Anemia in pregnancy and its association with pregnancy outcomes in the Arctic Russian town of Monchegorsk, 1973-2002.

Abstract

OBJECTIVES: The purpose of this study was to determine the prevalence of anemia in pregnancy in Monchegorsk, north-west Russia, and to analyse its association with birth weight and the risk of stillbirth and preterm birth. STUDY DESIGN: A registry study based on the Kola Birth Registry. METHODS: A total of 24,525 women who gave birth in Monchegorsk between 1973 and 2002 and who had data on anemia in pregnancy in the Kola Birth Registry (KBR) were included in the study. For these women, data on maternal anemia, age, occupation, marital status, parity, smoking, alcohol, gestational age, birth weight, stillbirth and year of delivery were obtained from the KBR. Linear regression was used to study the effect of maternal anemia on birth weight. Logistic regression was used to estimate the effect of anemia on the risks of stillbirth and preterm birth, with adjustment for the above-mentioned characteristics. Crude and adjusted odds ratios (OR) were calculated. RESULTS: The prevalence of anemia increased from 43.7% in the 1970s to 89.8% in the beginning of the 2000s. Infants born to women with anemia were 48 grams (95% CI 36, 59) heavier than infants of non-anemic women. Women with anemia in pregnancy were less likely to have stillbirths (OR=0.68; 95% CI 0.52, 0.89) and preterm births (OR=0.66; 95% CI 0.58, 0.75) after adjustment for potential confounders. CONCLUSION: The prevalence of anemia in pregnant women as defined by the KBR more than doubled during the 30-year period. Positive associations with birth weight and negative associations with the risk of stillbirth and live preterm birth were observed.