Association between maternal anemia and adverse maternal and fetal outcomes in Somali women: a prospective study BMC Women’s Health

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Our study evaluated the association between maternal anemia at birth and maternal and fetal outcomes during hospitalization in Somali women. To our knowledge, this is the largest series of pregnant women examining the impact of maternal anemia at delivery on adverse maternal and fetal outcomes in sub-Saharan Africa. Her prevalence of anemia at birth was surprisingly high at 64.8%, representing her second highest rate of all African countries after being reported from the Republic of Benin (68.2%). [7], a relatively small West African country with a small population compared to Somalia (≈13 vs 17 million). In Somalia, a 2019 World Bank report (https://data.worldbank.org/indicator/SH.PRG.ANEM?locations=SO) reported anemia prevalence of 49% in pregnant women It has been. A recent systematic review and meta-analysis of subsharan African countries found that the prevalence of anemia among pregnant women is Significant regional differences have been reported. %), Kenya (36.2–57%), Uganda (22.1–32.5%) [7]A meta-analysis of 20 studies in Ethiopia reported a prevalence of anemia in pregnant women of 31.66%, with the highest prevalence in the Somali region of Ethiopia at 56.80%. [6].

In this study, the majority of anemic patients (59.8%) had moderate anemia, followed by mild (33.8%) and severe (6.4%) anemia (Table 1), 30.6% and 25.3%, respectively. , compared with 1.2%, reported in Tanzania [8] Egypt reported 39%, 21.1% and 12% respectively. [9].

In relation to maternal outcomes, our study compared the incidence of postpartum hemorrhage and placental abruption and the need for maternal blood transfusion, ICU admission, and oxytocin administration to facilitate labor in anemic and nonanemic women. showed a significant difference between Univariate analysis found that maternal anemia was significantly associated with postpartum hemorrhage, maternal transfusion, and oxytocin administration.

Furthermore, univariate analysis showed that moderate but not mild maternal anemia was significantly associated with increased risk of postpartum hemorrhage (OR 4.93), maternal blood transfusion (OR 9.66), and oxytocin administration (OR 2.15). I understand. More importantly, severe maternal anemia is associated with subsequent The number of risks has increased significantly. , as well as maternal blood transfusion (OR 301.50), maternal need for her ICU admission (OR 8.33), and oxytocin administration (OR 3.77).

A systematic review and meta-analysis of 26 studies of anemic pregnant women with low birth weight infants found that low birth weight (RR: 1.3), preterm birth (RR: 1.63), and perinatal mortality (RR: 1.51) A significantly higher risk ratio (RR) was found. ) [10]Another systematic review and meta-analysis involving 148 studies found that maternal anemia was a predictor of postpartum hemorrhage, blood transfusions, preeclampsia, low birth weight, premature birth, stillbirth, and perinatal mortality. Reported. [11]A Chinese study found that the presence of anemia (mild, moderate, or severe) during pregnancy was associated with an increased risk of placental abruption and severe postpartum hemorrhage, as well as an increased risk of stillbirth, premature birth, and maternal death. associated with concomitant moderate or severe anemia. [12]In another study from Gambia, severe maternal anemia was associated with stillbirth, low birth weight, NICU admission, and preterm birth. [13]Similarly, pregnancies in severely anemic women from Pakistan and India were compounded by stillbirth, premature birth, low birth weight and postpartum haemorrhage. [14]Adverse effects of maternal anemia included postpartum bleeding and ICU admission, as well as pregnancy-induced hypertension in Nepalese women. [15].

The current study shows that determining the severity level of anemia in pregnant women, especially in the third trimester, is important in low- and middle-income countries, especially in poverty-stricken African countries with limited resources to address pregnancy-related health problems. clearly shows that there is Therefore, given the severity of anemia, preventive and therapeutic interventions such as dietary habits and iron supplementation are necessary, and international solidarity and assistance are particularly important for this.

Limitations

Our study provides clear data on the current status of pregnancy in Somali women and the adverse effects of maternal anemia, but despite its rather large sample size, it reflects single-center experience May not be representative of the general population.



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