Journal de la grossesse et de la santé infantile

Abstrait

Maternal Hemoglobin, Preterm Pains, Failure of Tocolysis, Preterm Birth, Small for Gestational Age Neonate

Chhabra S and Chopra S

Background: Small for gestational age (SGA) babies have higher perinatal mortality, morbidity, sequelae. Iron deficiency anaemia in mother significantly increases SGA. Objective: To know relationship between SGA neonate, preterm pains, preterm births with anaemia in mother. Material methods: Analysis of case records of primigravida who delivered single live SGA baby, with equal controls (appropriate for gestational age) over 5 years. Results: Of 27,984 who delivered, 1500 (5.36%) were study subjects, as per inclusion, exclusion 1190 (79.3%) were anaemic, 1002(66.8%) controls anaemic, significant difference. Amongst study 41.8% (628) were mildly, 33.6% (505) moderately, 3.8% (57) severely anaemic, 20.7% nonanaemic, 620 (41.3%) controls, mildly 352(23.5%), moderately 30(2%), severely anaemic, 33.2% nonanaemic. Most study, controls were of 20-29 years. Significantly more nonanaemic study cases were labourers (9.6%), compared to controls (2.6%). With SGA baby, risk of preterm birth increasing with severity of anaemia. Of 50, (8.0%) with mild anaemia SGA babies, who had preterm pains, tocolytics were able to arrest birth in 12%.Preterm births were 7.2% in nonanaemic, 5.5% mildly anaemic, 14.5% moderatly,43.9% severe (p < 0.05). Preterm birth arrest by tocolytics decreased from 22.7% without anaemia to 16.7% with severe, 12% with mild, 8.8% moderate anaemia (p < 0.05). Amongst study subjects, 21(3.3%) with mild anaemia, 17(3.4%) moderate anaemia, 10(17.5%) severe anaemia, 9(2.9%) nonanaemiac had birth weight 1000-1499 gms., 142(22.6%) with mild anaemia, 276(54.6%) moderate anaemia,47(82.5%) severe anaemia, 8(2.6%) with no anaemia had weight 1500-1999 gms. 465(74.1%) with mild anaemia, 212 (42%) moderate anaemia, 293 (94.5%) no anaemia had weight 2000-2499 gms. MBW decreasing with increasing severity of anaemia.