Abstract
Objectives: To determine the hemoglobin levels in normal pregnant women and investigate the association of anemia with gestational age, number of antenatal visits, obstetrical complications and mode of delivery.
 Methodology: This is a cross-sectional study conducted at the Lady Willingdon Hospital, Khairpur Mirs, Pakistan from May 2021 to August 2021. A total of 139 normal pregnant women were recruited during antenatal visits. Patients were grouped into normal and anemic groups based on serum hemoglobin levels. Gestational age, obstetrical complications, mode of delivery and fetal outcome were recorded to find its association with anemia. Data was analyzed on SPSS 20.0 and p-value < 0.05 was considered as statistically significant.
 Results: Out of n=139 normal pregnant women, n=26 women had normal hemoglobin levels, n=49 were mild anemic, n=46 had moderate anemia whereas n=18 had severe anemia. Overall, the prevalence of gestational anemia was 81%. There was significant association between hemoglobin status and number of antenatal visits and complications in previous pregnancies. Hemoglobin status was not significantly associated with gestational age and mode of delivery.
 Conclusion: In conclusion, we found that gestational anemia is highly prevalent in Pakistan. Early detection of anemia and its correction via supplementations are recommended.
Highlights
Gestational anaemia is a global problem, affecting half billion women in their reproductive age
The hemoglobin status according to gestational age has been shown in Table 1, Fig. 2
Among the pregnant women, who had normal hemoglobin levels, majority had more than 4 antenatal visits (39%)
Summary
Gestational anaemia is a global problem, affecting half billion women in their reproductive age. Anemia during pregnancy may lead to higher maternal mortality and morbidity and obstetrical complications including miscarriage, prematurity, low birth weight and stillbirth especially in developing countries [2], [3]. In Pakistan, the prevalence of anemia among reproductive age women has been showed around 41% to 77%, with higher frequency in women from rural areas [4]. The risk factors and the cause of gestational anaemia are iron deficiency [1] that may be due to insufficient dietary intake, malabsorption, increased requirements during pregnancy, iron losses due to menstruation. Apart from that, thalassemia and hemoglobinopathies may be the underlying cause among women presenting with anemia during pregnancy. It has been estimated that the prevalence of haemoglobinopathies in Pakistan were about 28.4%, out of which the most prevalent was thalassaemia trait (25.6%), followed by thalassaemia major (1.4%) and HbS or HbD (1.4%) [7]
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