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IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 12 Ver. IV (Dec. 2015), PP 09-11
www.iosrjournals.org
DOI: 10.9790/0853-141240911 www.iosrjournals.org 9 | Page
The Relationship between Maternal Anemia and Birth Weight in
New Born
Pagadpally Srinivas1
, P Srinivasan2
1
Associate professor, Dept of Paediatrics, Vinayaka Mission’s Medical college and Hospital,Karaikal
2
Post Graduate(DCH), Dept of Paediatrics, Vinayaka Mission’s Medical college and Hospital,Karaikal
Abstract:
Objective :To study the relationship between maternal anemia and perinatal outcome as a retrospective study of
pregnant women and to highlight the importance of antenatal care regarding maternal health and fetal outcome.
Methodology :A retrospective study where delivery sample of 1182 mother by systemic random sampling
delivered at GH, Karaikal between January 2014 to December 2014 was done. Data were collected and assessed
for maternal age, haemoglobin, gestation, blood group and the fetal birth weight, mode of delivery.Data was
analysed by SPSS -16.
Study period: Deliveries between January 2014 to December 2014.
Result: Out of 1182 pregnant mothers, 924 were anemic (Hemoglobin <11g/dL) . Perinatal outcome include
low birth weight , mode of delivery, risk of LBW among anemic mother were (118) 12% and in non-anemic
mother (17) 6%. Birth weight, risk of LSCS among anemic mother were (537) and in non-anemic were (386).
The rest are normal delivery in anemic mother (146) and in non-anemic (111).
Conclusion:No correlation was found between maternal anemia & low birth weight and operative delivery
tended to be higher in the anemic pregnant women.
Keywords: Maternal anemia, Low birth weight
I. Introduction
Anemia in pregnancy is a main challenge worldwide particularly in developing countries1
. Maternal
anaemia influences perinatal outcomes such as risk of low birth weight, mode of delivery2,3
.
Maternal anemia is one of the most common medical problem in India and has varied in etiology and severity.
Anemia in pregnancy is defined as Hemoglobin less than 11g/dL according to WHO. Several research have
reported an association between anemia in pregnancy and low birth weight but many limitations have
complicated the interpretation of the result.
The objective of this study was to evaluate if there is a relationship between maternal anaemia and low
birth weight infant in women delivering at Government Hospital, Karaikal, Puducherry UT.
This study was designed to investigate not only the correlation between maternal anemia and low birth
weight but also effect of anemia on neonatal route of delivery.
II. Materials and Methods
The retrospective study was conducted at the Government Hospital, Karaikal, Puducherry UT. The
study enrolled pregnant women who gave birth at GH, Karaikal from 1st
January 2014 to 31st
December 2014.
Inclusion Criteria
1. Pregnant women whose (Hb <11g/dL) included into the study group and women whose Hb >11g/dL
was included as a control group
2. HIV negative
Exclusion criteria
1. Multiple pregnancy
2. PIH
3. GDM
4. Placenta praevia
5. Abruptio placenta
6. Maternal medical complaints
were chosen randomly based on a cut-off (Hb 11g/dL). All pregnant women belong to the range of 17-
37yrs.
The study and the control groups were extracted from MRD (Medical Records Department). The
research proposal was approved by the ethical committee of Vinayaka Mission Medical College &, Karaikal,and
Medical Superintendent, RMO, Head of Department of Obstetrics & Gynaecology of Government General
The Relationship between Maternal Anemia and Birth Weight in New Born
DOI: 10.9790/0853-141240911 www.iosrjournals.org 10 | Page
Hospital, Karaikal, Puducherry UT. There were 1182 pregnant women who delivered at GH Karaikal during this
period.
Maternal demographic data was collected including Maternal age, Hemoglobin (third trimester),
Gravida, mode of delivery.
The primary outcome checked was low birth weight i.e birth weight less than 2500gms. The secondary
outcome were mode of delivery – normal vaginal delivery or operative delivery (LSCS).
Statistical analysis was undertaken using SPSS-16. Statistical significance was evaluated using the chi-
square test. The p value <0.05 was considered statistically significant.
III. Results
From January 1, 2014 to December 31, 2014; total of 1182 women fulfil criteria. Among this, 924
were anemic and 258 were non-anemic.
