Anemia, a condition characterized by a less than the adequate number of red blood cells or low oxygen-carrying capacity, has been strongly linked to postpartum hemorrhage (PPH), severe vaginal bleeding that can occur after childbirth. This link was uncovered in a recent study titled ‘Maternal anemia and the risk of postpartum hemorrhage: a cohort analysis of data from the WOMAN-2 trials’, published in The Lancet Journal.
Data from WOMAN-2 Trials
The WOMAN-2 trial, which formed the basis of this study, involved the participation of women suffering from moderate or severe anemia from hospitals in Pakistan, Nigeria, Tanzania, and Zambia. These women were observed during their vaginal births, and the data collected was used in this study.
Understanding Postpartum Hemorrhage
Postpartum Hemorrhage (PPH) is a condition marked by severe vaginal bleeding after childbirth. PPH is categorized as either WHO-defined postpartum hemorrhage (estimated blood loss of at least 500 mL) or calculated postpartum haemorrhage (blood loss of more than or equal to 1,000 mL). It’s potentially fatal and can cause other symptoms like dizziness, feeling faint, and blurred vision.
Findings of the Study
The study found a direct relationship between anemia and PPH. For instance, estimated blood loss was 301 mL for women with moderate anemia and 340 mL for women with severe anemia. Moreover, the risk of clinical postpartum hemorrhage was 6.2% for women with moderate anemia and 11.2% for women with severe anemia.
Anemia and Pregnancy
Globally, over half a billion women of reproductive age suffer from anemia. It’s estimated that approximately 70,000 postpartum deaths occur annually, largely in low- and middle-income countries.
Blood Loss and Shock
Lower hemoglobin values, indicative of anemia, are associated with increased blood loss and clinical PPH. Anemic individuals are more prone to shock due to their reduced oxygen-carrying capacity.
Recommendations to Reduce PPH
To prevent PPH, the World Health Organization recommends certain medications like oxytocin and oral misoprostol. Late cord clamping and early initiation of essential newborn care are also advised.
Anemia: A Deeper Look
Anemia is primarily caused by iron deficiency, although other conditions like vitamin deficiencies, chronic inflammation, parasitic infections, and inherited disorders can also lead to anemia. In India, the prevalence of anemia is quite high across different age groups and sexes.
Government Initiatives to Tackle Anemia
In response to the significant health challenge posed by anemia, the Indian government has launched several initiatives. These include the Anaemia Mukt Bharat (AMB) campaign and Weekly Iron and Folic Acid Supplementation (WIFS) program, among others. The government is also strengthening infrastructure like Blood Banks and Blood Storage Units.
Anaemia Mukt Bharat and UPSC Civil Services Examination
Anaemia Mukt Bharat (AMB), a government initiative launched in 2018, focuses on reducing anemia by providing supplements such as calcium to children, adolescents, and pregnant women. Its interventions were the subject of a question in the previous year’s UPSC Civil Services Examination.
Conclusion
This article has discussed the serious issue of anemia and its impact on maternal health, mainly through its link with postpartum hemorrhage. The severity of anemia is a measure of its potential danger, and the importance of public health campaigns like Anaemia Mukt Bharat in fighting this problem cannot be understated.
