Iron-Deficiency Anemia During Pregnancy And Its Influence On Low Birth Weight And Preterm Birth

Objective:Iron-deficiency anemia (IDA) is the most common cause of anemia in pregnancy and is associated with increased risk of low birth weight and preterm birth. The aim of this observational study is to assess iron-deficiency anemia in which trimester of pregnancy carries a greater risk of low birth weight (LBW) infants and preterm birth.Methods:A prospective cohort study was carried out at the department of the First Affiliated Hospital of Guangxi Medical University from January 2014 to December 2014. Venous blood samples of 500 pregnant mothers were collected in early, mid and third trimester of pregnancy. Hemoglobin and serum ferritin levels in each trimester of pregnancy were recorded. The mothers were followed till delivery and the gestational week of delivery and birth weight of babies were recorded. Descriptive statistics was used for baseline characteristics. The influence of anemia in different trimester of pregnancy on birth weight and gestational week was explored using multivariate logistic regression analysis. Comparison of means was done using Student’s t test.Results:In different periods of pregnancy, there is a certain percentage of anemia and low levels of serum ferritin. The hemoglobin and serum ferritin levels of 500 cases of pregnant women were compared in early, middle and late trimesters of pregnancy. Mean hemoglobin and serum ferritin were lowest in the second trimester compared to the first and last trimester.149 (29.8%) cases of pregnant women did not have anemia throughout pregnancy,75 (15.0%) of pregnant women were anemic throughout pregnancy. Compared with the non-anemic group throughout pregnancy, the level of education of pregnant women who were anemic throughout the pregnancy is lower than those without anemia group (p<0.05), the parity between the two groups is also statistically significant number (p<0.05). Average newborn weight and full gestation period in whole pregnancy period anemia group were (2850±218.4) g and (37.7±.1) weeks. The average birth weight and gestation period in whole pregnancy no anemia group is (3040 ± 232.5) g and (38.4±1.6) weeks. When comparing the birthweight and gestational weeks in these two groups, the difference is significant. Multivariate logistic regression analysis showed that early, middle trimesters anemia followed by uncorrected anemia in late pregnancy group and middle trimester anemia followed by uncorrected anemia in late pregnancy group had a statistical difference (p<0.05) in birthweight and gestational week compared to the normal group. In late trimester anemia group, hemoglobin concentration was positively correlated with birthweight (r= 0.97, p<0.05). The proportion of low birth weight babies and preterm birth in late pregnancy, anemia group compared to late pregnancy no anemia group was higher and this difference was statistically significant (p<0.05). The occurrence of low birth weight babies and preterm birth in whole pregnancy no anemia group compared to whole pregnancy anemia group was higher and the difference was statistically significant (p>0.05). The difference in serum ferritin levels in middle and late pregnancy anemia group compared to middle and late pregnancy no anemia group was statistically significant (p<0.05)Conclusions:The incidence of low birth weight babies and preterm deliveries were significantly more in mothers who were anemic in the middle and third trimesters of pregnancy and during whole pregnancy no anemia group. More educated pregnant women were more prone to anemia.