Оbstetric and perinatal outcomes of preterm birth in relation to the severity of anemia

Objective: To study obstetric and perinatal outcomes of preterm birth in women with mild and moderate anemia.

Material and methods: A retrospective study of the birth histories of women with mild anemia (n=81) and moderate anemia (n=39) was conducted. The severity of anemia was classified by hemoglobin levels according to WHO recommendations. Hemoglobin was determined using the cyanmethemoglobin methodmethod using the Mini Gem device. Preterm births were classified according to standard gestational age categories. The obtained data were statistically processed using parametric and nonparametric statistical methods.

Results: A strong correlation was established between the incidence of preeclampsia and labor anomalies and the severity of anemia. The degree of anemia was shown to have no statistically significant effect on the distribution of spontaneous preterm birth by gestational age, but a significantly higher incidence of induced preterm births was found in patients with moderate anemia.

Conclusion: The findings suggest an interconnected chain of pathogenetically determined events reflecting the progression of hypoxic-placental dysfunction.

1. Karami M, Chaleshgar M, Salari N et al.Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis. Matern Child Health J. 2022;26(7):1473-1487. doi: 10.1007/s10995-022-03450-1.

2. World Health Organization. Global anaemia reduction efforts among women of reproductive age: impact, achievement of targets and the way. Geneva: World Health Organization, 2020. https://www.who.int/ru/health-topics/anaemia#tab=tab_1

3. National Micronutrient Status Survey in Tajikistan. 2016; 130, https://www.unicef.org/tajikistan/sites/unicef.org.tajikistan/files/2019-07/Nutrition%20Forum_Ru_2016.pdf. (In Russ.).

4. Agency on Statistics under the President of the Republic of Tajikistan, the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, and the ICF Tajikistan Demographic and Health Survey 2023: Key Indicators Report. Dushanbe, 2024;49

5. Paradkar MN, Mejia I, Abraheem R, Marroquín León E, Firdous A. et al. Assessing the Impact of Hematological Changes in Pregnancy on Maternal and Fetal Death: A Narrative Review. Cureus. 2024;16(8):e66982. doi: 10.7759/cureus.66982.

6. Jin J, Xu Z, Liu Z, Huang L, Liu F, Liu M, Sun Y. Association between maternal iron status and the risk of pre-eclampsia: a case-control study. Asia Pac J Clin Nutr. 2024; 3(2):184-193. doi: 10.6133/apjcn.202406_33(2).0005.

7. Tang L, Luo Y, Sheng Y et al. Hemoglobin concentrations in early pregnancy and their associations with adverse pregnancy outcomes in Western China: a population-based study.BMC Pregnancy Childbirth. 2024$ 24(1):761. doi: 10.1186/s12884-024-06968-0.

8. Rahman MA, Khan MN, Rahman MM. Maternal anaemia and risk of adverse obstetric and neonatal outcomes in South Asian countries: A systematic review and meta-analysis. Public Health Pract (Oxf). 2020;1:100021. doi: 10.1016/j.puhip.2020.100021.

9. Safarzadeh S, Banihashemi F, Montazeri F, Roozbeh N, Darsareh F. Maternal and Neonatal Outcomes of Iron Deficiency Anemia: A Retrospective Cohort Study. Cureus. 2023;15(12):e51365. doi: 10.7759/cureus.51365.

10. Smith JS, Bullens LM, van der Hout-van der Jagt MB, van Runnard Heimel PJ, Oei SG. Effect of Intrapartum Maternal Hemoglobin on Mode of Delivery and Short-Term Neonatal Outcome: A Systematic Review. Obstet Gynecol Surv. 2022;77(10):595-605. doi: 10.1097/OGX.0000000000001074.

11. Yang L, Wang Z, Cao L, Li Y, Wang J, Ding Set al. Impact of maternal iron and zinc intake on low birth weight risk: a nested case-control study. PeerJ. 2025;13:e19896. doi: 10.7717/peerj.19896.

12. Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis. / Karami M, Chaleshgar M, Salari N et al. //Matern Child Health J. 2022.26(7):1473-1487. doi: 10.1007/s10995-022-03450-1. Epub 2022 May 24. PMID: 35608810.

13. Detlefs SE, Jochum MD, Salmanian B et al.The impact of response to iron therapy on maternal and neonatal outcomes among pregnant women with anemia. Am J Obstet Gynecol MFM. 2022; 4(2):100569. doi: 10.1016/j.ajogmf.2022.100569.

14. Association between maternal iron status and the risk of pre-eclampsia: a case-control study./ Jin J, Xu Z, Liu Z, Huang L, Liu F, Liu M, Sun Y. // Asia Pac J Clin Nutr. – 2024. – 3(2):184-193. doi: 10.6133/apjcn.202406_33(2).0005. PMID: 38794978; PMCID: PMC11170009

15. Maternal and Neonatal Outcomes of Iron Deficiency Anemia: A Retrospective Cohort Study / Safarzadeh S, Banihashemi F, Montazeri F, Roozbeh N, Darsareh F. // Cureus. 2023.15(12):e51365. doi: 10.7759/cureus.51365. PMID: 38292987; PMCID: PMC10825386.

16. Kharate MA, Choudhari SG. Effects of Maternal Anemia Affecting Fetal Outcomes: A Narrative Review. //Cureus. 2024.16(7):e64800. doi: 10.7759/cureus.64800. PMID: 39156476; PMCID: PMC11330297.

17. Severity of Anemia During Pregnancy and Adverse Maternal and Fetal Outcomes / Shi H, Chen L, Wang Y et al. //JAMA Netw Open. 2022.5(2):e2147046. doi: 10.1001/jamanetworkopen.2021.47046. PMID: 35113162; PMCID: PMC8814908.