Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Aug 8;8(8):e021623.
doi: 10.1136/bmjopen-2018-021623.

Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India

Archana Patel  1 , Amber Abhijeet Prakash  1 , Prabir Kumar Das  1 , Swarnim Gupta  1 , Yamini Vinod Pusdekar  1 , Patricia L Hibberd  2
Affiliations
Observational Study

Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India

Archana Patel et al. BMJ Open. .

Abstract

Objectives: To study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes.

Design: Prospective observational cohort study.

Setting: Catchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India.

Participants: 72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH's Global Network, enrolled from 2009 to 2016.

Main outcome measures: Mode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies.

Results: Over 90% of the women included in the study were anaemic and over a third were underweight (BMI <18 kg/m2) and with both conditions. Mild anaemia at any time during delivery significantly increased the risk (Risk ratio; 95% confidence interval (RR;(95% CI)) of stillbirth (1.3 (1.1-1.6)), neonatal deaths (1.3 (1-1.6)) and LBW babies (1.1 (1-1.2)). The risks became even more significant and increased further with moderate/severe anaemia any time during pregnancy for stillbirth (1.4 (1.2-1.8)), neonatal deaths (1.7 (1.3-2.1)) and LBW babies (1.3 (1.2-1.4)).,. Underweight at anytime during pregnancy increased the risk of neonatal deaths (1.1 (1-1.3)) and LBW babies (1.2;(1.2-1.3)).The risk of having stillbirths (1.5;(1.2-1.8)), neonatal deaths (1.7;(1.3-2.3)) and LBW babies (1.5;(1.4-1.6)) was highest when - the anaemia and underweight co-existed in the included women. Obesity/overweight during pregnancy increased the risk of maternal complications at delivery (1.6;(1.5-1.7)) and of caesarean section (1.5;(1.4-1.6)) and reduced the risk of LBW babies 0.8 (0.8-0.9)).

Conclusion: Maternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously.

Trial registration number: NCT01073475.

Keywords: anemia; body mass index; malnutrition; neonatal deaths; pregnancy; stillbirth.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Categorical anaemia (g/dL) in included women by body mass index (kg/m2) over year of enrolment.
Figure 2
Figure 2
Proportions of anaemia (g/dL) and body mass index (kg/m2) interaction in included women over year of enrolment.
See this image and copyright information in PMC

References

    1. Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427–451. 10.1016/S0140-6736(13)60937-X - DOI - PubMed
    1. Bhutta ZA, Das JK, Rizvi A, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 2013;382:452–77. 10.1016/S0140-6736(13)60996-4 - DOI - PubMed
    1. Black RE, Allen LH, Bhutta ZA, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008;371:243–60. 10.1016/S0140-6736(07)61690-0 - DOI - PubMed
    1. United Nations Development Program. Sustainable development goals. http://www.undp.org/content/undp/en/home/sustainable-development-goals.html (accessed 30 Nov 2017).
    1. World Health Organization. Global nutrition targets 2025:. http://apps.who.int/iris/bitstream/10665/149018/1/WHO_NMH_NHD_14.2_eng.p....

Publication types

MeSH terms

Associated data