MATERIALS and METHODS
This record based retrospective comparative observational study was conducted in the department of Obstetrics and Gynaecology at LHMC and SSK Hospital, Delhi for a duration of six months from July 2020 to December 2020 during COVID pandemic (study group) and a six month Pre COVID period from July 2019 to December 2019 (control group). The study included all antenatal women admitted at a gestational age >26 weeks (third trimester) with severe anaemia that is haemoglobin level of <7 gm% for delivery as per ICMR classification for grading of anemia in pregnancy. The case records of patients having severe anaemia due to acute blood loss like antepartum haemorrhage were not included in the study.
After obtaining ethical clearance from institutional ethics committee eligible subjects were identified from birth entry register and case records were retrieved. A proforma was used to record the relevant demographic details including maternal age, registration status of pregnancy, parity, gestational age in weeks at admission, inter-conception period, gestational age in weeks at delivery, presence of factors contributing to anaemia (such as intolerance to iron, non-availability and lack of antenatal care) ; clinical complaints at admission (exercise intolerance, easy fatiguability, breathlessness etc); clinical data on management (such as injectable iron, Vit B12, blood transfusion); complications (like abruption, postpartum haemorrhage, ICU admission, need of intubation , maternal death, foetal growth restriction); mode of delivery (vaginal delivery, LSCS); laboratory investigations (hemoglobin level, peripheral smear, serum ferritin, serum B12 and folic acid levels and foetal outcome ( gestational age, live or still birth, birth weight, APGAR score and need of nursery/NICU admission).
Statistical analysis: The data collected during the study was entered in Microsoft Excel spreadsheet. The statistical analysis was performed using the Statistical Package for the Social Sciences for Windows version 18 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were expressed as mean ± standard deviation for continuous variables and frequencies or percentages for categorical variables. Normality of the data distribution were assessed with the Kolmogorov-Smirnov test. Depending upon normality of data, appropriate tests were used. Chi-square test and students t-test were applied to see the difference between study and control groups for baseline clinical and laboratory characteristics and outcomes. Univariate logistic regression models were used to assess the association between year and maternal/perinatal out­comes. Odds ratios and 95% confidence intervals were pre­sented. A p value of less than 0.05 was considered statistically significant.