Prevalence and predictors of postpartum anemia after caesarean delivery in Ethiopia: A retrospective analysis of risk factors

Abstract

Background: Despite the burden of anemia during pregnancy has been extensively studied, the magnitude of postpartum anemia (PPA) and its predictors, especially after caesarean delivery remains unexplored. Therefore, we investigated the prevalence of postpartum anemia, and its predictors among women who underwent cesarean delivery.

Methods: A retrospective study was conducted among women who underwent caesarean delivery in Southern Ethiopia. Data were retrospectively retrieved from the medical records of the participants. Multivariate logistic regression analysis identified independent predictors associated with postpartum anemia. An adjusted odd ratio (AOR), and a 95% confidence interval (CI), were used to identify associations. A p-value < 0.05 is considered statistically significant.

Results: A total of 368 women who underwent caesarean delivery were included in this study. The overall incidence of PPA using a cut-off value of hemoglobin level < 11 g/dl after cesarean delivery was 103(28%). Multiple logistic regression analysis showed that the predictors of PPA were more likely among women with Prepartum Anemia (AOR=5.46: 95% CI=2.09-14.31), Grand parity (AOR=3.98: 95% CI=1.45-10.90), Placenta previa (AOR=7.73: 95% CI=1.91-31.38), ANC follow-up < 3 times (AOR=2.33: 95% CI=1.07-3.47), and those who developed Postpartum Hemorrhage (AOR=2.73: 95% CI=1.51-4.93).

Conclusion: More than one-fourth of women who underwent caesarean delivery in Southern Ethiopia had PPA. Poor ANC- follow-up, grand parity, placenta previa, Prepartum anemia, and PPH were the best predictors of PPA. Therefore, implementing strategies that consider the identified predictors could help to reduce the prevalence of PPA and its complications.

Keywords: Anemia during pregnancy; Caesarean delivery; Postpartum anemia; Postpartum hemorrhage; Women.