The incidence of maternal anemia during the study period average 78.2%
Table 3 shows correlation between anemic ,non anemic mother and birth wt of their new born
Table 1 shows demographic characteristic of the group. The mean of the Hemoglobin was 9.8g/dL and in group
was 13.5g the control /dL
Frequency Percentage Cumulative percentage %
Anemia 924 78.2 78.2
Normal 258 21.8 21.8
Total 1182
Figure 1: incidence of anaemia
Table 2: Mode of delivery
LBW NBW TOTAL
Mode of delivery LSCS 537 146 683
ND 388 111 499
Total 925 257 1182
Figure 2: Mode of delivery
anaemic
78%
normal
22% 0% 0%
LSCS
58%
ND
42%
0%
4th Qtr
0%
The Relationship between Maternal Anemia and Birth Weight in New Born
DOI: 10.9790/0853-141240911 www.iosrjournals.org 11 | Page
Table 3: shows correlation between anemic ,non anemic mother and birth wt of their new born
LBW NBW Total
Maternal anemia Anemic 118 (12%) 806 924
Normal 17 (6%) 241 258
Total 135 1042 1182
IV. Discussion:
Out of 1182 pregnant mothers, 78%(n=924) were anemic (Hemoglobin <11g/dL) and 258 were non-
anemic (Hemoglobin >11g/dL). Incidence of low birth weight delivery among anaemic mother was
12%(n=118) and in non-anemic mother 6%(n=17). The rest of 1042 were normal birth weight. Risk of LSCS
among anaemic mother was 45%(n=537) and in non-anemic was 32% (n=386). The rest are normal delivery:
in anemic mother (146) and in non-anemic (111).
Anaemia in pregnancy defined by the WHO as a haemoglobin level 11g/dl. In our study, mean Hb value is
9.6g/dl
In this study there was no increase in LBW in anaemic group,where as the most published results of
studies on maternal anemia and foetal outcome shows that maternal anaemia was associated with increased
LBW and LSCS rates4,5,6,7
.
There is a significant difference between the route of delivery among the 2 group (p<0.010)
We conclude that the maternal anemia is not correlated with low birth weight from this study.there was no
increase in LBW but increase in LSCS in anemic compare to non anaemic pregnant women. This is in contrast
from previous studies finding which found association between maternal anemia and low birth weight4,5,6,7
. This
may be because of mother mean (Hb9.8g/dl) is not very severe anemia, anaemia in the first trimester and not
during the third trimester influences birth weight8,9,10
and may be some other nutritional deficiency in
association with anaemia can produce LBW and most of mothers received iron and folic acid during pregnancy.
References:
[1]. World Health Organization. The prevalence of anaemia in women: atabulation of available information. 2nd ed. Geneva: World
Health Organization, 1992.
[2]. Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Williams Obstetrics. 21
st
ed. McGraw-Hill.
2001;1308–16.
[3]. Amalia L A, Drora F B, Miriam Katz C, Moshe M C, Eyal S. Maternal anemia during pregnancy is an independent risk factor for
low birthweight and preterm delivery. EJOGRB. Elsevier Ireland Ltd 2005; 122:182–6.
[4]. Bondevik GT, Lie RT, Ulstein M, Kvale G. Maternal hematological status and risk of low birth weight and preterm delivery in
Nepal. Acta Obstet Gynecol Scand 2001;80:402–8.
[5]. Ren A., Wang J., Ye R.W., Li S., Liu J.M., Z. Li. Low first–trimester hemoglobin and low birth weight, preterm birth and small for
gestational age newborns. Int J Gynecol Obstet 2007;98:124-8.
[6]. Chumnijarakij T, Nuchprayoon T, Chitinand S, Onthuam Y, Quamkul N, Dusitsin N, et al. Maternal risk factors for low birth
weight newborn in Thailand. J Med Assoc Thai 1992;75:445-52.
[7]. Cessie S Le, Verhoeff F H, Mengistie G, Kazembe P, Broadhead R, Brabin B J. Changes in Haemoglobin levels in infants in
Malawi : effect of low birth weight and fetal anaemia. Arch Dis Child Fetal Neonatal Ed 2002;86:182-
[8]. Henna Hamalainen, Katja Hakkarainen, Seppo Heinonen. Anaemia in the first but not in the second or third trimester is a risk factor
for low birth weight. Clin Nutr 2003;22: 271-5
[9]. Monika Malhotra, Sharma J.B., Batra S., Sharma S., Murthy N.S., Arora R. Maternal and perinatal outcome in varying degrees of
anemia. Int J Gynecol Obstet 2002;79:93-100.
[10]. Scanlon KS, Yip R, Schieve LA, Cogswell ME. High and low haemoglobin levels during pregnancy: differential risks for preterm
birth and SGA. Obstet Gynecol 2000;96:741–7.
CORRESPONDING AUTHOR
DR. PAGADPALLY SRINIVAS,
27, VELLAI PILLAIYAR KOIL ST,
KOTTUCHERRY,
KARAIKAL-609609.
