The significance of anemia in an obstetric population in Australia.

Abstract

SummaryIn a series of 15 321 consecutive patients 568 (3.7 per cent) had haemoglobin values below 9.2 g. per 100 ml. before delivery. The commonest causes of amaemia were iron deficiency (49 per cent) and β‐thalassaemia minor (28 per cent), the latter being explained by a high proportion of patients of Mediterranean origin. The most important cause of anaemia, in terms of maternal morbidity and perinatal mortality, was chronic renal disease which had an incidence of 7 per cent (39 of 568). Maternal age and parity were significantly higher in the anaemia series than in a control series of non‐anaemic patients. The incidence of twin pregnancy was 5.2 per cent or five times that of whole obstetric population.Maternal oestriol excretion was low in 24 per cent of anaemic patients tested (55 of 225), including 12 of 13 patients tested whose infants died. The association between maternal anaemia and placental hypertrophy was confirmed.In the whole anaemia series the perinatal mortality rate was 3.8 per cent, and it was 6.4 per cent (13 of 202) in patients with haemoglobin values below 8.2 per 100 ml. Patients with anaemia who were most likely to have perinatal deaths were those with associated chronic renal disease. Renal function tests should be performed during pregnancy when anaemia is severe of fails to respond to treatment.