Evaluation of the factors associated with anemia in neonates admitted to the Neonatal Unit of Maiwand Teaching Hospital: A cross-sectional study

Abstract

Background

While anemia has been associated with severe outcomes in neonates, there is a lack of scientific data regarding the associated factors of this problem in newborn babies of Afghanistan; hence, this study was undertaken to fill that gap. The objective of this study was to evaluate the factors associated with anemia in neonates who were admitted to the Neonatal Unit.

Methods

This analytic cross-sectional study with retrospective document review was conducted at the Neonatal Unit of the Maiwand Teaching Hospital in Kabul City, Afghanistan, in 2023. SPSS 26 and certain statistical methods were used to carry out the statistical analysis.

Results

Of the 220 newborns enrolled in this study, anemia occurred in 26.8% of them. Based on gestational age, the occurrence rates of neonatal anemia within groups of term and preterm neonates were 23% and 41.3%, respectively. The occurrence of neonatal anemia was found to be 60% in extremely low birth weight, 41.2% in very low birth weight, 27.2% in low-birth-weight neonates, and 23.9% in normal birth weight neonates. The neonates in the anemic group versus the non-anemic group had a mean birth weight of (2516.18 ± 898.79 vs 2749.62 ± 766.02 g, P = 0.03, 95%CI= -691_-9.9), a mean gestational age of (35.47 ± 3.7 vs 37.4 ± 2.5 w, P = 0.04, 95% CI= -1.6_ -0.9), a mean age of (11.41 ± 6.39 vs 9.9 ± 6.88 days, P = 0.35, 95%CI= -1.6_4.6), a mean CRP level of (13.6 ± 7.6 vs 9.8 ± 5.6 mg, P = 0.01, 95%CI= 0.8_7.8) and a mean hemoglobin level of (11.1 ± 1.7 vs 17.3 ± 2.5 g, P = 0.04, 95%CI=-7.4_-5.1). There was a significant association between neonatal anemia and preterm birth (OR=2.4, P = 0.04, 95%CI=0.08_0.5), male sex (OR=2.4, P = 0.04, 95%CI= 0.1_0.3), neonatal sepsis (OR=2.5, P = 0.01, 95%CI= 0.1_ 0.6), cesarean delivery (OR=3.4, P = 0.00, 95%CI=1.7_6.5), maternal age greater than 35 years (OR=2.9, P = 0.03, 95%CI=0.04_0.6), no iron intake by the mother during pregnancy (OR=1.9, P = 0.002, 95%CI=1.1_3.4), antepartum hemorrhage (OR=4.7, P = 0.00, 95%CI=1.3_10.3), and poor household income (OR=2.6, P = 0.03, 95%CI=0.03_0.2).

Conclusions

Newborns admitted to the Neonatal Unit had a significant prevalence of neonatal anemia. The highest occurrence rates were seen within groups of preterm and extremely low-birth-weight newborn babies. Neonatal anemia was found to be associated with lower mean neonatal birth weight and gestational age, as well as with preterm birth, male sex, a higher CRP level, neonatal sepsis, older maternal age, cesarean delivery, no maternal iron consumption, antepartum hemorrhage, and a poor household income.