Meta-Analysis: The Effect of Anemia in Pregnant Women on the Risk of Postpartum Bleeding and Low Birth Weight

Abstract

Background: Anemia in pregnancy usually occurs in the 1st and 3rd trimesters with Hb levels below 11g% and in the 2nd trimester with Hb levels less than 10.5g%. The prevalence of anemia in pregnant women around the world ranges from 41.8% to 43.8%, which means that around 56-59 million pregnant women suffer from anemia. Factors that cause anemia that often appear in pregnant women are malnutrition and iron deficiency, so that iron anemia in pregnancy can result in increased maternal mortality rates (MMR). Anemia during pregnancy can result in fetal death, abortion, birth defects, low birth weight and can cause bleeding during labour. Subjects and Method: Meta-analysis was carried out using the PRISMA flowchart and the PICO model (Population: pregnant women, Intervention: anemia, Comparison: no anemia, Outcome: LBW and postpartum hemorrhage). The databases used are PubMed, Research Gate, Science Direct, and Google Scholar with the keywords “maternal anemia” AND “postpartum hemorrhage” AND cohort, “maternal anemia” AND “low birth weight” AND cohort. There were 17 cohort studies published in 2012-2022 that met the inclusion criteria. The total sample in this meta-analysis was 719,172. Analysis was performed with Revman 5.3. Results: 17 articles with cohort research designs originating from China, Taiwan, Japan, India, Bangladesh, England, Scotland, North America and the United States involving 719,172 pregnant women. A meta-analysis of 9 cohort studies showed that anemia in pregnant women increased the risk of giving birth to LBW babies 1.35 times compared to pregnant women who were not anemic (aOR= 1.35; 95% CI = 1.05 to 1.75; p=0.020). A meta-analysis of 8 cohort studies showed that anemia in pregnant women increased the risk of postpartum hemorrhage 1.99 times compared to pregnant women who were not anemic (aOR= 1.99; 95% CI = 1.24 to 3.18; p=0.004). Conclusion: Anemia in pregnant women can increase the risk of LBW babies and postpartum hemorrhage. Keywords: Pregnant women, anemia, LBW, postpartum hemorrhage, and Meta-Analysis Correspondence: Fahmi Adhimukti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: fahmiadhimukti13@gmail.com. Mobile: +628-5743155133. Journal of Maternal and Child Health (2023), 08(01): 58-69 https://doi.org/10.26911/thejmch.2023.08.01.06