Association of maternal anemia with other risk factors in occurrence of Great obstetrical syndromes at university clinics, Kinshasa, DR Congo

BACKGROUND Maternal anemia, a common situation in developing countries, provokes impairment of nutrients/oxygen supply to the placenta-fetus unit that leads to Great obstetrical syndromes (GOS). In our setting, however, occurrence of GOS has been found also depending on variables existing prior to pregnancy such as diabetes in family, hypertension in family, previous macrosomia, stillbirth, SGA and pre-eclampsia as well as overweight/obesity. Our study thus aimed to determine the magnitude of maternal anemia and its association with these pre-pregnancy high-risk variables in occurrence of GOS. METHODS This is a cross-sectional study including women delivered at the University Clinics of Kinshasa, DR Congo, 12. during 18 months. Anemia was stated at hemoglobin blood concentration < 10 g/dL. Sampled women were checked for pregnancy high-risk factors and pregnancy complications. Odds ratios (95% confidence intervals) were calculated to establish associations of anemia with various variables. Multivariate calculations aimed to isolate variables influencing these associations. The p <0.05 was considered significant. RESULTS The study sample included 412 women, among whom 220 (53.4%) were diagnosed anemic. Anemia was found significantly linked to malaria, urinary infection, cesarean section, prematurity, SGA and stillbirth whose risk was 1.6 - 6.1 times augmented. Anemia was also found linked to pre-pregnancy high-risk factors such as age < 18 and ≥ 35 years, previous miscarriage, grand multiparity, diabetes in family, previous prematurity, overweight/obesity, previous cesarean section and previous pre-eclampsia, all of them enhancing the link of maternal anemia with complications. CONCLUSION Maternal anemia is very prevalent among pregnant women of our setting. It strongly contributes to worsening of morbidities that act with pregnancy high-risk factors in raising the risk of cesarean section, prematurity, SGA and stillbirth.