Severe anaemia doubles risk of maternal death in pregnancy: New global research findings

21 Mar 2018

Iron deficiency anaemia is the most common nutritional deficiency across the globe. People with anaemia have a lack of healthy red blood cells which can leave them feeling tired, short of breath and getting heart palpitations. For pregnant women, the effects can be deadly.

New research that we’ve funded by Queen Mary University of London shows that pregnant women with severe anaemia are twice as likely to die during or shortly after pregnancy, compared to those without the condition.

The work was an analysis of the WHO Multicountry Survey on Maternal and Newborn Health, the largest study of maternal death and severe complications in the world. Lead author Dr Jahnavi Daru used two statistical approaches to study 312,281 pregnancies across 29 countries. She says: “The burden of anaemia and associated maternal mortality rates were not robustly quantified. The objective of this work was to assess the association between severe anaemia and maternal death.

"From our analyses, irrespective of other factors, if a woman develops severe anaemia at any point in her pregnancy or in the 7 days after delivery, she is a higher risk of dying than a woman who does not have severe anaemia.”

Previous studies had suggested that anaemia was strongly associated with death, but that this was due to other clinical reasons, and not anaemia directly. This research is the first to take into account factors that influence the development of anaemia in pregnancy (such as blood loss or malaria infection) which may have been skewing the results of previous studies.

Impact of the results

Published in the The Lancet Global Health journal, the research has global impact, showing how anaemia - which affects 32 million pregnant women worldwide - is related to maternal death. This is even more important in low and middle income countries, where up to half of all pregnant women are affected by anaemia due to conditions like inherited blood disorders and infections like malaria.

Dr Daru says: “This work is important because it shows that anaemia in pregnancy, although a common condition, should be treated promptly and not allowed to worsen to a situation where it becomes severe. This work shows that irrespective of when severe anaemia is diagnosed, it is strongly related to maternal death. Preventing death of women in pregnancy and childbirth is a global priority and tackling severe anaemia may contribute to lowering maternal death rates, especially in countries with a high burden of disease.”

“Anaemia is a readily treatable condition, but the existing approaches so far have not been able to tackle the problem. Clinicians, policy makers and healthcare professionals should now focus their attention on preventing anaemia, using a multifaceted approach, not just hoping that iron tablets will solve the problem.”

Charity funding

Dr Daru was awarded an Academic Clinical Fellow grant from us in 2015 which enabled her to spend time at the WHO headquarters in Geneva and work with a group of international researchers to conduct this project. She is part of Queen Mary’s Barts Research Centre for Women’s Health (BARC), pictured above, who received a £2m grant from us in 2017 for research into reproductive health, pregnancy and childbirth. The BARC team will also benefit from the charity-funded remodelling of the Women’s and Neonatal Unit at Whipps Cross Hospital, which will provide new dedicated space for research, making it easier for the 50,000 women expected to visit over the next ten years to take part in clinical trials.

Our Director of Grants, Francesca Gliubich adds: “Barts Charity are proud of having contributed to this work. The research will help to shape health policies worldwide by providing scientific evidence of the importance of prevention and treatment of maternal anaemia, ultimately saving lives and avoiding preventable deaths."

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