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Parturient Anemic: Epidemiology and Outcome of Pregnancy in Three Maternities of Brazzaville (Republic of Congo)

Received: 25 June 2019    Accepted: 18 July 2019    Published: 5 August 2019
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Abstract

Objective: Anemia during childbirth remains a concern for reproductive health personnel, both in terms of frequency and the risks involved in all periods of pregnancy and childbirth. This work aims to analyze the epidemiological profile of anemic parturient and the outcome of their pregnancy. Methods: A multicenter case-control study conducted from February 1st to July 31st, 2017, in three Brazzaville maternity clinics, comparing the ratio of one case for two controls, the anemic parturient (n = 67) to those without anemia (n = 134). Any parturient with a hemoglobin level < 11 g / dl was considered anemic. The variables studied were sociodemographic and reproductive, related to anemia, per and postpartum. Results: Sixty-seven anemic parturient were recorded among 10,106 deliveries, a frequency of 0.7%. Anemic female parturient were older (30.1 ± 1.6 years vs 27.5 ± 1.9 years, p < 0.05), out of school (OR = 13.1 [1.5-111], p < 0.05) and unemployed (OR = 3.8 [2.1-7.2], p < 0.05). The mean hemoglobin level was 8.1 ± 0.1g / dl vs 12.1 ± 0.8g / dl. Anemia was microcytic hypochromic (28.4%) and normochromic normocytic (71.6%). Anemia was mild (40.3%), moderate (44.7%) and severe (15%). Delivery was more by caesarean section in cases (97% vs 1.5%, p < 0.05) with a higher recourse to blood transfusion (55.4% vs 3.8%, OR = 29.9 [10.8-82.6], p < 0.05). Maternal lethality was 13-fold higher in case of anemia (OR = 13 [1.5-111], p < 0.05). Neonatal morbidity was represented by poor adaptation to extrauterine life (OR = 40.7 [9.1-180.7), p < 0.05), hypotrophy (OR = 21.9 [7.2-67.1], p < 0.05), prematurity (OR = 6.6 [2.6-16.9], p < 0.05), neonatal resuscitation (OR = 35.4 [10.2-122.5), p < 0.05) and neonatal transfer (OR = 2.8 [2-4], p < 0.05). Neonatal lethality was three times higher in case of anemia (OR = 3.3 [2.6-4.8], p < 0.05). Conclusion: Maternal and neonatal prognosis is poor in anemic female parturient. Reducing the maternal and fetal impact of anemia during childbirth requires early detection and case management during prenatal contact.

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 4)
DOI 10.11648/j.jgo.20190704.14
Page(s) 116-119
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Anemia, Childbirth, Epidemiology, Prognosis, Brazzaville

