Frequency of Post Partum Hemorrhage among Pregnant Women with Anemia

Authors

  • Sadyia Gul Department of Obstetrics and Gynecology, Mardan Medical Complex, Mardan, KP, Pakistan.
  • Naila Department of Obstetrics and Gynecology, Mardan Medical Complex, Mardan, KP, Pakistan.
  • Asia Habib Department of Obstetrics and Gynaecology, Rehman Medical Institute Peshawar, KP, Pakistan.
  • Sharukh Department of Obstetrics and Gynecology, Mardan Medical Complex, Mardan, KP, Pakistan.
  • Huma Arshad Department of Obstetrics and Gynecology, Mardan Medical Complex, Mardan, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i6.1992

Keywords:

Anemia, Pregnancy, Postpartum Hemorrhage

Abstract

Background: Anemia in pregnancy is a prevalent maternal health issue in low- and middle-income countries, contributing significantly to maternal morbidity and mortality. It increases the risk of postpartum hemorrhage (PPH), a leading cause of maternal deaths, particularly in resource-limited settings like Mardan. While the link between anemia and PPH is well established, region-specific data remain scarce. Objective: To determine the frequency of post-partum hemorrhage among pregnant women with anemia. Study Design: Cross-sectional study. Duration and Place of Study: This study was conducted at the Department of Obstetrics and Gynecology, Mardan Medical Complex, from October 2024 to April 2025. Methodology: A total of 157 pregnant women with third-trimester anemia (Hb <12.0 g/dL) were enrolled. Women with renal disease, hepatitis B/C, or irregular menstrual cycles were excluded. Blood loss was assessed after delivery using pad weight method, with PPH defined as blood loss >500 mL. Demographic and clinical data were recorded. Results: The mean age was 29.41±6.51 years, with a mean hemoglobin level of 10.05±0.97 g/dL and blood loss of 373.59±122.21 mL. PPH occurred in 17 out of 157 women (10.8%). A statistically significant association was observed between BMI and PPH (p<0.001), with lower BMI (≤25 kg/m²) showing higher risk. Conclusion: Postpartum hemorrhage occurs in approximately one in ten anemic pregnant women, with lower BMI emerging as a significant risk factor.

Downloads

Download data is not yet available.

References

1. Azzam, A., Khaled, H., Alrefaey, A. K., Basil, A., Ibrahim, S., Elsayed, M. S., Khattab, M., Nabil, N., Abdalwanees, E., & Halim, H. W. (2025). Anemia in pregnancy: A systematic review and meta-analysis of prevalence, determinants, and health impacts in Egypt. BMC Pregnancy and Childbirth, 25(1).

https://doi.org/10.1186/s12884-024-07111-9

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. Zhang, J., Li, Q., Song, Y., Fang, L., Huang, L., & Sun, Y. (2022). Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis. Frontiers in Public Health, 10.

https://doi.org/10.3389/fpubh.2022.1041136

4. Smith, J. S., Bullens, L. M., Van der Hout-van der Jagt, M. B., Van Runnard Heimel, P. J., & Oei, S. G. (2022). Effect of intrapartum maternal hemoglobin on mode of delivery and short-term neonatal outcome: A systematic review. Obstetrical & Gynecological Survey, 77(10), 595-605.

https://doi.org/10.1097/ogx.0000000000001074

5. Shi, H., Chen, L., Wang, Y., Sun, M., Guo, Y., Ma, S., Wang, X., Jiang, H., Wang, X., Lu, J., Ge, L., Dong, S., Zhuang, Y., Zhao, Y., Wei, Y., Ma, X., & Qiao, J. (2022). Severity of anemia during pregnancy and adverse maternal and fetal outcomes. JAMA Network Open, 5(2), e2147046.

https://doi.org/10.1001/jamanetworkopen.2021.47046

6. Loechl, C. U., Datta-Mitra, A., Fenlason, L., Green, R., Hackl, L., Itzkowitz, L., Koso-Thomas, M., Moorthy, D., Owino, V. O., Pachón, H., Stoffel, N., Zimmerman, M. B., & Raiten, D. J. (2023). Approaches to address the anemia challenge. The Journal of Nutrition, 153, S42-S59.

https://doi.org/10.1016/j.tjnut.2023.07.017

7. Khaskheli, M., Baloch, S., Baloch, A. S., Baloch, S., & Khaskheli, F. K. (2016). Iron deficiency anaemia is still a major killer of pregnant women. Pakistan Journal of Medical Sciences, 32(3).

https://doi.org/10.12669/pjms.323.9557

8. De Moor, V., Mesens, T., Soulliaert, S., Van der Merwe, H., Vergote, S., Verheecke, M., Page, G., & Lewi, L. (2025). Iron deficiency anaemia (IDA) in pregnancy: Screening and management. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 27, 100402.

