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Mid Pregnancy Fetal Growth Restriction and Maternal Anaemia a Prospective Study
Chhabra S and Chopra S
Background: Fetal growth restriction (FGR) in anaemic women leads to high perinatal morbidity, mortality and long term sequelae too. Objective: Was to know relationship between mid gestation FGR, maternal anaemia and neonatal outcome.
Materials and methods: Case control study was done in 500 study subjects with special criteria (primigravida with FGR at midgestation with or without anaemia, no other disorders), 500 controls were with similar criteria without FGR.
Results: Of 500 study subjects with FGR at 20-24 weeks, 79.2% were anaemic, (53.3% had mild, 41.7% moderate, 5% severe anaemia), 20.8% nonanaemic. Amongst controls, 63.4% were anaemic, (66.2% mild, 30.5% moderate, 3.15% severe), 36.6% nonanaemic. Significantly more study subjects were anaemic, (moderately, severely) with 2.2 times more chances of anaemia in study compared to controls. 7.2% with mild, 14.5% with moderate, 43.9% with severe, 5.5% without anaemia had preterm birth, significant increase in preterm births with increasing severity of anaemia. There was significant (p<0.05) difference between mean birth weight. MBW decreasing with anemia severity. Risk for LBW, VLBW in mild, moderate, severe anaemia was 1.2 and 1.7, 3.8 and 1.5, and 1.9 and 4.2 respectively, MBW of study cases with mild anaemia was, (2085.72 ± 317.2 g), with moderate MBW, (1950.26 ± 410.3 g), with severe (1380.25 ± 480.1 g), without anaemia (2146.42 ± 279.1 g), significant difference in moderate and severe anaemia cases (p<0.01). None with anaemia at 20-24 weeks became nonanaemic with increasing gestation.
Conclusion: FGR at midgestation is significantly associated with anaemia in mother, risk of FGR increases with severity of anaemia. With FGR and anaemia risk of preterm pains, preterm births increase with increase in severity of anaemia MBW decreases. In day to day practice women with anaemia at mid gestation do not become nonanaemic. In anaemic women, FGR can occur in later weeks of pregnancy also.