DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20195480

Maternal anemia and low birth weight in a community development block of Purba Bardhaman, West Bengal: a retrospective cohort analysis

Puspendu Biswas, M. Samsuzzaman, Amitava Chakraborty, Dilip Kumar Das

Abstract


Background: Being both highly prevalent public health problems in India, anemia in pregnancy (AIP) is hypothesized as a potential risk factor for low birth weight (LBW) baby as pregnancy outcome. In this context, this study was conducted among pregnant mothers registered in last 2 years under Bhatar block of Purba Bardhaman district, West Bengal. Objectives of this study were to assess the relationship of LBW babies with maternal anemia in antenatal period and also with background characteristics and pregnancy related factors.

Methods: A retrospective cohort analysis was conducted among postnatal mothers who were registered during their pregnancy in sub-centers of this block during a reference period from April’15th - March’17th. The study subjects were identified from the records of each sub-centre and further categorized into two groups: Exposed (anemic) - Hb <11 gm% in any antenatal visits and Non-exposed(non-anemic) - Hb ≥11 gm% in all antenatal visits. Sample size of 988 for each group was calculated. From each sub-centre’s antenatal record 26 subjects for each group were selected by simple random sampling. Data collected with predesigned pretested schedule and data analyzed using Microsoft Excel and SPSS 20. Logistic regression was performed to establish association.

Results: Overall incidence of LBW was 8.1%; in anemic, non-anemic group incidence were 10.5%, 5.7% respectively. AIP had relative risk 1.85 (1.36-2.54) over LBW. On multivariable logistic regression, LBW was significantly associated with AIP (2.11, 1.51-2.95), multi-parity (0.63, 0.44-0.9), inadequate ANC visits (2.7, 1.75-4.15) and female gender (1.64, 1.19-2.27).

Conclusions: Anemia in pregnancy significantly increases risks of LBW which also strongly associated with female new-born, primi-parity, and incomplete ANC visits.


Keywords


Anemia, Cohort, Low birth weight, Pregnancy, Retrospective

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References


World Health Organization (WHO). Pregnancy, Childbirth, Postpartum and New-born Care: A guide for essential practice. Geneva: World Health Organization; 2006.

Bugg GJ, Atwal GS, Maresh M. Grand multipara in a modern setting. BJOG. 2002;109(3):249-53.

Bai J, Wong F, Bauman A, Mohsin M. Parity and pregnancy outcomes. Am J Obstet Gynecol. 2002;186:274-8.

Hughes PF, Morrison J. Birth weight distribution in the United Arab Emirates. Asia Oceania J Obstet Gynaecol. 1994;20:73-6.

Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al. Anemia in pregnancy in Malaysia: a cross-sectional Survey. Asia Pac J Clin Nutr. 2007;16(3):527-36.

Aziz FA. Pregnancy and labor of grand multiparous Sudanese women. Int J Gynaecol Obstet. 1980;18:144-6.

ACOG Practice Bulletin No. 95: Anemia in pregnancy. Obstet Gynecol. 2008;112:201.

Jaleel R, Khan A. Severe anemia and adverse pregnancy outcome. J Surg Pak (International). 2008;13:147-50.

Rusia U, Madan N, Agarwal N, Sikka M, Sood SK. Effect of maternal iron deficiency anemia on foetal outcome. Indian J pathol Microbiol. 1995;38:273-9.

Haggaz AD, Radi EA, Adam I. Anemia and low birth weight in western Sudan. Trans R Soc Trop Med Hyg. 2010;104:234-6.

Levy A, Fraser D, Katz M, Sheiner E. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol. 2005;122:182-6.

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.

Ministry of Health and Family Welfare. National Family Health Survey-4 West Bengal Factsheet. 2015-2016:1-6.

Ministry of Health and Family Welfare. National Family Health Survey-4 India Factsheet. 2015-2016:1-8.

Low birth weight database. Available at: https://data.unicef.org/topic/nutrition/low-birthweight/. Accessed on 4th September 2018.

Salimi S, Nakhostin B, Alijahan J, Hazrati S. Relationship hemoglobin and mother bmi in pregnancy with low birth weight. J Ardebil Univ Med Sci. 2012;15:14-20.

Bodeau-Livinec F, Briand V, Berger J, Xiong X, Massougbodji A, Day KP, et al. Maternal anemia in Benin: prevalence, risk factors, and association with low birth weight. Am J Trop Med Hyg. 2011;85(3):414-20.

Documentation for Sample Size for a Cross-Sectional, Cohort, or Clinical Trial Studies. Available at: http://www.openepi.com/PDFDocs /SSCohortDoc.pdf. Accessed on 4th September 2018.

Kumar KJ, Asha N, Murthy DS, Sujatha MS, Manjunath VG. Maternal anemia in various trimesters and its effect on newborn weight and maturity: an observational study. Int J Prevent Med. 2013;4(2):193.

Lee HS, Kim MS, Kim MH, Kim YJ, Kim WY. Iron status and its association with pregnancy outcome in Korean pregnant women. Eu J Clin Nutrit. 2006;60(9):1130.

Sukrat B, Wilasrusmee C, Siribumrungwong B, McEvoy M, Okascharoen C, Attia J, et al. Hemoglobin concentration and pregnancy outcomes: a systematic review and meta-analysis. BioMed Res Int. 2013;2013:1-9.

Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346:1-19.

Rahmati S, Delpishe A, Azami M. Maternal anemia during pregnancy and infant low birth weight: A systematic review and Meta-analysis. Int J Reprod Biomed (Yazd). 2017;15(3):125-34.

Dougherty CRS, Jones AD. The determinants of birth weight. Am J Obstet Gynecol. 1982;144:190-200.

Van Roosmallen J. Birth weights in two rural hospitals in the United Republic of Tanzania. Bull WHO. 1988;66:653-8.

Murphy JF, Dauncey M, Newcombe R, Garcia J, Elbourne D. Employment in pregnancy: prevalence, maternal characteristics, perinatal outcome. Lancet. 1984;1:1163-6.

Hirve SS, Ganatra BR. Determinants of low birth weight: a community based prospective cohort study. Indian Pediatr. 1994;31(10):1221-5.

Mavalankar DV, Gray RH, Trivedi CR. Risk factors for preterm and term low birthweight in Ahmedabad, India. Int J Epidemiol. 1992;21(2):263-72.

Fikree FF, Berenes HW, “Risk factors for term intrauterine growth retardation: a community-based study in Karachi,” Bulletin of the World Health Organization. 1994;72:581-7.

Yadav S, Choudhary D, Mandal RK, Sharma A, Chauhan SS, Agrawal P. Adverse reproductive outcomes associated with teenage pregnancy. McGill J Med. 2008;11(2):141-4.

Joshi HS, Subba SH, Dabral SB, Dwivedi S, Kumar D, Singh S. Risk factors associated with low birth weight in newborns. Indian J Community Med. 2005;30(4):142-3.

Hosain M, Chatterjee N, Begum A, Saha SC. Factors associated with low birthweight in Rural Bangladesh. J Trop Pediatr. 2006;52(2):87-91.

Yadav DK, Chaudhary U, Shrestha N. Risk factorsassociated with low birth weight. J Nepal Health Res Council. 2011;9(19):159-64.

Bhaskar RK, Deo KK, Neupane U, Chaudhary Bhaskar S, Yadav BK, Pokharel HP, et al. A case control study on risk factors associated with low birth weight babies in eastern Nepal. Int J Pediatr 2015: 1-7.