Assessing the Effects of Anaemia and Covid-19 Infection on Pregnancy Outcomes in Pregnant Women in Accra, Ghana

Abstract

Introduction: Anaemia is a significant public health issue around the globe, especially in underdeveloped nations, including Ghana, where the prevalence is high. Poor intrauterine growth, a higher chance of preterm birth, miscarriage, and low birth weight rates are all linked to anaemia during pregnancy. As a result, there is an increase in the rate of newborn mortality as well as perinatal morbidity and mortality. Comorbidities like hypertension and anaemia in pregnant women puts them at greater risk of experiencing poor pregnancy outcomes, like preterm births. Recently, COVID-19 has been reported to have an impact on hemoglobin levels in patients. The existence of other comorbidities in pregnant women who are infected with COVID-19 could expose them to poor pregnancy outcomes more than those who are not, but little knowledge exists regarding this association. Objective: to assess the effects of anaemia and COVID-19 on pregnancy outcomes in Accra, Ghana. Methods: This is a secondary data analysis on 211 participants recruited as part of the COVID-19 and pregnancy study who were eligible for analysis. Descriptive analyses were performed to show frequency distribution of the various categories. At the bivariate level, t-test and multiple logistic regression were used to determine differences between groups and associations between background factors and anaemia. The data was analyzed in STATA version 16. Results: The prevalence of anaemia in pregnancy was 24.1% and that of COVID-19 among unvaccinated pregnant women was 57.6%. There was no significant difference in mean haemoglobin levels among pregnant women who were exposed and unexposed to COVID-19 at enrollment and delivery Pr(|T| > |t|) = 0.06. The findings also showed that for women who were anemic at enrollment, their odds of being anemic at delivery were almost 5 times higher than those who were not anemic at enrollment (OR 4.9, CI:2.02-12.05, p<0.001). The results also show that with each unit increase in a woman’s age at pregnancy, there was a 1.05 increase in the odds of developing anaemia at delivery (OR=1.05, CI:1.01-1.10) p<0.04) when controlling for parity, place of residence, number of fetuses, educational level, and COVID-19 exposure status. Although age and anaemia status at enrolment was significantly associated with anaemia at delivery there was no significant association between anaemia at delivery and COVID-19 on pregnancy outcomes. Recommendation: Based on these findings, it is recommended that to avert anaemia in pregnancy, programmes and ANC services that routinely monitor hemoglobin levels should be strengthened. More research needed with larger samples sizes to be conducted in relation to anaemia and COVID-19 in pregnant women.