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.

Risk factors of anemia among preschool children in Ethiopia: a Bayesian geo-statistical model

Background The etiology and risk factors of anemia are multifactorial and varies across context. Due to the geospatial clustering of anemia, identifying risk factors for anemia should account for the geographic variability. Failure to adjust for spatial dependence whilst identifying risk factors of anemia could give spurious association. We aimed to identify risk factors of anemia using a Bayesian geo-statistical model. Methods We analyzed the Ethiopian Demographic and Health Survey (EDHS) 2016 data. The sample was selected using a stratified, two- stage cluster sampling design. In this survey, 9268 children had undergone anemia testing. Hemoglobin level was measured using a HemoCue photometer and the results were recorded onsite. Based on the World Health Organization’s cut-off points, a child was considered anaemic if their altitude adjusted haemoglobin (Hb) level was less than 11 g/dL. Risk factors for anemia were identified using a Bayesian geo-statistical model, which accounted for spatial dependency structure in the data. Posterior means and 95% credible interval (BCI) were used to report our findings. We used a statistically significant level at 0.05. Result The 9267 children in our study were between 6 and 59 months old. Fifty two percent (52%) of children were males. Thirteen percent (13%) of children were from the highest wealth quintile whereas 23% from the lowest wealth quintile. Most of them lived in rural areas (90%). The overall prevalence of anemia among preschool children was 57% (95% CI: 54.4–59.4). We found that child stunting (OR = 1.26, 95% BCI (1.14–1.39), wasting (OR = 1.35, 95% BCI (1.15–1.57), maternal anemia (OR = 1.61, 95% BCI (1.44–1.79), mothers having two under five children (OR = 1.2, 95% BCI (1.08–1.33) were risk factors associated with anemia among preschool children. Children from wealthy households had lower risk of anemia (AOR = 0.73, 95% BCI (0.62–0.85). Conclusion Using the Bayesian geospatial statistical modeling, we were able to account for spatial dependent structure in the data, which minimize spurious association. Childhood Malnutrition, maternal anemia, increased fertility, and poor wealth status were risk factors of anemia among preschool children in Ethiopia. The existing anaemia control programs such as IFA supplementation during pregnancy should be strengthened to halt intergenerational effect of anaemia. Furthermore, routine childhood anaemia screening and intervention program should be part of the Primary health care in Ethiopia.

Effect of maternal anemia on cord blood haemoglobin of newborn

Background: Anemia during pregnancy is linked to major maternal and fetal problems. The aim of the study was to find any correlation between maternal anemia and neonatal cord blood haemoglobin (Hb) levels.Methods: This cross-sectional study was done in the department of pediatrics and department of obstetrics and gynaecology at the Hind Institute of Medical Sciences, Barabanki over 9 months from January 2021 to September 2021. A total of 308 pregnant females more than 34 weeks of gestation who delivered participated in the study and cord blood hemoglobin of their new-born was collected. The mean maternal hemoglobin and mean cord blood hemoglobin were compared using the Pearson correlation coefficient in different groups i.e., non-anemic, anemic, mild, moderate, and severe anemic groups. Results: Out of 308 pregnant women, 198 (64.3%) were anemic, and 110 (35.7%) were nonanemic. The mean maternal hemoglobin among non-anemic mothers and anemic mothers was 11.91 (0.70) and 9.14 (1.56) respectively. The Pearson correlation coefficient of non-anemic, anemic, mild, moderate, and severe anemic groups were 0.6985, 0.8453, 0.7772, 0.6321, and 0.7226 respectively with a statistically significant p value<0.05 showing a positive correlation between maternal hemoglobin and cord hemoglobin.Conclusions: From this study, we concluded that maternal anemia affects neonatal cord blood hemoglobin. According to the findings, anemic women deliver new-born with lower hemoglobin levels than non-anemic mothers. The findings revealed a linear correlation between maternal hemoglobin and cord blood hemoglobin of their new-born.

Effect of maternal hemoglobin and iron status on fetal hemoglobin, iron status, growth and maturity

Background: Iron deficiency anemia during pregnancy is a major health issue in India. However, the status of iron stores in infants born to iron depleted mothers remains controversial and inadequately investigated. The present study is therefore an attempt to understand whether maternal anemia and iron stores have any significant effect on iron status and growth of fetus.Methods: This is a prospective, cross-sectional, hospital based study conducted at Mata Chanan Devi Hosital, Janakpuri, New Delhi. Hemoglobin and iron profile of 100 newborns and their mothers were taken. Mothers were divided into anemic and non anemic group to see the effect of maternal anemia on fetus.Results: A total of 100 newborns and their mothers were analysed. Cord hemoglobin and iron profile was significantly reduced in anemic compared to non anemic group. Birth weight of newborn was significantly reduced only in moderately anemic group as compared to non anemic group but there was no difference seen in length and head circumference.Conclusions: Maternal serum ferritin levels should be measured for the diagnosis of occult iron deficiency in the fetus so that timely measures can be taken to prevent iron deficiency anemia in the newborn.

