Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India. Issue 8 (8th August 2018)

• Record Type: Journal Article
• Authors: Patel, Archana; Prakash, Amber Abhijeet; Das, Prabir Kumar; Gupta, Swarnim; Pusdekar, Yamini Vinod; Hibberd, Patricia L
• Is Part Of: BMJ open. Volume 8:Issue 8(2018)
• Publication Date: 2018-08-08
• Subjects: body mass index -- anemia -- pregnancy -- neonatal deaths -- malnutrition -- stillbirth; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-021623
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes. Design: Prospective observational cohort study. Setting: Catchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India. Participants: 72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH's Global Network, enrolled from 2009 to 2016. Main outcome measures: Mode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies. Results: Over 90% of the women included in the study were anaemic and over a third were underweight (BMI <18 kg/m2) and with both conditions. Mild anaemia at any time during delivery significantly increased the risk (Risk ratio; 95% confidence interval (RR;(95% CI)) of stillbirth (1.3 (1.1–1.6)), neonatal deaths (1.3 (1–1.6)) and LBW babies (1.1 (1–1.2)). The risks became even more significant and increased further with moderate/severe anaemia any time during pregnancy for stillbirth (1.4 (1.2–1.8)), neonatal deaths (1.7 (1.3–2.1)) and LBW babies (1.3 (1.2–1.4))., . Underweight at anytime during pregnancy increased the risk of neonatal deaths (1.1 (1–1.3)) and LBW babies (1.2;(1.2–1.3)).The risk of having stillbirths (1.5;(1.2–1.8)), neonatal deaths (1.7;(1.3–2.3)) and LBW babies (1.5;(1.4–1.6)) was highest when - the anaemia and underweight co-existed in the included women. Obesity/overweight during pregnancy increased the risk of maternal complications at delivery (1.6;(1.5–1.7)) and of caesarean section (1.5;(1.4–1.6)) and reduced the risk of LBW babies 0.8 (0.8–0.9)). Conclusion: Maternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously. Trial registration number: NCT01073475 .