Prenatal Anemia and Risk of Postpartum Hemorrhage Following Normal Vaginal Delivery of Patients Presenting to Mufti Mehmood Memorial Teaching Hospital, Gomal Medical College, D.I. Khan
DOI:
https://doi.org/10.70749/ijbr.v3i6.2628Keywords:
Anemia, Hemorrhage, Obstetrics, Pregnancy, Risk Factors, Vaginal Delivery.Abstract
Background: Prenatal anemia is very common in pregnant women because many women start pregnancy with low iron in the body and poor diet. When the level of hemoglobin becomes low, the mother cannot carry good oxygen, and this makes her weak, tired, and more at risk during childbirth. Women who have anemia before giving birth cannot handle blood loss well, so the danger of postpartum hemorrhage becomes very high. Objective: To determine the frequency of postpartum hemorrhage in pregnant women presenting with prenatal anemia following normal vaginal delivery. Study Design: Cross sectional research study. Duration and Place of Study: This study was done from October 2024 to April 2025 in the Department of Obstetrics and Gynaecology, Gomal Medical College, Dera Ismail Khan. Methodology: A total of 146 pregnant women aged 15 to 45 years with prenatal anemia and normal vaginal delivery were included. Hemoglobin values were checked, and blood loss after delivery was recorded. Postpartum hemorrhage was defined as blood loss equal to or more than 500 milliliters in the first twenty-four hours after delivery. Chi-square test and Fisher exact test were used for finding association, and a p-value less than or equal to 0.05 was taken as significant. Results: The mean age was 31.62 years, and the mean hemoglobin was 9.14 grams per deciliter. Postpartum hemorrhage happened in 32 women (21.90%), while 114 women (78.10%) did not have postpartum hemorrhage. Women aged thirty years or less had postpartum hemorrhage in 28.4% cases, and women above thirty years had 16.5% cases (p = 0.083). Rural women showed more postpartum hemorrhage (26.1%) than urban women (15.5%) (p = 0.129). Socioeconomic groups also showed differences, but these were not significant (p = 0.134). Conclusion: This study shows that postpartum hemorrhage was high in women who had prenatal anemia.
Downloads
References
1. Zych-Krekora, K., Sylwestrzak, O., & Krekora, M. (2025). The critical role of iron in pregnancy, puerperium, and fetal development. Journal of Clinical Medicine, 14(10), 3482.
https://doi.org/10.3390/jcm14103482
2. Obeagu, G. U., Altraide, B. O., & Obeagu, E. I. (2025). Iron deficiency anemia in pregnancy and related complications with specific insight in Rivers State, Nigeria: A narrative review. Annals of Medicine & Surgery, 87(6), 3435-3444.
https://doi.org/10.1097/ms9.0000000000003224
3. Alemu, G. G., Adugna, D. G., Mesfin, A., Agimas, M. C., Baffa, L. D., Abuhay, H. W., Aweke, M. N., Alemu, T. G., & Baykemagn, N. D. (2025). Adherence to iron-folic acid supplementation and its associated factors among pregnant women in Kenya: A multilevel data analysis of the 2022 Kenyan demographic and health survey. PLOS One, 20(8), e0329458.
https://doi.org/10.1371/journal.pone.0329458
4. Ramasauskaite, D., Schlembach, D., Ubom, A. E., Nieto‐Calvache, A. J., Evans, C., Gülmezoglu, A. M., Beyeza‐Kashesya, J., Jacobsson, B., & Wright, A. (2025). FIGO call to action: multisectoral approach to postpartum hemorrhage. International Journal of Gynecology & Obstetrics, 171(1), 45-53.
https://doi.org/10.1002/ijgo.70449
5. Alonso-Burgos, A., Díaz-Lorenzo, I., Muñoz-Saá, L., Gallardo, G., Castellanos, T., Cardenas, R., & Chiva de Agustín, L. (2024). Primary and secondary postpartum haemorrhage: A review for a rationale endovascular approach. CVIR Endovascular, 7(1).
https://doi.org/10.1186/s42155-024-00429-7
6. Mohamed, T. A., & Chandraharan, E. (2024). Recognition and management of postpartum hemorrhage. Maternal-Fetal Medicine, 7(1), 29-37.
https://doi.org/10.1097/fm9.0000000000000256
7. Hamdan, M., Lim, C., Tang, B. N., Abdul Hamid, H., Narayanan, V., Abdul Ghani, N. A., Ismail, M. P., Selvaratnam, V., Wadhawan, S., & Mukherjee, D. (2025). Postpartum haemorrhage burden, management and challenges in Malaysia: A scoping review and expert recommendations for effective management. Cureus.