https://doi.org/10.1016/j.eurox.2025.100402

9. Fenn, M. G., Al Falahi, M., Al Hannai, T., Al Shukaili, L., & Al Riyami, N. (2024). Postpartum hemorrhage following vaginal and cesarean section deliveries at a single tertiary hospital: A five-year cross-sectional study. Oman Medical Journal, 39(6), e695-e695.

https://doi.org/10.5001/omj.2024.116

10. 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

11. Pettersen, S., Falk, R. S., Vangen, S., & Nyfløt, L. T. (2025). Tone or tissue? A comparison of trends and risk factors of severe postpartum hemorrhage according to uterine atony or retained tissue in a hospital setting. PLOS ONE, 20(2), e0318770.

https://doi.org/10.1371/journal.pone.0318770

12. Khezri, R., Rezaei, F., Jahanfar, S., & Ebrahimi, K. (2025). Association between maternal anemia during pregnancy with low birth weight their infants. Scientific Reports, 15(1).

https://doi.org/10.1038/s41598-025-91316-1

13. Engidaw, M. T., Lee, P., & Ahmed, F. (2025). Iron and folic acid supplementation compliance during pregnancy and its effect on post-pregnancy anaemia among reproductive-age women in East Africa. Women's Health, 21.

https://doi.org/10.1177/17455057251317547

14. Jones, A. J., Federspiel, J. J., & Eke, A. C. (2023). Preventing postpartum hemorrhage with combined therapy rather than oxytocin alone. American Journal of Obstetrics & Gynecology MFM, 5(2), 100731.

https://doi.org/10.1016/j.ajogmf.2022.100731

15. Naz, S., Shahid, S., Noorani, S., Fatima, I., Jaffar, A., Kashif, M., Yazdani, N., Khan, U., Rizvi, A., Nisar, M. I., Jehan, F., & Hoodbhoy, Z. (2024). Management of iron deficiency anemia during pregnancy: A midwife-led continuity of care model. Frontiers in Nutrition, 11.

https://doi.org/10.3389/fnut.2024.1400174

16. Bambo, G. M., Kebede, S. S., Sitotaw, C., Shiferaw, E., & Melku, M. (2023). Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, northwest Ethiopia: A facility-based, cross-sectional study. Frontiers in Medicine, 10.

https://doi.org/10.3389/fmed.2023.1105307

17. Brenner, A., 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. (2022). Postpartum haemorrhage in anaemic women: Assessing outcome measures for clinical trials. Trials, 23(1).

https://doi.org/10.1186/s13063-022-06140-z

18. Kodan, L. R., Verschueren, K. J. C., Prüst, Z. D., Zuithoff, N. P. A., Rijken, M. J., Browne, J. L., Klipstein-Grobusch, K., Bloemenkamp, K. W. M., & Grunberg, A. W. (2020). Postpartum hemorrhage in Suriname: A national descriptive study of hospital births and an audit of case management. PLOS ONE, 15(12), e0244087.

https://doi.org/10.1371/journal.pone.0244087

19. Kebede, B. A., Abdo, R. A., Anshebo, A. A., & Gebremariam, B. M. (2019). Prevalence and predictors of primary postpartum hemorrhage: An implication for designing effective intervention at selected hospitals, Southern Ethiopia. PLOS ONE, 14(10), e0224579.

https://doi.org/10.1371/journal.pone.0224579

20. Huwaida, H. A. (2024). Relationship between anemia in pregnancy and postpartum hemorrhage. World Journal of Advanced Research and Reviews, 24(3), 753-758.

https://doi.org/10.30574/wjarr.2024.24.3.3728

21. 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.

https://jimdc.org.pk/jimdc/Volumes/1-3/5-Frequency%20of%20Postpartum%20Haemorrhage%20in%20Caesarean%20Section%20in%20Anaemic%20and%20Non%20Anemic%20Patients.pdf

22. Alshahrani, M., Al Mansour, A., Alkazaim, S., Alshamrani, S., Alyami, N., Alessa, M., Alwadai, N., AL Mustanyir, H., Alrefaei, A., & Al-shadadi, F. (2025). Prevalence of postpartum anemia and associated risk factors in Najran hospitals, Saudi Arabia; A retrospective observational study. International Journal of Women's Health, 17, 681-693.

https://doi.org/10.2147/ijwh.s503671

Downloads

Published

2025-06-30

How to Cite

Gul, S., Naila, Habib, A., Sharukh, & Arshad, H. (2025). Frequency of Post Partum Hemorrhage among Pregnant Women with Anemia. Indus Journal of Bioscience Research, 3(6), 953-957. https://doi.org/10.70749/ijbr.v3i6.1992