Gulshan Ara Saeed, Nasim Khattak, Rehana Hamid.
Anemia in Pregnancy and spontaneous preterm birth.
J Pak Inst Med Sci Jan ;13(2):698-701.

This randomized, prospective study was conducted at obstetrics & gynaecology department of Federal Government Services Hospital, Islamabad, over a period pf one year, to look into an association between anemia during pregnancy and spontaneous preterm birth and to see whether any relationship is present between maternal anemias and fetal birth weight. All pregnant women with a gestation age of more than 12 weeks coming to the Gynae and Obstetrics Department over the study period were evaluated through history, examination and investigations. They were divided into two groups according to their hemoglobin levels, Group I: Hemoglobin => 11 gm/dl and Group II: Hemoglobin <= 11gm/dl. Group II was further sub-divided into sub-group a: gestational amenhorrea <= 26 weeks and sub-group b: gestational amenhorrea > 26 weeks. Prevalence of spontaneous preterm labor and small for gestational age babies was calculated for the different groups. There were a total of 7000 deliveries included in the study of which anemia was diagnosed in 3125 (44.64%) patients, which were then divided into subgroups depending on their gestation and hemoglobin concentration. It was seen that the incidence of preterm labor was 31.6% in the anemia group as compared to 22.01 % in non-anemic group. Out of these anemic women 34.2% cases of women with anemia diagnosed in the second trimester of pregnancy went into preterm labor with the delivery of babies whose mean birth weight was 2.59 kg. In comparison the mean birth weight of babies in non-anemic group was 3.14 and that in women with anemia during any time in pregnancy was 2.86. It was concluded that anemia during the second trimester of pregnancy was associated with a greater incidence of preterm births and also the birth of small for gestational age babies than non-anemic patients and those with alleluia during third trimester of pregnancy.

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