Jebmh.com Original Research Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 4/Issue 05/Jan. 16, 2017 Page 228 POSTPARTUM PERIOD- A WINDOW OF OPPORTUNITY FOR ANAEMIA CORRECTION Hema Divakar 1 , Priti Kumar 2 , Kavita Bansal 3 , Pragya Tripathi 4 , Shelly Dutta 5 , Isaac Manyonda 6 1 Chief Consultant, Department of Obstetrics and Gynaecology, Divakars Speciality Hospital, Bangalore. 2 Consultant Gynaecologist, Department of Obstetrics and Gynaecology, Sunflower Medical Centre, Lucknow. 3 Consultant Gynaecologist, Department of Obstetrics and Gynaecology, Fatima Hospital, Lucknow. 4 Consultant Gynaecologist, Department of Obstetrics and Gynaecology, Kanti Kuber Hospital, Bahraich. 5 Biotech Research Assistant, Divakars Speciality Hospital, Bangalore. 6 Honorary Professor, Department of Obstetrics and Gynaecology, St. George’s University of London. ABSTRACT BACKGROUND The aim of the study is to determine the prevalence of anaemia after delivery and highlight the need for postpartum anaemia services in India. MATERIALS AND METHODS Women were recruited at admission for delivery; excluded were mothers with non-iron-deficiency anaemia, haematological disease or who had preterm deliveries. Hb levels were measured at admission for delivery and 24-hours postpartum. An estimate of the number of women with Hb less than 10 g/dL that would qualify for parenteral iron therapy was made. Design- Multicenter study. Setting- Obstetric departments of semi-urban, rural and urban hospitals in India. Population- Women ≥18 years old irrespective of date of admission and mode of delivery. RESULTS 221 (67.03%) women had vaginal births, while 466 (32.96%) women had C-sections. The prevalence of severe anaemia, moderate anaemia and mild anaemia increased between the two study points from 0.43% to 1.74% (McNemar=0.021), 8.01% to 11.21% (McNemar=0.0021) and 60.12% to 69.58% (McNemar <0.001), respectively. The proportion of women who did not have anaemia decreased from 31.44% to 17.47% (McNemar <0.001). Hb levels at 24 hours postpartum were lower in 553 women (80.49%). CONCLUSION We showed that the prevalence of mild, moderate and severe anaemia increase after delivery. Furthermore, vaginal birth and C-section are associated with decreases in Hb. The study highlights the need to institutionalise postpartum anaemia correction services in India to reduce postpartum anaemia prevalence and improve the quality of maternal care. Tweetable abstract- The prevalence of mild, moderate and severe anaemia increase after vaginal birth or C-section. KEYWORDS Postpartum Anaemia, Parenteral Iron, Haemoglobin, Institutional Delivery. HOW TO CITE THIS ARTICLE: Divakar H, Kumar P, Bansal K, et al. Postpartum period- A window of opportunity for anaemia correction. J. Evid. Based Med. Healthc. 2017; 4(5), 228-232. DOI: 10.18410/jebmh/2017/44 BACKGROUND Iron deficiency is one of the most prevalent nutritional deficiencies in the world 1 affecting an estimated two billion people. 2 Although, it disproportionately affects young children, pregnant women and postpartum women. Iron deficiency is endemic in regions where poor diets and/or infections associated with blood loss are prevalent. 3,4 Iron deficiency is the most significant contributing factor of anaemia accounting for at least half of all reported cases. 3,4 Among pregnant women, the global incidence of anaemia is 38% with pregnant women in South-East Asia, the Eastern Mediterranean and Africa having the highest anaemia burden. 4 In India, the prevalence of anaemia among pregnant women falls between 37-67% 5 with Iron- Deficiency Anaemia (IDA) being the most common form. 6 Anaemia during pregnancy is defined as a haemoglobin concentration of less than 11.0 g/dL in the first and third trimesters and a haemoglobin concentration of less than 10.5 g/dL in the second trimester. 7 It is correlated with premature birth and low birth weight of the newborn. 8,9 Furthermore, it is one of the strongest predictors of postpartum anaemia, 7 which is conservatively defined as a haemoglobin concentration of less than 11 g/dL at childbirth and during the subsequent 6 weeks. 3,10 Postpartum anaemia can impair maternal functioning and health, affecting physical performance, mood, cognition and the immune response. 11-14 These symptoms may, in turn, interfere with Financial or Other, Competing Interest: None. Submission 24-12-2016, Peer Review 31-12-2016, Acceptance 13-01-2017, Published 14-01-2017. Corresponding Author: Dr. Hema Divakar, No. 220, 9 th Cross, J. P. Nagar 2 nd Phase, Bangalore - 560078. E-mail: drhemadivakar@gmail.com DOI: 10.18410/jebmh/2017/44