Abstract
Author(s): Maryam k. Alaasam, Nagham Yahya Ghafil
Background: Anemia affects over fifty percent of reproductive-age women globally, with a frequency of 29.9% among individuals aged 15–49 and 36.5% among pregnant women in 2019. Iron deficiency anemia (IDA) is common but often inadequately treated, leading to serious maternal and fetal complications, including postpartum depression, maternal mortality, and impaired brain development in children. Anemia can be classified by red blood cell size (microcytic, normocytic, macrocytic) or cause (low production vs. high loss), requiring comprehensive lab tests for accurate diagnosis. “The World Health Organization (WHO)” defines anemia in pregnancy as hemoglobin levels below 11 g/dl, with moderate cases between 10-10.9 g/dl and severe cases below 7 g/dl. Oral iron supplements have low compliance due to side effects, while intravenous iron is underutilized due to perceived risks and costs. Blood transfusions are critical but require careful monitoring and health sector support. Comprehensive diagnostic tests like serum iron and transferrin saturation are essential, especially with systemic inflammation or infection. The CDC also considers hemoglobin below 11 g/dl and hematocrit below 33% as anemic in pregnant women, emphasizing early and effective treatment to prevent severe complications. Aim: The study aims to evaluate how anemia during pregnancy is managed in Al-Najaf hospitals, focusing on intravenous iron and blood transfusion, and their correlation with lab characteristics. Method: A descriptive cross-sectional study was conducted in six hospitals in Al-Najaf. Data from pregnant patients treated for severe anemia were collected and compared with national guidelines to assess management practices. Results: Blood transfusion was predominantly used for microcytic anemia (66 cases) and showed a significant association with moderate anemia (Hb scores 7-9.9 g/dL, P=0.001). Intravenous iron was mainly administered for moderate anemia (32 cases). The dosage of IV iron varied, primarily used for moderate anemia, with doses ranging from 1 to 4 amps. Conclusion: Misdiagnosis of anemia is common. The majority of cases throghout pregnancy are microcytic anemia (98%) which treated with blood transfusions (67%), although intravenous iron (33%), which is considered safer, is also used. Following ASH guidelines and having a diverse blood supply are essential for effectively managing maternal anemia.