Skhvitaridze Natia, Gamkrelidze Amiran, Manjavidze Tinatin, Brenn Tormod, Anda Erik Eik, Rylander Charlotta
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
National Center for Disease Control and Public Health, Tbilisi, Georgia.
PLoS One. 2025 Jan 30;20(1):e0294832. doi: 10.1371/journal.pone.0294832. eCollection 2025.
Anemia in pregnancy is an important public health challenge; however, it has not been thoroughly studied in Georgia. We assessed the prevalence of anemia during pregnancy across Georgia and the association between anemia in the third trimester of pregnancy and adverse maternal outcomes.
We used data from the Georgian Birth Registry and included pregnant women who delivered between January 1, 2019, and August 31, 2022 (n = 158,668). The prevalence of anemia (hemoglobin (Hb) < 110 g/L) at any time during pregnancy was calculated per region. Pregnant women were classified into anemia severity groups based on their lowest measured Hb values, taking into account the thresholds for each trimester of pregnancy as defined by the WHO recommendations for anemia classification. Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) were calculated for the associations between anemia status and post-delivery intensive care unit (ICU) admission and preterm delivery.
The prevalence of anemia occurring at least once during pregnancy was 33.1%, with large regional differences in anemia prevalence (19.2%-32.8%). Of 105,811 pregnant women with Hb measurements in the third trimester, 71.0% had no anemia; 20.9%, mild anemia; and 8.1%, moderate or severe anemia. The odds of post-delivery ICU admission did not increase linearly with decreasing Hb value (P for trend .13), and the relationship was inverse for preterm delivery (P for trend .01).
A considerable proportion of pregnant women in Georgia have anemia during pregnancy, and the prevalence and quality of reporting differ across regions. Anemia occurring in the third trimester did not substantially increase the odds of maternal ICU admission or preterm delivery. To progress toward sustainable development goals and alleviate the public health burden of anemia, it is essential to not only identify and manage anemia during pregnancy but also address underlying factors with a multifaceted response.
妊娠期贫血是一项重大的公共卫生挑战；然而，在格鲁吉亚尚未对其进行全面研究。我们评估了格鲁吉亚各地妊娠期贫血的患病率以及妊娠晚期贫血与不良孕产妇结局之间的关联。
我们使用了格鲁吉亚出生登记处的数据，纳入了2019年1月1日至2022年8月31日期间分娩的孕妇（n = 158,668）。按地区计算妊娠期任何时间贫血（血红蛋白（Hb）< 110 g/L）的患病率。根据孕妇最低测量Hb值，按照世界卫生组织贫血分类建议所定义的各孕期阈值，将孕妇分为贫血严重程度组。计算贫血状态与产后重症监护病房（ICU）入院和早产之间关联的调整优势比（aOR）及95%置信区间（CI）。
妊娠期至少发生一次贫血的患病率为33.1%，贫血患病率存在较大的地区差异（19.2% - 32.8%）。在妊娠晚期进行Hb测量的105,811名孕妇中，71.0%无贫血；20.9%为轻度贫血；8.1%为中度或重度贫血。产后入住ICU的几率并未随Hb值降低呈线性增加（趋势P = 0.13），而早产的关系则相反（趋势P = 0.01）。
格鲁吉亚相当一部分孕妇在孕期患有贫血，且各地区的患病率及报告质量存在差异。妊娠晚期发生的贫血并未大幅增加孕产妇入住ICU或早产的几率。为朝着可持续发展目标迈进并减轻贫血的公共卫生负担，不仅要在孕期识别和管理贫血，还必须从多方面应对潜在因素。
