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Maternal anemia and blood loss at childbirth and postpartum in Pemba Island, Zanzibar, Tanzania
Author(s) -
Kavle Justine Avinash,
Stoltzfus Rebecca J.,
Tielsch James R.,
Khalfan Sabra Said,
Caulfield Laura E.
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a614
Subject(s) - tanzania , childbirth , obstetrics , medicine , anemia , pregnancy , geography , environmental planning , biology , genetics
Severe bleeding at childbirth or postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. Anemia is purported to contribute to PPH, however, the relationship between blood loss and maternal anemia has not been examined. A study of these relationships requires a reliable, valid technique to measure blood loss and a setting where maternal anemia is prevalent. The study objectives were to quantify blood loss at childbirth and 24‐hours postpartum and to evaluate determinants of blood loss. This study was nested within a community‐based trial evaluating treatments to prevent severe anemia. Participants from antenatal clinics provided prenatal blood draws and presented for childbirth at a government hospital. We quantified blood loss using the alkaline hematin method. Approximately 61% of women were anemic during pregnancy. Our blood loss estimates, median (5th‐ 95th percentiles) for delivery, postpartum and in total were 153 mL, (21 – 416), 112 mL (43 – 242), and 286 mL (97 – 579). Moderate to severely anemic women had greater blood loss, (91 mL), than non‐anemic women (p < 0.01). These findings have implications for treatment strategies alleviating maternal anemia. Future research may extend the alkaline hematin technique to elucidate risk factors for blood loss in home deliveries and to evaluate methods for the reduction of blood loss and prevention of postpartum hemorrhage.