title: Maternal and fetal outcome after severe anemia in pregnancy in rural Ghana.
abstract: 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.
authors.affiliation: Holy Family Hospital, Berekum and Mathias Hospital, Yeji, Ghana.
authors.forename: Diederike
authors.initials: D
authors.lastname: Geelhoed
authors.forename: Florence
authors.initials: F
authors.lastname: Agadzi
authors.forename: Lucia
authors.initials: L
authors.lastname: Visser
authors.forename: Emelia
authors.initials: E
authors.lastname: Ablordeppey
authors.forename: Kofi
authors.initials: K
authors.lastname: Asare
authors.forename: Peter
authors.initials: P
authors.lastname: O'Rourke
authors.forename: Jules Schagen
authors.initials: JS
authors.lastname: Van Leeuwen
authors.forename: Jos
authors.initials: J
authors.lastname: Van Roosmalen
mesh_terms: 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
chemical_list: D006454:Hemoglobins