Association of Gestational Anemia with Pregnancy-Induced Hypertension in a Private Hospital Maternity Care : Gestational Anemia with Pregnancy-Induced Hypertension

Kainaat Zafar; Saba Anam; Amina Shahid; Hala Shahid

doi:10.54393/pjhs.v4i12.1235

Authors

Kainaat Zafar Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
Saba Anam Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
Amina Shahid Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
Hala Shahid Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i12.1235

Keywords:

Anemia, Preeclampsia, Hemoglobin, Trophoblast Cells

Abstract

Anemia, a prevalent global health concern affecting a quarter of the world's population, notably impacts pregnant women, with approximately 56 million affected globally. Its repercussions on maternal and neonatal health are extreme, leading to increased risks of low birth weight, fetal complications, and maternal morbidity and mortality. Concurrently, pregnancy-induced hypertension (PIH) poses significant risks to maternal and fetal well-being, yet the link between anemia and PIH remains an understudied area, particularly in Pakistan. Objective: To investigate the association between anemia and the heightened risk of PIH, offering critical insights into perinatal outcomes. Methods: A retrospective study was designed and the data was collected from Hijaz Hospital Gulberg III Lahore, Pakistan. Total 120 pregnant women were selected for the study and split into two groups. Group A consisted of 65 pregnant women with hypertension, whereas group B included 55 non-hypertensive pregnant women. Hemoglobin levels and Complete Blood Count were evaluated using standard protocols. The association of hemoglobin levels and PIH was investigated using independent-students test and one-way ANOVA by utilizing SPSS version-25. Results: Our findings showed that the hemoglobin levels were lowest (9.953846±1.924584 g/dl) in hypertensive women as compared to no-hypertensive women (11.52±1.584172) in their 3rd trimester. It coincided with the lowest number of red blood cells (4.1067±0.57816 million/mm3) in women with hypertension. Conclusions: Our finding demonstrated that the lower the levels of hemoglobin, the higher the risk of PIH.

References

Zekarias B, Meleko A, Hayder A, Nigatu A, Yetagessu T. Prevalence of anemia and its associated factors among pregnant women attending antenatal care (ANC) in Mizan Tepi University Teaching Hospital, South West Ethiopia. Health Science Journal. 2017 Oct; 11(5): 1-8. doi: 10.21767/1791-809X.1000529. DOI: https://doi.org/10.21767/1791-809X.1000529

Juárez-Cedillo T, Basurto-Acevedo L, Vega-García S, Manuel-Apolinar L, Cruz-Tesoro E, Rodríguez-Pérez JM, et al. Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study. Annals of Hematology. 2014 Dec; 93: 2057-62. doi: 10.1007/s00277-014-2155-4. DOI: https://doi.org/10.1007/s00277-014-2155-4

Abdulwahid RG and Ahmed HM. Nutritional characteristics of pregnant women and its relation with anemia during pregnancy in a sample of Kurdish women/Iraq. Cihan University-Erbil Scientific Journal. 2020 Jan; 4(1): 37-44. doi: 10.24086/cuesj.v4n1y2020.pp37-44. DOI: https://doi.org/10.24086/cuesj.v4n1y2020.pp37-44

De-Regil LM, Harding KB, Roche ML. Preconceptional nutrition interventions for adolescent girls and adult women: global guidelines and gaps in evidence and policy with emphasis on micronutrients. The Journal of Nutrition. 2016 Jul; 146(7): 1461S-70S. doi: 10.3945/jn.115.223487. DOI: https://doi.org/10.3945/jn.115.223487

Ali AA, Rayis DA, Abdallah TM, Elbashir MI, Adam I. Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan. BMC Research Notes. 2011 Dec; 4(1): 1-5. doi: 10.1186/1756-0500-4-311. DOI: https://doi.org/10.1186/1756-0500-4-311

Karegoudar DJ. Evaluation of Prevalence of Pregnancy Induced Hypertension and Its Associated Factors Among Women at a Tertiary Care Centre. International Journal of Life Sciences Biotechnology and Pharma Research. 2020 Feb; 9(1): 5-7.

