Maternal anaemia after delivery: prevalence and risk factors

Abstract

The purpose of this study was to assess the prevalence of postpartum anaemia and determine the clinical risk factors for this condition to provide a viable alternative to postpartum haemoglobin measurement. In total, 1415 patients at Hospital Universitario del Tajo, Madrid, who underwent postpartum haemoglobin testing were included, and risk factors for having an Hb level <10 g/dl were determined. We found that 29% of the mothers were anaemic, and birth canal lacerations, caesarean delivery, episiotomy and South American origin were identified as the main risk factors for this condition. When we examined the performance of each risk factor alone in the prediction of postpartum anaemia, none of them achieved a sensitivity of 30%. Selective screening of women who had any of these five risk factors resulted in 23% of cases remaining unidentified. Despite the high incidence and disease burden of this condition, the management of puerperal anaemia is not standardised, and this condition is not easy to predict. Universal screening should be considered in high-prevalence settings.

Impact statement

• The World Health Organisation (WHO) describes the postnatal period as the most critical and yet most neglected phase in the lives of mothers and infants. It is a common knowledge that a woman’s adjustment to life with her new infant is very difficult. This period, known as the puerperium, often involves poor sleep quality, pain and fatigue, if not other major complications.

• In this context, we must face the challenge of increasing breastfeeding rates, which is why health care providers should be aware of the medical and psychological needs of the new mother.

• This work reports that postpartum anaemia, a potentially preventable or treatable condition that can make it more difficult to resume everyday activities, is highly prevalent.

• It remains to be seen whether ensuring the appropriate diagnosis and treatment of anaemia after delivery will result in improvements in the physical and psychological well-being of obstetric patients.

Keywords:

• Postpartum
• anaemia
• blood loss
• haemoglobin
• screening

Disclosure statement

The authors report no conflicts of interest.