Bagcilar Medical Bulletin (Jun 2024)
Effect of Iron Deficiency Anemia on Fetal and Maternal Morbidity
Abstract
Objective: To investigate the effect of third-trimester iron deficiency anemia on fetal and maternal morbidity. Method: A total of 240 pregnant women whose third trimester hemoglobin level was found to be <11 g/dL in the retrospective review of medical records were included in the study. Pregnant women who had blood samples taken at least twice for the diagnosis of anemia in the third trimester constituted the study group. Pregnant women whose gestational weeks were matched and without anemia were included as the control group. Multivariate logistic regression analysis was performed to identify independent risk factors for anemia after adjusting for age and body mass index (BMI). Results: The rates of cesarean delivery, preterm labor, placental abruption, premature membrane rupture, low birth weight, and admission to intensive care due to fetal distress were significantly higher in the anemic group than in the non-anemic group. Vaginal birth rates in the anemic group (29.2%) were significantly lower than those in the non-anemic group (50%). While 170 patients in the anemic group underwent cesarean section (70.8%), 120 patients in the non-anemic pregnant group underwent cesarean section (50%). Logistic regression analysis revealed that high gravidity (95% confidence interval 1.176-2.677), parity (95% confidence interval 1.138-2.033), and gestational weeks (95% confidence interval 1.003-1.006), were independent risk factors for anemia severity after adjustment for potential confounders, including age and BMI. Conclusion: Anemia during pregnancy increases cesarean delivery rates and decreases vaginal birth rates. Gravidity, parity, and gestational age increase the severity of anemia regardless of age and BMI. Treating anemic pregnant women with iron supplementation may reduce cesarean section rates and increase normal birth rates in a more cost-effective manner.
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