Prevalence and factors associated with early postpartum anemia among women delivered by caesarean section at Kawempe National Referral Hospital

Abstract

Introduction Early postpartum anemia (48 hours after delivery) is a global problem with deleterious consequences. It remains unacceptably high despite various interventions. There is scarcity of data on the prevalence of anaemia among women during early or immediate postpartum period (48 hours postpartum) in Uganda. We therefore, aimed to determine the prevalence and factors associated with early postpartum anaemia (Hb<11g/dl) among women delivered by caesarean section at Kawempe National Referral Hospital. Methods We performed a cross sectional study, recruited women who had delivered by caesarean section 48 hours into postpartum period. Data was collected from 355 participants using an interviewer administered questionnaire. Haemoglobin estimation was obtained using portable HemoCue Hb 301 system. The prevalence of anaemia was determined as a proportion of women with hemoglobin < 11.0g/dl. A modified poison regression analysis for factors associated with anaemia. Results The prevalence of early postpartum anemia among women delivered by caesarean section was 71.8%. Following a multivariate analysis patient who had lost 500mls of blood and more during surgery were 34% more likely to have postpartum anemia as compared to those who lost less than 500mls, aPR = 1.34 [95%CI: 1.02-1.76], P=0.035. Patients who had intraoperative transfusion for any reason during surgery were 45% more likely to have postpartum anemia as compared to those who were not transfused, aPR =1.45 [95%CI: 1.02- 2.04], P=0.037. Conclusion Early postpartum anemia among women delivered by caesarean section was very high in our setting and it was found to be positively associated with blood loss of 500 ml or more, intraoperative blood transfusion. This illustrates the burden posed by early postpartum anemia in our setting. Interventions such as routine Hb estimation preoperatively and postoperatively to enable Hb optimization, adherence to good hematinic use and utilization of tranexamic acid during surgery to lower blood loss should be implemented.