Association of Maternal Anemia and Adverse Fetal Birth Outcomes Among Women Who Gave Birth at Public Hospitals in Southern Ethiopia: An Unmatched Case-Control Study.

BACKGROUND

In Ethiopia, approximately 10% of births are affected by adverse fetal birth outcomes. Yet, data was limited on the relationship of anemia with adverse fetal birth outcomes in Ethiopia, particularly in the study region. This study reported the association of maternal anemia and adverse fetal birth outcomes among women who gave birth at public hospitals in southern Ethiopia.

METHODS

A multicenter, unmatched case-control study was conducted from May 28 to July 27, 2024, in four selected public hospitals in the study region. Data was collected using a structured and pretested questionnaire. A total of 433 participants were randomly selected, where 152 were cases and 281 were controls. The logistic regression model was fitted to detect statistical associations between the outcome and predictors at a P value of < 0.05.

RESULTS

The majority of participants were in the age range of 20-35 years. Types of adverse fetal birth outcomes reported range from 10 (2.3%) others (asphyxia, anomaly, and post-term births) to 53 (12.2%) low birth weights. The overall anemic participants (anemia immediately before birth) among cases were 68 (44.7%), and controls were 48 (17.1%). The proportion of anemia status was highest with the stillbirths, 19 (73.1%), and lowest with the preterm births, 4 (20%). Participants with anemia status (immediately before birth) were 2.19 (95% CI: 1.26, 3.80) times more likely to have adverse fetal birth outcomes than non-anemia. Participants who have better adherence to iron-folic acid supplementations during pregnancy were 52% (AOR: 0.48; 95% CI: 0.28, 0.80) less likely to face adverse fetal birth outcomes. Participants who had a low level of educational attainment, a previous history of adverse fetal birth outcomes, and intermenstrual bleeding (current history) were likely to face adverse fetal birth outcomes in the current birth.

CONCLUSIONS

Anemia has an association with adverse fetal birth outcomes. Adherence to iron-folic acid in pregnancy had a protective association with adverse fetal birth outcomes. Interventions to facilitate anemia prevention strategies in pregnancy should be encouraged.