Maternal and perinatal outcome in varying degrees of anemia

Objectives: To analyze the maternal and perinatal outcome in varying degrees of anemia. Methods: A total of 447 pregnant women were divided into group I (Hb > 11 g%, n = 123 women), group II (Hb 9-10.9 g%, n = 214 women), group III (Hb 7-8.9 g%, n = 79 women) group IV (Hb < 7 g%, n = 31 women). Their maternal and perinatal outcome, mode of delivery, duration of labor and postpartum complications were noted and analyzed using multiple logistic regression to calculate odds ratios (95% CI) for duration of labor, mode of delivery and low birth babies. Chi square or Fisher's exact test was employed for difference in proportions and Student's t-test for testing difference between means. Results: Mean age (27 +/- 4.25 years) and number of women with parity > 3 were highest in group IV. The patients with Hb < 8.9 g% had a 4-6-fold higher risk of prolonged labor compared to Hb > 11 g%. The odds ratios for abnormal delivery (cesarean and operative vaginal deliveries) showed a 4.8-fold higher risk (95% Cl 1.82, 12.7) in patients with Hb less than or equal to 7.5 g%. The mean birth weight was maximum in the 9.6-10.5 g% category that fell with both increasing and decreasing hemoglobin values, being lowest in Group IV Women in Group II had lowest number of low birth weight and IUGR babies, no stillbirths and neonatal deaths, lowest induction and operative delivery rates. Conclusions: Mild anemia fared best in maternal and perinatal outcome. Severe anemia was associated with increased low birth weight babies, induction rates, operative deliveries and prolonged labor. (C) 2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.