Maternal and fetal outcome after severe anemia in pregnancy in rural Ghana

Background. Anemia in pregnancy contributes to poor outcome for mother and child in low-income countries. This study analyzes adverse maternal and fetal outcome after severe anemia in pregnancy in rural Ghana. Methods. A cohort study in two (sub)district hospitals, including 157 pregnant women exposed to severe anemia (Hb < 8.0 g/dl) and 152 nonexposed pregnant women (Hb ≥ 10.9 g/dl), matched for age and parity strata. Adverse outcomes analyzed were postpartum hemorrhage, need for blood transfusion, maternal mortality, low birth-weight, and perinatal mortality. Results. Compared to nonexposed women, exposed women had an increased risk of maternal death (5/157 versus 0/152). Fetal outcome did not significantly differ between the study groups, although perinatal mortality was increased with exposure to Hb < 7.0 g/dl (OR 3.1; 95%CI 1.0–9.4), and low birth-weight was increased with exposure to Hb < 6.0 g/dl (OR 2.5; 95%CI 1.2–5.4). Overall fetal outcome was significantly better when hemoglobin prior to childb...