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.