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The Journal of Health, Population and Nutrition
ISSN: 1606-0997
EISSN: 1606-0997
Vol. 26, No. 2, 2008, pp. 232-240
Bioline Code: hn08025
Full paper language: English
Document type: Research Article
Document available free of charge

The Journal of Health, Population and Nutrition, Vol. 26, No. 2, 2008, pp. 232-240

 en Association between Anaemia during Pregnancy and Blood Loss at and after Delivery among Women with Vaginal Births in Pemba Island, Zanzibar, Tanzania
Kavle, Justine A.; Stoltzfus, Rebecca J.; Witter, Frank; Tielsch, James M.; Khalfan, Sabra S. & Caulfield, Laura E.


The study sought to identify determinants of blood loss at childbirth and 24 hours postpartum. The study was nested in a community-based randomized trial of treatments for anaemia during pregnancy in Wete Town, Pemba Island, Zanzibar, United Republic of Tanzania. Status of anaemia during pregnancy, nutritional information, obstetric history, and socioeconomic status were assessed at enrollment during routine antenatal care. Pregnant women presented for spontaneous vaginal delivery, and nurse-midwives collected information on labour and delivery via partograph. Blood-stained sanitary napkins and pads from childbirth and 24 hours postpartum were quantified using the alkaline hematin method. Moderateto-severe anaemia (Hb <90 g/L) at enrollment was strongly associated with blood loss at delivery and the immediate postpartum period, after adjusting for maternal covariates and variables of biological relevance to blood loss. Greater blood loss was associated (p<0.10) with duration of the first stage of labour, placental weight, receipt of oxytocin, preterm birth, and grand multiparity. The findings provide unique evidence of a previously-suspected link between maternal anaemia and greater blood loss at childbirth and postpartum. Further research is needed to confirm these findings on a larger sample of women to determine whether women with moderate-to-severe anaemia are more likely to experience postpartum haemorrhage and whether appropriate antenatal or peripartum care can affect the relationships described here.

Anaemia; Blood loss; Childbirth; Community-based studies; Delivery; Postpartum haemorrhage; Pregnancy; Vaginal birth; Tanzania

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