Background: Iron deficiency anemia (IDA) is the most common micronutrient deficiency globally, particularly prevalent among pregnant women in developing countries, and is a significant contributor to adverse feto-maternal health outcomes. This study aimed to determine the prevalence of IDA in early pregnancy, identify associated risk factors, and assess its impact on subsequent adverse perinatal outcomes in a cohort of women at a tertiary care center.
Methods: This was a prospective cohort study conducted at Kanachur Institute of Medical Sciences, Mangalore, from January 2024 to December 2024. A total of 420 pregnant women presenting before 20 weeks of gestation were enrolled. IDA was defined as hemoglobin (Hb) < 11.0 g/dL and serum ferritin < 30 mug/L. Participants were stratified into IDA and Non-Anemic/Non-Iron Deficient groups and followed until delivery. Outcome measures included Preterm Premature Rupture of Membranes (PPROM), Preterm Birth (PRE TERM LABOUR), Low Birth Weight (LBW), and Postpartum Hemorrhage (PPH). Statistical analysis utilized chi^2 tests, Student's t-tests, and binary logistic regression.
Results: The prevalence of IDA in the early pregnancy cohort was 30.95% (n=130). Significant predictors of IDA included lower socio-economic status (p<0.001), higher parity (p=0.015), and delayed initiation of antenatal care (p=0.005). The IDA group exhibited significantly higher rates of adverse outcomes compared to the control group: PRE TERM LABOUR (16.9% vs. 7.9%; p=0.005), LBW (21.5% vs. 10.7%; p=0.004), and PPH (10.8% vs. 4.8%; p=0.021). Multivariate logistic regression confirmed IDA as an independent risk factor for the composite adverse perinatal outcome (Adjusted Odds Ratio (AOR) 2.21, 95% CI 1.35-3.62; p=0.001), adjusting for maternal age, parity, and BMI.
Conclusion: Iron deficiency anemia in early pregnancy is highly prevalent and is an independent, modifiable risk factor significantly associated with adverse perinatal outcomes. Early screening, aggressive iron supplementation, and nutritional education are critical interventions required to mitigate these risks in high-prevalence settings.
International Journal of Clinical Obstetrics and Gynaecology
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