An additional study using data from several thousand women confirms the link between anemia during pregnancy and the increased risk of postpartum hemorrhage.
- A low hemoglobin concentration before birth greatly increases the likelihood of postpartum hemorrhage.
- Anemia during pregnancy could cause uterine atony due to poor oxygenation of the uterus.
- Reduced blood viscosity due to anemia could lead to increased blood flow.
According research published on June 27 in The Lancet, low hemoglobin concentration before birth greatly increases the likelihood of postpartum hemorrhage. Researchers analyzed data from thousands of women and found that the risk of postpartum hemorrhage and postpartum death was higher in women with anemia than in those without, for all categories of anemia combined (mild, moderate, severe). This study highlights the importance of detecting and treating anemia in pregnant women to prevent this serious complication.
Processes that link anemia to increased postpartum hemorrhage
This study also provides insight into the underlying mechanisms that link anemia to increased postpartum hemorrhage. The researchers identified several factors that could explain this association. First, the increased heart rate and cardiac output caused by anemia could increase blood flow to bleeding vessels, which would promote bleeding. Then, the reduction in blood viscosity due to anemia could lead to increased blood flow, which would compromise the body’s ability to control bleeding.
Additionally, anemic blood clots might be more susceptible to dissolution by plasmin (fibrinolysis), an enzyme that breaks down blood clots. If the clots dissolve too quickly, it can lead to bleeding. Finally, it is suggested that anemia could cause an absence of uterine contractions after childbirth (uterine atony), which would prevent the closure of uterine blood vessels and increase the risk of postpartum hemorrhage.
It is important to treat anemia before childbirth
Although anemia is not recorded as the main cause of postpartum hemorrhage, the results of this study highlight its role as an important risk factor. It is essential to make every effort to correct anemia before delivery to reduce the risk of postpartum hemorrhage in women with severe anemia.
This may include the prescription of iron supplements, a nutrient-dense diet, and in some cases, blood transfusions. By treating anemia, the risk of postpartum hemorrhage and postpartum death can be significantly reduced, which will contribute to the health and safety of women during and after pregnancy.