PONDICHERRY UT.
sreenu77@gmail.com
DR. P SRINIVASAN,
I-2, STAFF QTS, N-2, VMMC,
KARAIKAL-609609.
PONDICHERRY UT

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The Relationship between Maternal Anemia and Birth Weight in New Born

  • 1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 12 Ver. IV (Dec. 2015), PP 09-11 www.iosrjournals.org DOI: 10.9790/0853-141240911 www.iosrjournals.org 9 | Page The Relationship between Maternal Anemia and Birth Weight in New Born Pagadpally Srinivas1 , P Srinivasan2 1 Associate professor, Dept of Paediatrics, Vinayaka Mission’s Medical college and Hospital,Karaikal 2 Post Graduate(DCH), Dept of Paediatrics, Vinayaka Mission’s Medical college and Hospital,Karaikal Abstract: Objective :To study the relationship between maternal anemia and perinatal outcome as a retrospective study of pregnant women and to highlight the importance of antenatal care regarding maternal health and fetal outcome. Methodology :A retrospective study where delivery sample of 1182 mother by systemic random sampling delivered at GH, Karaikal between January 2014 to December 2014 was done. Data were collected and assessed for maternal age, haemoglobin, gestation, blood group and the fetal birth weight, mode of delivery.Data was analysed by SPSS -16. Study period: Deliveries between January 2014 to December 2014. Result: Out of 1182 pregnant mothers, 924 were anemic (Hemoglobin <11g/dL) . Perinatal outcome include low birth weight , mode of delivery, risk of LBW among anemic mother were (118) 12% and in non-anemic mother (17) 6%. Birth weight, risk of LSCS among anemic mother were (537) and in non-anemic were (386). The rest are normal delivery in anemic mother (146) and in non-anemic (111). Conclusion:No correlation was found between maternal anemia & low birth weight and operative delivery tended to be higher in the anemic pregnant women. Keywords: Maternal anemia, Low birth weight I. Introduction Anemia in pregnancy is a main challenge worldwide particularly in developing countries1 . Maternal anaemia influences perinatal outcomes such as risk of low birth weight, mode of delivery2,3 . Maternal anemia is one of the most common medical problem in India and has varied in etiology and severity. Anemia in pregnancy is defined as Hemoglobin less than 11g/dL according to WHO. Several research have reported an association between anemia in pregnancy and low birth weight but many limitations have complicated the interpretation of the result. The objective of this study was to evaluate if there is a relationship between maternal anaemia and low birth weight infant in women delivering at Government Hospital, Karaikal, Puducherry UT. This study was designed to investigate not only the correlation between maternal anemia and low birth weight but also effect of anemia on neonatal route of delivery. II. Materials and Methods The retrospective study was conducted at the Government Hospital, Karaikal, Puducherry UT. The study enrolled pregnant women who gave birth at GH, Karaikal from 1st January 2014 to 31st December 2014. Inclusion Criteria 1. Pregnant women whose (Hb <11g/dL) included into the study group and women whose Hb >11g/dL was included as a control group 2. HIV negative Exclusion criteria 1. Multiple pregnancy 2. PIH 3. GDM 4. Placenta praevia 5. Abruptio placenta 6. Maternal medical complaints were chosen randomly based on a cut-off (Hb 11g/dL). All pregnant women belong to the range of 17- 37yrs. The study and the control groups were extracted from MRD (Medical Records Department). The research proposal was approved by the ethical committee of Vinayaka Mission Medical College &, Karaikal,and Medical Superintendent, RMO, Head of Department of Obstetrics & Gynaecology of Government General
  • 2. The Relationship between Maternal Anemia and Birth Weight in New Born DOI: 10.9790/0853-141240911 www.iosrjournals.org 10 | Page Hospital, Karaikal, Puducherry UT. There were 1182 pregnant women who delivered at GH Karaikal during this period. Maternal demographic data was collected including Maternal age, Hemoglobin (third trimester), Gravida, mode of delivery. The primary outcome checked was low birth weight i.e birth weight less than 2500gms. The secondary outcome were mode of delivery – normal vaginal delivery or operative delivery (LSCS). Statistical analysis was undertaken using SPSS-16. Statistical significance was evaluated using the chi- square test. The p value <0.05 was considered statistically significant. III. Results From January 1, 2014 to December 