Bergen NE, Schalekamp-Timmermans S, Roos-Hesselink J, Roeters van Lennep JE, Jaddoe VV, Steegers EA. Hypertensive disorders of pregnancy and subsequent maternal cardiovascular health. European Journal of Epidemiology. 2018 Aug; 33: 763-71. doi: 10.1007/s10654-018-0400-1. DOI: https://doi.org/10.1007/s10654-018-0400-1

Srivastava T, Negandhi H, Neogi SB, Sharma J, Saxena R. Methods for hemoglobin estimation: A review of" what works. Journal of Hematology & Transfusion. 2014 Nov; 2(3): 1028.

Abid F, Ali R, Tahir MM, Siddique K. A Cross-Sectional Study to Assess the Dietary Intake and Habits of Expecting Women with Anemia. Annals of Punjab Medical College (APMC). 2019 Sep; 13(2): 160-3.

Mozos I. Mechanisms linking red blood cell disorders and cardiovascular diseases. BioMed Research International. 2015 Oct; 2015; 682054. doi: 10.1155/2015/682054. DOI: https://doi.org/10.1155/2015/682054

Weiss G. Anemia of chronic disorders: new diagnostic tools and new treatment strategies. Seminars in Hematology. 2015 Oct; 52(4): 313-20. doi: 10.1053/j.seminhematol.2015.07.004. DOI: https://doi.org/10.1053/j.seminhematol.2015.07.004

Zohora F, Bidad K, Pourpak Z, Moin M. Biological and immunological aspects of iron deficiency anemia in cancer development: a narrative review. Nutrition and Cancer. 2018 May; 70(4): 546-56. doi: 10.1080/01635581.2018.1460685. DOI: https://doi.org/10.1080/01635581.2018.1460685

He GL, Sun X, Tan J, He J, Chen X, Liu CX, et al. Survey of prevalence of iron deficiency and iron deficiency anemia in pregnant women in urban areas of China. Zhonghua fu Chan ke za zhi. 2018 Nov; 53(11): 761-7.

Tang YM, Chen XZ, Li GR, Zhou RH, Ning H, Yan H. Effects of iron deficiency anemia on immunity and infectious disease in pregnant women. Wei sheng yan jiu= Journal of Hygiene Research. 2006 Jan; 35(1): 79-81.

Chakraborty D, Cui W, Rosario GX, Scott RL, Dhakal P, Renaud SJ, et al. HIF-KDM3A-MMP12 regulatory circuit ensures trophoblast plasticity and placental adaptations to hypoxia. Proceedings of the National Academy of Sciences. 2016 Nov; 113(46): E7212-21. doi: 10.1073/pnas.1612626113. DOI: https://doi.org/10.1073/pnas.1612626113

Awad O, Ochieng SJ, Malek A, Ogeng’o J. Chronic anaemia causes degenerative changes in trophoblast cells of the rat placenta. Anatomy. 2017 Aug; 11(2): 72-8. doi: 10.2399/ana.17.013. DOI: https://doi.org/10.2399/ana.17.013

Labarrere CA, DiCarlo HL, Bammerlin E, Hardin JW, Kim YM, Chaemsaithong P, et al. Failure of physiologic transformation of spiral arteries, endothelial and trophoblast cell activation, and acute atherosis in the basal plate of the placenta. American Journal of Obstetrics and Gynecology. 2017 Mar; 216(3): 287-e1. doi: 10.1016/j.ajog.2016.12.029. DOI: https://doi.org/10.1016/j.ajog.2016.12.029

Lewandowska M, Sajdak S, Lubiński J. Can serum iron concentrations in early healthy pregnancy be risk marker of pregnancy-induced hypertension? Nutrients. 2019 May; 11(5): 1086. doi: 10.3390/nu11051086. DOI: https://doi.org/10.3390/nu11051086

Johnson A, Vaithilingan S, Avudaiappan SL, Vaithilingan Sr S. The Interplay of Hypertension and Anemia on Pregnancy Outcomes. Cureus. 2023 Oct; 15(10). doi: 10.7759/cureus.46390. DOI: https://doi.org/10.7759/cureus.46390

Asres AW, Samuel S, Daga WB, Tena A, Alemu A, Workie SB, et al. Association between iron-folic acid supplementation and pregnancy-induced hypertension among pregnant women in public hospitals, Wolaita Sodo, Ethiopia 2021: a case-control study. BMC Public Health. 2023 Dec; 23(1): 1-1. doi: 10.1186/s12889-023-15794-6. DOI: https://doi.org/10.1186/s12889-023-15794-6