Severe Maternal Anaemia Increases Stillbirth Risk by 27 Percent in Indian Study

Why It Matters

Anaemia remains a widespread health challenge in India, affecting more than half of the pregnant population. This research establishes a direct link between maternal blood health and fetal survival, suggesting that many stillbirths are preventable through targeted medical intervention. By identifying low hemoglobin as a modifiable risk, the study provides a roadmap for public health policies to decrease infant mortality rates across the country.

Key Facts

• The study analyzed 214,709 single-fetus pregnancies from the ICMR-SPIC dataset, spanning ten Indian states.
• Moderate to severe anaemia, defined as hemoglobin levels below 10 grams per decilitre, affected 52% of the women studied.
• Pregnant women with moderate-to-severe anaemia face a 27% higher risk of stillbirth after 28 weeks of gestation.
• Severe anaemia alone can triple the risk of stillbirth compared to women with normal or mild hemoglobin levels.
• Fetuses of severely anaemic mothers often face mortality earlier, typically around the 29th week, compared to the 31st week in other groups.

Background

The research consortium included experts from the University of Oxford, the London School of Hygiene and Tropical Medicine, and the Indian Institute of Public Health Bengaluru. They utilized the Indian Council of Medical Research (ICMR)-Stillbirth Pooled Indian Cohort Consortium (SPIC) data, which aggregates findings from eight observational studies and two randomized controlled trials. Previously, generalizable evidence regarding how varying levels of anaemia severity impacted different trimesters was limited.

Scientists propose several biological theories for these outcomes. Maternal anaemia may trigger embryonic anaemia, leading to oxidative stress within the fetus. Furthermore, the condition might induce cardiovascular defects in the offspring, both of which can lead to pregnancy termination. While many causes of anaemia are modifiable through nutrition and treatment, researchers noted that genetic or non-modifiable forms of the condition require distinct clinical strategies.