31, 2014; total of 1182 women fulfil criteria. Among this, 924 were anemic and 258 were non-anemic. The incidence of maternal anemia during the study period average 78.2% Table 3 shows correlation between anemic ,non anemic mother and birth wt of their new born Table 1 shows demographic characteristic of the group. The mean of the Hemoglobin was 9.8g/dL and in group was 13.5g the control /dL Frequency Percentage Cumulative percentage % Anemia 924 78.2 78.2 Normal 258 21.8 21.8 Total 1182 Figure 1: incidence of anaemia Table 2: Mode of delivery LBW NBW TOTAL Mode of delivery LSCS 537 146 683 ND 388 111 499 Total 925 257 1182 Figure 2: Mode of delivery anaemic 78% normal 22% 0% 0% LSCS 58% ND 42% 0% 4th Qtr 0%
  • 3. The Relationship between Maternal Anemia and Birth Weight in New Born DOI: 10.9790/0853-141240911 www.iosrjournals.org 11 | Page Table 3: shows correlation between anemic ,non anemic mother and birth wt of their new born LBW NBW Total Maternal anemia Anemic 118 (12%) 806 924 Normal 17 (6%) 241 258 Total 135 1042 1182 IV. Discussion: Out of 1182 pregnant mothers, 78%(n=924) were anemic (Hemoglobin <11g/dL) and 258 were non- anemic (Hemoglobin >11g/dL). Incidence of low birth weight delivery among anaemic mother was 12%(n=118) and in non-anemic mother 6%(n=17). The rest of 1042 were normal birth weight. Risk of LSCS among anaemic mother was 45%(n=537) and in non-anemic was 32% (n=386). The rest are normal delivery: in anemic mother (146) and in non-anemic (111). Anaemia in pregnancy defined by the WHO as a haemoglobin level 11g/dl. In our study, mean Hb value is 9.6g/dl In this study there was no increase in LBW in anaemic group,where as the most published results of studies on maternal anemia and foetal outcome shows that maternal anaemia was associated with increased LBW and LSCS rates4,5,6,7 . There is a significant difference between the route of delivery among the 2 group (p<0.010) We conclude that the maternal anemia is not correlated with low birth weight from this study.there was no increase in LBW but increase in LSCS in anemic compare to non anaemic pregnant women. This is in contrast from previous studies finding which found association between maternal anemia and low birth weight4,5,6,7 . This may be because of mother mean (Hb9.8g/dl) is not very severe anemia, anaemia in the first trimester and not during the third trimester influences birth weight8,9,10 and may be some other nutritional deficiency in association with anaemia can produce LBW and most of mothers received iron and folic acid during pregnancy. References: [1]. World Health Organization. The prevalence of anaemia in women: atabulation of available information. 2nd ed. Geneva: World Health Organization, 1992. [2]. Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Williams Obstetrics. 21 st ed. McGraw-Hill. 2001;1308–16. [3]. Amalia L A, Drora F B, Miriam Katz C, Moshe M C, Eyal S. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. EJOGRB. Elsevier Ireland Ltd 2005; 122:182–6. [4]. Bondevik GT, Lie RT, Ulstein M, Kvale G. Maternal hematological status and risk of low birth weight and preterm delivery in Nepal. Acta Obstet Gynecol Scand 2001;80:402–8. [5]. Ren A., Wang J., Ye R.W., Li S., Liu J.M., Z. Li. Low first–trimester hemoglobin and low birth weight, preterm birth and small for gestational age newborns. Int J Gynecol Obstet 2007;98:124-8. [6]. Chumnijarakij T, Nuchprayoon T, Chitinand S, Onthuam Y, Quamkul N, Dusitsin N, et al. Maternal risk factors for low birth weight newborn in Thailand. J Med Assoc Thai 1992;75:445-52. [7]. Cessie S Le, Verhoeff F H, Mengistie G, Kazembe P, Broadhead R, Brabin B J. Changes in Haemoglobin levels in infants in Malawi : effect of low birth weight and fetal anaemia. Arch Dis Child Fetal Neonatal Ed 2002;86:182- [8]. Henna Hamalainen, Katja Hakkarainen, Seppo Heinonen. Anaemia in the first but not in the second or third trimester is a risk factor for low birth weight. Clin Nutr 2003;22: 271-5 [9]. Monika Malhotra, Sharma J.B., Batra S., Sharma S., Murthy N.S., Arora R. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynecol Obstet 2002;79:93-100. [10]. Scanlon KS, Yip R, Schieve LA, Cogswell ME. High and low haemoglobin levels during pregnancy: differential risks for preterm birth and SGA. Obstet Gynecol 2000;96:741–7. CORRESPONDING AUTHOR DR. PAGADPALLY SRINIVAS, 27, VELLAI PILLAIYAR KOIL ST, KOTTUCHERRY, KARAIKAL-609609. PONDICHERRY UT. sreenu77@gmail.com DR. P SRINIVASAN, I-2, STAFF QTS, N-2, VMMC, KARAIKAL-609609. PONDICHERRY UT