References
[1] WHO, Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity, Vitamin and Mineral Nutrition Information System, World Health Organization, Geneva, Switzerland, 2011, http://www.who.int/vmnis/indicators/haemoglobin/en/.
[2] WHO, Pregnancy, Childbirth and Prenatal Care, Essential Practice Guide, World Health Organization, Geneva, Switzerland, 2003, https://www.who.int/maternal_child_adolescent/documents/924159084x/fr/.
[3] National Center for Statistics and Economic Studies of Congo Brazzaville. Demographic and Health Survey 2011-2012, https://dhsprogram.com>pubs>pdf.
[4] International Nutritional Anemia Consultative Group (INACG), Adjusting Hemoglobin Values in ProgramSurveys, International Nutritional Anemia Consultative Group (INACG), Washington, DC, USA, 2002, http://inacg.ilsi.org.
[5] Grum T, Brhane E, Hintsa S, Kahsay G. Magnitude and factors associated with anemia among pregnant women attending antenatal care in public health centers in central zone of Tigray region, northern Ethiopia: a cross sectional study. BMC Pregnancy and Childbirth 2018; 18: 433.
[6] Anlaakuu P, Anto F. Anaemia in pregnancy and associated factors: a cross sectional study of antenatal attendants at the Sunyani Municipal Hospital, Ghana. BMC Res Notes 2017; 10: 402.
[7] Nguefack Chente C, Ngouadjeu Dongho Tsakeu E, Nguea AG, Njamen TN, Ekane GH, Belley Priso E. Prevalence and factors associated with anemia in pregnancy at Douala General Hospital. Pan Afr Med J 2016; 25: 133.
[8] Takele WW, Tariku A, Shiferaw FW, Demsie A, Alemu WG, Anlay DZ. Anemia among Women Attending Antenatal Care at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia, 2017. Anemia, vol. 2018, Article ID 7618959, 10 pages, 2018.
[9] Ebuy Y, Alemayehu M, Mitiku M, Goba GK. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia. PloS ONE 2017; 12 (11): e0186724.
[10] Ahenkorah B, Nsiah K, Baffoe P. Sociodemographic and Obstetric Characteristics of Anaemic Pregnant Women Attending Antenatal Clinic in Bolgatanga Regional Hospital. Scientifica, vol. 2016, Article ID 4687342, 8 pages, 2016.
[11] Alemu T, Umeta M. Reproductive and Obstetric Factors Are Key Predictors of Maternal Anemia during Pregnancy in Ethiopia: Evidence from Demographic and Health Survey (2011). Anemia, vol. 2015, Article ID 649815, 9 pages, 2015.
[12] Nair M, Choudhury MK, Choudhury SS and al. Association between maternal anemia and pregnancy outcomes: a cohort study in Assam, India. BMJ Global Health 2016; 1: e000026.
[13] Patel A, Prakash AA, Das PK, Gupta S, Pusdekar YV, Hibberd PL. Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India. BMJ Open 2018; 8: e021623.
[14] El Guindi W, Pronost J, Carles G et al. Severe maternal anemias resulting from pregnancy. J Gynecol Obstet Biol Reprod 2004; 33: 506-9.
[15] Taner CE, Ekin A, Solmaz U et al. Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery. J Turk Ger Gynecol Assoc 2015; 16: 231-6.
[16] French National College of Gynecologists and Obstetricians. Recommendation for clinical practice. Supplementation during pregnancy. Encycl. Med. Chir 1999 (Paris), 5-042-A-30: 5.
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    Itoua Clautaire, Ngaliba Olivia Firmine, Buambo Gauthier Régis Jostin, Ngami Ariane Glore, Mokoko Jules César, et al. (2019). Parturient Anemic: Epidemiology and Outcome of Pregnancy in Three Maternities of Brazzaville (Republic of Congo). Journal of Gynecology and Obstetrics, 7(4), 116-119. https://doi.org/10.11648/j.jgo.20190704.14

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    ACS Style

    Itoua Clautaire; Ngaliba Olivia Firmine; Buambo Gauthier Régis Jostin; Ngami Ariane Glore; Mokoko Jules César, et al. Parturient Anemic: Epidemiology and Outcome of Pregnancy in Three Maternities of Brazzaville (Republic of Congo). J. Gynecol. Obstet. 2019, 7(4), 116-119. doi: 10.11648/j.jgo.20190704.14

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    AMA Style

    Itoua Clautaire, Ngaliba Olivia Firmine, Buambo Gauthier Régis Jostin, Ngami Ariane Glore, Mokoko Jules César, et al. Parturient Anemic: Epidemiology and Outcome of Pregnancy in Three Maternities of Brazzaville (Republic of Congo). J Gynecol Obstet. 2019;7(4):116-119. doi: 10.11648/j.jgo.20190704.14

