia and was later diagnosed with Wilson’s disease for the first time during pregnancy. With prompt treatment, she delivered a healthy albeit pre-term child.

Literature Review : Hubungan Status Gizi dengan Kejadian Anemia pada Ibu Hamil

The Number of Maternal Mortality in Indonesia was highest in 2019 due to bleeding in 1.280 cases. Bleeding can occur due to anemia in pregnancy. Anemia in pregnancy can be said to be a conditions where hemoglobin (Hb) levels are below 11 gr % in the I and III trimesters, while in the II trimester hemoglobin levels are below 10,5 gr %. One of the causes of anemia in pregnancy is a lack of nutrients or malnutritions. To find out the relationship of nutritional status with the incidence of anemia in pregnant women through literature review. This study used literature review method with 6 articles sourced from online database with electronic search on Google Scholar and Garuda Portal published in 2011-2021. Critical study instrument used is using JBI (Joanna Briggs Institute). The result of this study showed that there is a link between nutritional status and the incidences of anemia in pregnant women with the result of p value <0,05. Nutritional status is one of the factors thet can lead to anemia in pregnant women.Keywords: Anemia; nutritional status; pregnant women. AbstrakAngka Kematian Ibu di Indonesia paling tinggi tahun 2019 disebabkan oleh perdarahan sebanyak 1.280 kasus. Perdarahan dapat terjadi karena anemia dalam kehamilan. Anemia dalam kehamilan dapat dikatakan suatu kondisi dimana kadar hemoglobin (Hb) dibawah 11 gr % pada trimester I dan III, sedangkan pada trimester II kadar hemoglobin dibawah 10,5 gr %. Salah satu penyebab anemia dalam kehamilan adalah kurangnya zat gizi atau malnutrisi. Untuk mengetahui hubungan status gizi dengan kejadian anemia pada ibu hamil melalui literature review. Penelitian ini menggunakan metode literature review 6 artikel yang bersumber dari database online dengan penelusuran elektronik pada Google Scholar dan Portal Garuda yang dipublish pada tahun 2011-2021. Instrument telaah kritis yang digunakan yaitu dengan menggunakan JBI (Joanna Briggs Institute). Hasil penelitian literature review dari 6 artikel menunjukkan ada hubungan antara status gizi dengan kejadian anemia pada ibu hamil dengan hasil p value <0,05. Status gizi merupakan salah satu faktor yang dapat mengakibatkan anemia pada ibu hamil.Kata kunci: Anemia; ibu hamil; status gizi.

The Burden of Anemia in Pregnancy Among Women Attending the Antenatal Clinics in Mkuranga District, Tanzania

Introduction: The burden of anemia in pregnancy is of global health importance. Tanzania is no exception. Its effects vary from one region to another due to the differing causes. Overall, it is a significant cause of maternal mortality. This study sought to assess the prevalence and factors associated with anemia among pregnant women attending the antenatal clinic (ANC) in the Mkuranga district of the Pwani region of Tanzania.Methodology: This cross sectional study was conducted among 418 pregnant women aged 15–49 years attending the Mkuranga District Hospital and Kilimahewa Health Center. The outcome variable of interest was anemia in pregnancy defined as a hemoglobin concentration of 11 g/dl or less. Data was collected using face-to-face interviews with a standardized pretested questionnaire, and through blood samples collected for hemoglobin testing. Descriptive analysis was used to determine the prevalence of anemia while multiple logistic regression was used to determine factors associated with anemia in pregnancy.Results: Anemia was prevalent among 83.5% of pregnant women attending the two major ANCs in Mkuranga district. Categorically, the hemoglobin of 16.3% of the included women was normal, 51.9% had moderate anemia, 24.4% had mild anemia, and 7.2% had severe anemia. Factors associated with anemia included being in the third trimester (AOR = 2.87, p = 0.026), not consuming vegetables (AOR = 2.62, p = 0.008), meat (AOR = 2.71, p = 0.003), eggs (AOR = 2.98, p = 0.002), and fish (AOR = 2.38, p = 0.005). The finding of unadjusted analysis revealed that women with inadequate minimum dietary diversity were having significantly greater odds of being anemic as compared with those with adequate dietary diversity (OR = 1.94, P = 0.016).Conclusion: More than 80% of pregnant women attending ANC in Mkuranga districts were anemic. Such unprecedented burden of anemia is associated with several factors, which include poor dietary practices such as not consuming iron-rich foods, for example vegetables, meat, eggs, and fish. Women in their third trimester were also more likely to suffer from anemia. This unprecedented burden of anemia in pregnancy can be addressed if efforts to improve feeding practices and early monitoring at the ANCs are sustained.