RESULTS
In the present study, 4031 women delivered in study period compared to 6659 in control period. Of these (3010/4031) 74.7% and (3446/6659) 51.6% were anaemic in study and control groups respectively. (p < .001). The overall prevalence of severe anemia was (51/4031) 1.27 % and (77/6659) 1.16% respectively amongst all deliveries in the study and control groups respectively (p value =0.616). (Table 1).
In the present study a total of 51 case records from study group and 77 case records from control group were analysed. Table no 2 shows the comparison between the epidemiological details including mean age of the pregnant women, their antenatal registration status, inter-conception period, mean gestational age at delivery and antenatal prophylactic iron supplementation.
Table no 3 describes the clinical presentation at the time of admission in the study and control groups. Majority of women were asymptomatic in both the groups at the time of admission. Of the symptomatic women breathlessness was the commonest symptom in both the groups. There was no difference in the clinical presentation in both the groups.
All patients received blood transfusion in both the groups in view of severe anemia whereas 5.9% and 2.6% in study and control groups received platelet transfusion. Parenteral iron was administered to 9.8% patients in study group compared to none in control group whereas parenteral Vit B12 was given to 19.6% and 26.8% patients in the study and control groups respectively.
The vaginal delivery rates were higher among control group (83.1%) as compared to study group (76.5%) however the difference was statistically not significant.
Mean hemoglobin level was significantly lower in study group than the control group. Microcytic hypochromic anemia was the most common morphological type of anemia in both study and control groups. Serum ferritin, serum iron, serum B12 and folic acid levels among study group were significantly (p<0.05) lower as compared to control group .
The odds ratio of maternal death in study group was 6.46 (95%CI: 0.70-59.63) as compared to control group. The odds ratio of maternal complications was such as abruption 2.34 (95%CI: 0.37-14.54), postpartum haemorrhage 2.65 (95% CI: 0.99-7.04) and ICU admission 3.29 (95% CI: 0.78-13.80) in study group compared to control group but the difference was statistically not significant as the confidence intervals were very wide. Odds of foetal growth restriction was 48% higher among study group as compared to control group (Table 4).
The odds ratio of neonatal deaths in study group was 4.84 (95%CI: 0.48-48.24) compared to control group. The odds ratio of new-born complications such as low birth weight 2.49 (95%CI: 1.04-5.91) and need for nursery or NICU admission 4.84 (95%CI: 0.48-48.24) was higher in study group as compared to control group. Low birth rate was higher in study group and was found to be statistically significant. Odds of still birth was 5% higher in study group as compared to control group (Table 6).