Shrivastava Chandrashekhar, Bansal Ruchi, Goyal Nitesh
Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Cureus. 2024 Nov 17;16(11):e73834. doi: 10.7759/cureus.73834. eCollection 2024 Nov.
Introduction Anemia during pregnancy can lead to poor pregnancy outcomes, increasing maternal, fetal, and neonatal morbidity and mortality. Timely detection and management can lead to improved pregnancy outcomes. Objective To study various fetomaternal outcomes in severe anemia during pregnancy. Methods It is a prospective observational study conducted on 102 pregnant females, who presented with severe anemia (hemoglobin (Hb) < 7 gm/dL) between February 2020 and March 2021. Results In this study, 50% of patients presented before term (<37 weeks of gestation). Patients predominantly belonged to the rural population (n = 71, or 69.61%), the majority were multigravidas (81.37%), and 56.86% belonged to the upper-lower socioeconomic class. The mean age at presentation was 26.55 ± 4.99 years. Among maternal outcomes, abruption was seen in 7.84% of patients, post-partum hemorrhage (PPH) in 14.71%, sepsis in 3.92%, prolonged hospitalization in 48.04%, intensive care unit (ICU) admission in 4.90%, and maternal mortality in one patient. Additionally, 82.35% of patients went into spontaneous labor, and 76.47% of patients delivered vaginally. Among fetal and neonatal outcomes, 50% of neonates were premature, 62.75% were low birth weight (LBW), 42.16% were small for gestational age (SGA), and 22.55% of neonates were admitted to the neonatal ICU, of which two neonates expired. Stillbirth was noted in six (5.88%) babies. When the studied population was divided on the basis of the severity of anemia into two groups (Group A: very severe anemia with Hb < 4 gm/dL and Group B: severe anemia with Hb ≥ 4 gm/dL but <7 gm/dL), most of the outcomes were much worse for group A, with a statistically significant difference. Conclusion Not only can very severe anemia (Hb < 4 gm/dL), but also severe anemia (Hb ≥ 4 gm/dL but <7 gm/dL), adversely affect both maternal and fetal outcomes if not diagnosed and optimized on time.
引言 孕期贫血可导致不良妊娠结局，增加孕产妇、胎儿和新生儿的发病率和死亡率。及时检测和管理可改善妊娠结局。目的 研究孕期重度贫血的各种母婴结局。方法 这是一项对102名孕妇进行的前瞻性观察性研究，这些孕妇在2020年2月至2021年3月期间出现重度贫血（血红蛋白（Hb）<7 g/dL）。结果 在本研究中，50%的患者在足月前（妊娠<37周）就诊。患者主要来自农村人口（n = 71，或69.61%），大多数为经产妇（81.37%），56.86%属于社会经济中下层。就诊时的平均年龄为26.55±4.99岁。在孕产妇结局方面，7.84%的患者出现胎盘早剥，14.71%出现产后出血（PPH），3.92%出现败血症，48.04%住院时间延长，4.90%入住重症监护病房（ICU），1例患者死亡。此外，82.35%的患者自然分娩，76.47%的患者经阴道分娩。在胎儿和新生儿结局方面，50%的新生儿早产，62.75%出生体重低（LBW），42.16%小于胎龄（SGA），22.55%的新生儿入住新生儿ICU，其中2例新生儿死亡。6名（5.88%）婴儿出现死产。当根据贫血严重程度将研究人群分为两组（A组：Hb<4 g/dL的极重度贫血和B组：Hb≥4 g/dL但<7 g/dL的重度贫血）时，A组的大多数结局要差得多，差异有统计学意义。结论 如果不及时诊断和优化，不仅极重度贫血（Hb<4 g/dL），而且重度贫血（Hb≥4 g/dL但<7 g/dL）都会对母婴结局产生不利影响。
