Objective: Evaluate the prevalence of anemia in term and preterm pregnancies and compare maternal and perinatal outcomes among groups.
Methods: Secondary analysis of Brazilian Multicenter Study on Preterm Birth (EMIP). Cross sectional study on preterm births, with sample of term births to evaluate risk factors and comparisons. Current analysis compared prevalence of anemia in term and preterm births and among their types (spontaneous preterm birth (sPTB), preterm premature rupture of membranes (pPROM), or provider initiated preterm birth (piPTB)) and between women with anemia in both groups, correlating maternal and neonatal findings. Multivariate analysis to identify conditions that independently associated to anemia in term and preterm groups was performed.
Results: Study included 3716 preterm and 1048 term births with hemoglobin level data. The prevalence of anemia was 33.23% and 27.74% in preterm and term pregnancies respectively. Anemia was higher among the pPROM group (36.3%, p=0.029). Less than 8 schooling years (p=0.003), maternal age <19 years old (p=0.047), non-white skin color (p<0.001) and children under 5 years (p<0.001) were associated with anemia and PTB. In this group, anemia was associated with adverse perinatal outcomes, including need of ventilatory support (p=0.003), sepsis (p=0.006), endocrine dysfunction (p=0.001), small for gestational age newborns (p<0.001), 5th minute Apgar score <7 (p=0.001), and neonatal death (p=0.002). Multivariate analysis showed association between living area and anemia in term group (p=0.001), urinary tract infection and anemia in sPTB and piPTBgroup (p<0.001), neonatal morbidity (p=0.001), inadequate number of prenatal care visits (p=0.009) and anemia in pPROM group.
Conclusion: Anemia was associated with poor maternal education, children below 5 years, late onset of prenatal care and less than six medical visits. Also, it is more prevalent in preterm births, especially among cases of pPROM and could be either associated to its cause or consequence, worsening an unfavorable condition.
Anemia, Pregnancy, Preterm birth, Antenatal care, Adverse neonatal outcomes