https://doi.org/10.7759/cureus.89915
8. Aimagambetova, G., Bapayeva, G., Sakhipova, G., & Terzic, M. (2024). Management of postpartum hemorrhage in low- and middle-income countries: Emergency need for updated approach due to specific circumstances, resources, and availabilities. Journal of Clinical Medicine, 13(23), 7387.
https://doi.org/10.3390/jcm13237387
9. Mansukhani, R., Shakur-Still, H., Chaudhri, R., Bello, F., Muganyizi, P., Kayani, A., Javaid, K., Okunade, O., Olayemi, O., Kawala, A., Temba, R., Bashir, A., Geer, A., Islam, A., Prowse, D., Balogun, E., Joseph, F., Yasmin, H., Khakwani, M., … Roberts, I. (2023). Maternal anaemia and the risk of postpartum haemorrhage: A cohort analysis of data from the WOMAN-2 trial. The Lancet Global Health, 11(8), e1249-e1259.
https://doi.org/10.1016/s2214-109x(23)00245-0
10. Brenner, A. C., Roberts, I., Balogun, E., Bello, F. A., Chaudhri, R., Fleming, C., Javaid, K., Kayani, A., Lubeya, M. K., Mansukhani, R., Olayemi, O., Prowse, D., Vwalika, B., & Shakur-Still, H. (2021). Postpartum haemorrhage in anaemic women: Assessing outcome measures for clinical trials.
https://doi.org/10.21203/rs.3.rs-868584/v1
11. Ende, H. B., Lozada, M. J., Chestnut, D. H., Osmundson, S. S., Walden, R. L., Shotwell, M. S., & Bauchat, J. R. (2021). Risk factors for atonic postpartum hemorrhage. Obstetrics & Gynecology, 137(2), 305-323.
https://doi.org/10.1097/aog.0000000000004228
12. Omotayo, M. O., Abioye, A. I., Kuyebi, M., & Eke, A. C. (2021). Prenatal anemia and postpartum hemorrhage risk: A systematic review and meta‐analysis. Journal of Obstetrics and Gynaecology Research, 47(8), 2565-2576.
https://doi.org/10.1111/jog.14834
13. Abdilahi, M. M., Kiruja, J., Farah, B. O., Abdirahman, F. M., Mohamed, A. I., Mohamed, J., & Ahmed, A. M. (2024). Prevalence of anemia and associated factors among pregnant women at Hargeisa group hospital, Somaliland. BMC Pregnancy and Childbirth, 24(1).
https://doi.org/10.1186/s12884-024-06539-3
14. Qasim, M. T. (2024). Effect of anemia in pregnancy on postpartum hemorrhage [dissertation]. Diyala University.
15. Adnan, Z., Nayyar, A., Nayyar, S., & Mehraj, A. (2018). Feto-Maternal Outcome in Pregnancy with Anemia. Journal of Islamic International Medical College (JIIMC), 13(2), 57-61.
https://journals.riphah.edu.pk/index.php/jiimc/article/view/1030
16. Feng, N., & Huang, X. (2023). Investigation and analysis of high-risk factors of postpartum hemorrhage in singleton primiparous women: a cross-sectional study. Int J Clin Exp Med, 16(2), 31-40.
https://e-century.us/files/ijcem/16/2/ijcem0136496.pdf
17. Tabraiz, I., & Awan, A. S. (2012). Frequency of postpartum haemorrhage in caesarean section in anaemic and non anaemic patients. J Islamabad Med Dental Coll, 1, 125-8.
18. Ashraf, B. (2023). Frequency of anemia and associated risk factors among pregnant women; a study from the remote outskirts of Quetta, Balochistan. Journal of The Society of Obstetricians and Gynaecologists of Pakistan, 13(2), 82-86.
https://www.jsogp.net/index.php/jsogp/article/view/626
19. Habtamu, G., Talie, A., Kassa, T., & Belay, D. M. (2025). Prevalence and associated factors of postpartum anemia after cesarean delivery in public hospitals of Awi zone, north west Ethiopia, 2023; a cross-sectional study. PLOS ONE, 20(1), e0311907.
https://doi.org/10.1371/journal.pone.0311907
20. Arshad, H., Amin, N., Shah, M. H., Gul, S., & Shahrukh. (2025). Maternal and fetal outcome in women with placenta Previa presenting at Mardan medical complex. Journal of Bacha Khan Medical College, 6(01), 68-76.
https://doi.org/10.69830/jbkmc.v6i1.227
21. Bai, P. (2022). Postpartum Hemorrhage After Cesarean Section In Anemic and Non Anemic Patients. Journal of Surgery Pakistan, 27(2), 65-69.
https://www.jsp.org.pk/index.php/jsp/article/view/319
22. Fayyaz, S., Faiz, N. R., Rahim, R., & Fawad, K. (2011). Frequency of postpartum haemorrhage in maternal mortality in a tertiary care hospital. Journal of Postgraduate Medical Institute, 25(3).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
