Maternal and fetal outcome after severe anemia in pregnancy in rural Ghana.
BACKGROUND
Anemia in pregnancy contributes to poor outcome for mother and child in low-income countries. This study analyzes adverse maternal and fetal outcome after severe anemia in pregnancy in rural Ghana.


METHODS
A cohort study in two (sub)district hospitals, including 157 pregnant women exposed to severe anemia (Hb < 8.0 g/dl) and 152 nonexposed pregnant women (Hb > or = 10.9 g/dl), matched for age and parity strata. Adverse outcomes analyzed were postpartum hemorrhage, need for blood transfusion, maternal mortality, low birth-weight, and perinatal mortality.


RESULTS
Compared to nonexposed women, exposed women had an increased risk of maternal death (5/157 versus 0/152). Fetal outcome did not significantly differ between the study groups, although perinatal mortality was increased with exposure to Hb < 7.0 g/dl (OR 3.1; 95% CI 1.0-9.4), and low birth-weight was increased with exposure to Hb < 6.0 g/dl (OR 2.5; 95% CI 1.2-5.4). Overall fetal outcome was significantly better when hemoglobin prior to childbirth was at least 8.0 g/dl (OR 3.9; 95% CI 1.6-9.6), body mass index at least 20 kg/m2 (OR 2.8; 95% CI 1.5-5.3), and number of antenatal visits at least 4 (OR 2.0; 95%CI 1.1-3.7).


CONCLUSIONS
Severe anemia in pregnancy results in relatively poor maternal and fetal outcome. Apparently maternal risks increase prior to fetal risks. In order to improve maternal and fetal outcome, it is recommended that district hospitals in low-income countries make prevention, early diagnosis, and treatment of severe anemia in pregnancy a priority.
Geelhoed
Diederike
D
Holy Family Hospital, Berekum and Mathias Hospital, Yeji, Ghana.
Agadzi
Florence
F
Visser
Lucia
L
Ablordeppey
Emelia
E
Asare
Kofi
K
O'Rourke
Peter
P
Van Leeuwen
Jules Schagen
JS
Van Roosmalen
Jos
J
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008428:Maternal Mortality; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data; D012424:Rural Population
D006454:Hemoglobins