PREVALENCE AND DETERMINANTS OF SEVERE ANAEMIA AMONG ANTENATAL WOMEN ATTENDING A TERTIARY CARE HOSPITAL IN MANIPUR

Introduction: WHO defines anaemia in pregnancy as haemoglobin <11gm/dl and severe anaemia as haemoglobin < 7gm/dl.Anaemia is a major health concern during pregnancy particularly for the developing countries like India. Not many studies have been done so far regarding this health issue in this part of the country.Hence,this study was done to estimate the magnitude of the problem with focus on severe anemia. Objectives: To determine the prevalence of anaemia among pregnant women attending JNIMS Hospital, Manipur and classify the grades of anaemia and determine the factors leading to anaemia and study the outcomes of severely anaemic patients. Materials and methods: A prospective, hospital-based study was conducted in the Department of Obstetrics and Gynaecology,Jawaharlal Nehru Institute of Medical Sciences (JNIMS),Porompat,from August 2017 to April 2019 among pregnant women in second and third trimesters in a 20 months' duration,in a twice weekly survey,recruitment was done on all eligible women attending Obstetrics and Gynecology OPD, JNIMS using a pre-tested semi-structured questionnaire. Haemoglobin was measured using colorimetry method. All the very severely anaemic study-subjects were followed up for any interventions given and the pregnancy outcome until discharged alive or death. Data was analysed by SPSS version 20. Mean, standard deviation, Chi square test etc. were used for analysis. The study was approved by the Institutional ethics committee. Results: The prevalence of anaemia was found to be 30.8%; mild anaemia was found in 288(17.9%), moderate in 124 (7.8%) and severe anaemia was 82 (5.1%). Severe anaemia was found to be significantly associated with age group 34 years and above, Muslim community, rural residence, being illiterate, ANC less than three times, never taken supplemental iron,with increasing gravida and booking ANC visit after 12 weeks.Blood transfusion was given to 62 out of 82 (75.6%) patients and 20 patients (24.3%) received parenteral iron. Six patients (7.3%) had associated preeclampsia, 3 (3.6%) had ante-partum haemorrhage, and 4 (4.8%) had associated post-partum haemorrhage. There were 6 (7.3%) intrauterine deaths,10 preterm deliveries (12.1%),and 7 low birth weight babies (8.5%). There was one maternal mortality with the baby in utero. Conclusion: Almost around a third of the pregnant women suffered from anaemia with a sixth of them having severe anaemia.Three fourths of the pregnant women having severe anaemia received blood transfusion. Severe anemia was associated with pre-eclampsia, ante-partum haemorrhage and post-partum haemorrhage, intra-uterine deaths, preterm deliveries, low birth weight and maternal mortality. Regular antenatal checkups, adequate intake of iron and folic acid tablets and proper age at the time of pregnancy should be encouraged.