PREVALANCE OF POST-PARTUM ANEMIA AND ASSOCIATED FACTORS IN A TERTIARY CARE HOSPITAL

Abstract

Background: Postpartum anemia is a common yet underrecognized maternal health problem that contributes substantially to maternal morbidity, impaired functional recovery, poor lactation, and adverse psychological outcomes. Despite national anemia control programs, its burden remains high in India. This study aimed to determine the prevalence of postpartum anemia and identify factors associated with its severity among women delivering in a tertiary care hospital. Methods: A hospital-based cross-sectional study was conducted among 374 postpartum women delivering at a tertiary care teaching hospital between October 2024 and October 2025. Antenatal hemoglobin values were obtained from hospital records, and postpartum hemoglobin was measured on post-delivery day two. Postpartum anemia was defined as hemoglobin <11 g/dL and classified according to World Health Organization criteria. Demographic, obstetric, and clinical characteristics were recorded using a structured proforma. Associations between variables were evaluated using chi-square test and one-way ANOVA. Pearson correlation, binary logistic regression, and multinomial logistic regression analyses were performed to identify independent predictors of postpartum anemia severity. Results: Among the 374 women, 350 (93.6%) had postpartum anemia, while only 24 (6.4%) had normal hemoglobin levels. Moderate anemia was the predominant category, affecting 245 (65.5%) women, followed by mild anemia in 80 (21.4%) and severe anemia in 25 (6.7%). The majority of participants were aged 25–29 years (119; 31.8%), and 287 (76.7%) were multiparous. Mean hemoglobin declined significantly from 10.22 ± 1.06 g/dL antenatally to 8.96 ± 1.46 g/dL postpartum, with a mean reduction of 1.26 ± 1.10 g/dL (p < 0.001). Oral iron supplementation was the most frequently prescribed treatment (214; 57.2%), whereas 58 (15.5%) women received intravenous iron, 41 (11.0%) required blood transfusion, and 23 (6.1%) received combined oral and intravenous iron therapy. Antenatal hemoglobin demonstrated a strong positive correlation with postpartum hemoglobin (r = 0.793, p < 0.001) and emerged as the only independent predictor of moderate-to-severe postpartum anemia (p < 0.001). Maternal age and parity were not independently associated with anemia severity after adjustment. Conclusion: Postpartum anemia remains highly prevalent among women delivering in this tertiary care hospital, with moderate anemia accounting for the largest proportion of cases. Lower antenatal hemoglobin was the strongest determinant of postpartum anemia severity, highlighting the importance of optimizing antenatal iron status. Routine postpartum hemoglobin screening, continuation of iron supplementation, and early identification and treatment of women at risk should be integrated into maternal healthcare programs to reduce postpartum morbidity and improve maternal health outcomes.