Abstract
BackgroundMany women suffer from anemia during their pregnancy. Austria, a central European country, has an instituted mandatory prenatal care system and therein two anemia screening tests (before end of week 16 and in weeks 25-28) are scheduled. Epidemiological data on the prevalence of anemia in pregnant women in Austria are missing.MethodsWe analysed data from Styria, an Austrian federal state, to determine the prevalence of anemia diagnosed in pregnant women aged 15-45 years with at least one examination in the first and second time period using the cut-off hemoglobin (Hb) concentration of 11 g/dl as recommended by the World Health Organisation (WHO). Sensitivity analyses for cut-off values with 10.5 and 7 g/dl (severe anemia) were performed. The STROBE checklist was applied for this retrospective cohort study.ResultsThe study included anemia screening tests from 25,922 women during 31,429 pregnancies from 2006-2014. Anemia was diagnosed in either time period in 13.7% (95% confidence interval (CI) 13.4-14.1) of pregnancies, in the first time period in 2.2% (95% CI 2.0-2.2), and in the second time period in 13.0% (95% CI 12.6-13.4). The annual age-adjusted anemia prevalence showed no change over time. Reducing the cut-off value to 10.5 g/dl resulted in an anemia prevalence in either time period of 5.6% (95% CI 5.3-5.8). The pattern of a higher prevalence in the second time period remained unchanged. Severe anemia (Hb <7 g/dl) was diagnosed in four pregnancies (0.01%).ConclusionThe estimated anemia prevalence of around 14% in pregnant women in Styria (Austria) is stable over the observed time window (2006-2014) and almost all are diagnosed in the second test period (in weeks 25-28). It seems that in a developed country like Austria the first examination (before week 16) is not mandatory for pregnancy care. However, in other countries where a high prevalence of anemia is common due to risk factors such as malaria and HIV, early screening in pregnancy might be very important.
Highlights
Many women around the world, in industrialized as well as in developing countries, suffer from anemia during their pregnancy [1, 2]
Anemia was diagnosed in either time period in 13.7% (95% confidence interval (CI) 13.4-14.1) of pregnancies, in the first time period in 2.2%, and in the second time period in 13.0%
Reducing the cut-off value to 10.5 g/dl resulted in an anemia prevalence in either time period of 5.6%
Summary
Many women around the world, in industrialized as well as in developing countries, suffer from anemia during their pregnancy [1, 2]. For the year 2011, the World Health Organisation (WHO) estimated for pregnant women aged 1549 years a global anemia prevalence of 38.2% (95% confidence interval (CI) 33.5–42.6), whereas the estimate for the European WHO region was 25.8% (95% CI 19.8–33.6) [1]. The 2009 Veterans Affairs/Department of Defense (VA/DoD) Clinical Practice Guideline for management of pregnancy recommends an anemia screening during weeks 6 to 8 and does not recommend a repeated testing for all women [8]. A central European country, has an instituted mandatory prenatal care system and therein two anemia screening tests (before end of week 16 and in weeks 25-28) are scheduled. Epidemiological data on the prevalence of anemia in pregnant women in Austria are missing. Editor: Samson Gebremedhin Gebreselassie, Hawassa University College of Medicine and Health Sciences, ETHIOPIA
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