Frequency and Determinants of Maternal Anaemia in Early Postpartum Period

Abstract

Objective: To determine the frequency and risk factors of maternal anaemia after delivery.
 Methods: A cross-sectional study was carried out in two private tertiary care hospitals of Karachi over a period of six month from April to October 2017. A sample of 300 postpartum women was recruited in the study by convenient sampling.
 Inclusions criteria were women more than 24 hours or up to one week following delivery of babies of more than 28 weeks of gestation and all booked cases of hospitals that consented to take part in re- search study. Exclusion criteria were women who had no antenatal visits and haemoglobin estima- tion in third trimester of pregnancy.
 Data was collected using predesigned questionnaire after taking informed consent. Haemoglobin lev- els were noted in early pregnancy, third trimester and postpartum period.
 Results: The study group comprises of 135 (47.9%) women with postpartum anaemia, whereas 147 (52.1%) women had normal level of haemoglobin. A total of 72 (25.5%) women had a rise in haemo- globin,192 (62%) women had low and 18 (6.4%) women had unchanged postpartum haemoglobin as compared to the third trimester haemoglobin level.
 The mean age of the study group was 27.59 ± 4.221. Inadequate iron intake was noted in 66 (48.9%) women in the anaemic group, whereas it was found in 51 (34.7%) women in the non-anaemic group (p-value=0.000, OR=0.083). Anaemia was diagnosed during pregnancy in 105 (77.8%) women in anaemic group, whereas 33 (22.4%) women had anaemia during pregnancy in non-anaemic post- partum group (p-value=0.000, OR=0.083). Caesarean section was performed in 84 (62.3%) women with postpartum anaemia (p-value=0.010, OR=0.537). A total of 27 (20%) women with postpartum anaemia had episiotomy during normal vaginal or instrumental deliveries (p-value=0.042, OR=1.765).
 Conclusion: Frequency of early postpartum anaemia is high. Anaemia during pregnancy, inadequate iron intake, vaginal delivery with episiotomy and caesarean section were significant risk factors.