Association of Prenatal Maternal Anemia with Tics and Tourette’s Syndrome in Offspring

Iron deficiency anemia (IDA) accounts for most of the anemia in pregnancy, and iron is essential for neurodevelopment. Tics and Tourette’s syndrome (TS) are neurodevelopmental disorders that manifest in childhood. A few studies reported an inconclusive association between iron deficiency and tics in children. No study has investigated the relationship between prenatal maternal anemia and tics in children. We aimed to assess the relationship between prenatal anemia exposure and the incidence of tics or TS in offspring. We linked the Taiwan National Health Insurance Research Database to the Maternal and Child Health Database for the analysis and identified 153,854 children with prenatal anemia exposure and 2,014,619 children without prenatal anemia exposure from 2004 to 2016 and followed them through 2017. Cox regression models were applied to compare the risk of tics or TS between the exposed and nonexposed groups. Among the exposed group, 37,832 were exposed at ≤12 weeks of gestational age (GA) and 116,022 at >12 weeks of GA. We observed an increased risk of tics and TS in those exposed at ≤12 weeks compared with the nonexposed group (adjusted hazard ratio (aHR) = 1.23, 95% confidence interval (CI): 1.12–1.34). The result remained consistent after adjusting for birth year, sex, birth order, maternal age, low-income levels, gestational age, birth weight, and alcohol use and smoking during pregnancy (aHR = 1.16, CI: 1.04–1.28). Fetuses exposed to maternal anemia at ≤12 weeks of GA are at high risk of tics or TS. However, this effect was attenuated to insignificance in the sibling comparison. Our study highlights the importance of detection of anemia during pregnancy and proper timing of iron supplementation.

Oral Iron Supplementation in Pregnancy: Current Recommendations and Evidence-Based Medicine

Objective To review the evidence about universal iron supplementation in pregnancy to prevent maternal anemia. Methods Bibliographic research of randomized and controlled clinical trials, meta-analyses, systematic reviews, and clinical guidelines, published between August 2009 and August 2019, using the MeSH terms: iron; therapeutic use; pregnancy; anemia, prevention and control. Results We included six clinical guidelines, three meta-analyses and one randomized controlled clinical trial. Discussion Most articles point to the improvement of hematological parameters and reduction of maternal anemia risk, with supplementary iron. However, they do not correlate this improvement in pregnant women without previous anemia with the eventual improvement of clinical parameters. Conclusion Universal iron supplementation in pregnancy is controversial, so we attribute a SORT C recommendation strength.

Predictive Value of Maternal Anemia in Cases of Fetal Growth Restriction

Anemia can be defined as a state of inadequate O2 delivery to tissues due to reduction of the O2 carrying capacity of blood practically, anemia is diagnosed when there is reduction in the hemoglobin concentration or haematocrit level below normal values. Iron deficiency anemia is a major public health problem among women of reproductive age in most of developing countries approximately 50% of pregnant women and 35% of non pregnant women are anemic. These nutritional disorders, has profound negative effects on pregnancy outcome, health of mothers and babies. The objective of this study: Is to evaluate the maternal anemia during pregnancy as a risk factor for fetal growth restriction. The study was done this study conducted on 120 pregnant women. Pregnant women with inclusion criteria: Singleton pregnancy, Gestational age more than 28 week and Hb level less than 10mg/dl. We exclude multiple pregnancy, Gestational age less than 28 week, Hb level more than 10 mg/dl and other medical disorder with pregnancy. The results of this study reveal the following: There was significant difference between group 1, 2, 3, 4 as regard to Hb level, (PCV), (MCV), (MCH), (MCHC), (Ht) and (CBC). The restriction of fatal growth was significant lower in sever anemic patient rather than mild or moderate anemic patient In conclusions: The result of this study shows that there was restriction of fatal growth was significantly high in sever anemic group than mild or moderate group also, incidence of low birth weight and risk of fatal morbidity or mortality was significantly high in sever anemic group than mild or moderate group.