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  • @article{10.11648/j.jgo.20190704.14,
      author = {Itoua Clautaire and Ngaliba Olivia Firmine and Buambo Gauthier Régis Jostin and Ngami Ariane Glore and Mokoko Jules César and Ngakengni Neli Yvette and Eouani Max Lévy Eméry and Iloki Léon Hervé},
      title = {Parturient Anemic: Epidemiology and Outcome of Pregnancy in Three Maternities of Brazzaville (Republic of Congo)},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {7},
      number = {4},
      pages = {116-119},
      doi = {10.11648/j.jgo.20190704.14},
      url = {https://doi.org/10.11648/j.jgo.20190704.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190704.14},
      abstract = {Objective: Anemia during childbirth remains a concern for reproductive health personnel, both in terms of frequency and the risks involved in all periods of pregnancy and childbirth. This work aims to analyze the epidemiological profile of anemic parturient and the outcome of their pregnancy. Methods: A multicenter case-control study conducted from February 1st to July 31st, 2017, in three Brazzaville maternity clinics, comparing the ratio of one case for two controls, the anemic parturient (n = 67) to those without anemia (n = 134). Any parturient with a hemoglobin level < 11 g / dl was considered anemic. The variables studied were sociodemographic and reproductive, related to anemia, per and postpartum. Results: Sixty-seven anemic parturient were recorded among 10,106 deliveries, a frequency of 0.7%. Anemic female parturient were older (30.1 ± 1.6 years vs 27.5 ± 1.9 years, p < 0.05), out of school (OR = 13.1 [1.5-111], p < 0.05) and unemployed (OR = 3.8 [2.1-7.2], p < 0.05). The mean hemoglobin level was 8.1 ± 0.1g / dl vs 12.1 ± 0.8g / dl. Anemia was microcytic hypochromic (28.4%) and normochromic normocytic (71.6%). Anemia was mild (40.3%), moderate (44.7%) and severe (15%). Delivery was more by caesarean section in cases (97% vs 1.5%, p < 0.05) with a higher recourse to blood transfusion (55.4% vs 3.8%, OR = 29.9 [10.8-82.6], p < 0.05). Maternal lethality was 13-fold higher in case of anemia (OR = 13 [1.5-111], p < 0.05). Neonatal morbidity was represented by poor adaptation to extrauterine life (OR = 40.7 [9.1-180.7), p < 0.05), hypotrophy (OR = 21.9 [7.2-67.1], p < 0.05), prematurity (OR = 6.6 [2.6-16.9], p < 0.05), neonatal resuscitation (OR = 35.4 [10.2-122.5), p < 0.05) and neonatal transfer (OR = 2.8 [2-4], p < 0.05). Neonatal lethality was three times higher in case of anemia (OR = 3.3 [2.6-4.8], p < 0.05). Conclusion: Maternal and neonatal prognosis is poor in anemic female parturient. Reducing the maternal and fetal impact of anemia during childbirth requires early detection and case management during prenatal contact.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Parturient Anemic: Epidemiology and Outcome of Pregnancy in Three Maternities of Brazzaville (Republic of Congo)
    AU  - Itoua Clautaire
    AU  - Ngaliba Olivia Firmine
    AU  - Buambo Gauthier Régis Jostin
    AU  - Ngami Ariane Glore
    AU  - Mokoko Jules César
    AU  - Ngakengni Neli Yvette
    AU  - Eouani Max Lévy Eméry
    AU  - Iloki Léon Hervé
    Y1  - 2019/08/05
    PY  - 2019
    N1  - https://doi.org/10.11648/j.jgo.20190704.14
    DO  - 10.11648/j.jgo.20190704.14
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 116
    EP  - 119
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20190704.14
    AB  - Objective: Anemia during childbirth remains a concern for reproductive health personnel, both in terms of frequency and the risks involved in all periods of pregnancy and childbirth. This work aims to analyze the epidemiological profile of anemic parturient and the outcome of their pregnancy. Methods: A multicenter case-control study conducted from February 1st to July 31st, 2017, in three Brazzaville maternity clinics, comparing the ratio of one case for two controls, the anemic parturient (n = 67) to those without anemia (n = 134). Any parturient with a hemoglobin level < 11 g / dl was considered anemic. The variables studied were sociodemographic and reproductive, related to anemia, per and postpartum. Results: Sixty-seven anemic parturient were recorded among 10,106 deliveries, a frequency of 0.7%. Anemic female parturient were older (30.1 ± 1.6 years vs 27.5 ± 1.9 years, p < 0.05), out of school (OR = 13.1 [1.5-111], p < 0.05) and unemployed (OR = 3.8 [2.1-7.2], p < 0.05). The mean hemoglobin level was 8.1 ± 0.1g / dl vs 12.1 ± 0.8g / dl. Anemia was microcytic hypochromic (28.4%) and normochromic normocytic (71.6%). Anemia was mild (40.3%), moderate (44.7%) and severe (15%). Delivery was more by caesarean section in cases (97% vs 1.5%, p < 0.05) with a higher recourse to blood transfusion (55.4% vs 3.8%, OR = 29.9 [10.8-82.6], p < 0.05). Maternal lethality was 13-fold higher in case of anemia (OR = 13 [1.5-111], p < 0.05). Neonatal morbidity was represented by poor adaptation to extrauterine life (OR = 40.7 [9.1-180.7), p < 0.05), hypotrophy (OR = 21.9 [7.2-67.1], p < 0.05), prematurity (OR = 6.6 [2.6-16.9], p < 0.05), neonatal resuscitation (OR = 35.4 [10.2-122.5), p < 0.05) and neonatal transfer (OR = 2.8 [2-4], p < 0.05). Neonatal lethality was three times higher in case of anemia (OR = 3.3 [2.6-4.8], p < 0.05). Conclusion: Maternal and neonatal prognosis is poor in anemic female parturient. Reducing the maternal and fetal impact of anemia during childbirth requires early detection and case management during prenatal contact.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo

  • Department of Clinical Hematology, University Hospital of Brazzaville, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo

  • Neonatology Department, Brazzaville University Hospital, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Loandjili General Hospital, Pointe Noire, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo

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