A study of women in Papua New Guinea (PNG) has found that more than 70 per cent experienced anemia during pregnancy and in the first 12 months after giving birth.
Pregnant women are at risk of anemia and iron deficiency due to physiological changes and increased iron demands that occur during pregnancy. In regions of the world, this risk is compounded by specific nutritional deficiencies and other factors.
The burden of anemia in the postpartum period – which begins after childbirth and can extend to several months – and the contribution of iron deficiency to postpartum anaemia are largely unknown.
Anemia in pregnancy contributes to maternal morbidity and mortality and increases the risk of adverse neonatal outcomes.
Conducted as part of the Healthy Mothers Healthy Babies program, the study followed 699 pregnant women from their first antenatal appointment through to the birth of their baby, with follow-up appointments at six and 12 months postpartum.
The research was led by a partnership of Burnet Institute and PNG Institute of Medical Research working with the East New Britain Provincial Health Authority.
Study lead author Dr Eliza Davidson said the research, published in the journal Cell Reports Medicine, sheds light on the burden of anemia among women in PNG in the first year after giving birth and offers insights into effective interventions.
“Our research highlights the high prevalence of anemia and iron deficiency beyond pregnancy and well into the postpartum period,” Dr Davidson said.
“It also highlights a critical gap in the implementation and timing of antenatal iron-folic acid supplementation, which is the primary preventive measure for maternal anemia.
“It shows that current supplementation strategies, typically administered during the later stages of pregnancy in resource-limited settings, may not adequately address the high prevalence of maternal anemia.”
Continued anemia in the postpartum period can contribute to poor health and increases the likelihood of entering subsequent pregnancies already anemic.
The research suggests that interventions focusing on early iron supplementation during and between pregnancies, in conjunction with malaria prevention strategies, will be important in breaking the cycle of chronic anemia in women of reproductive age in Papua New Guinea.
Based on the high prevalence of anemia observed during the first 12 months postpartum in this study, researchers suggest it is fair to assume that populations experiencing a high burden of anemia during pregnancy will continue to have a high prevalence of anemia in the postpartum period, in the absence of any intervention.
“Given that every second pregnant woman is estimated to be anemic in resource-limited settings globally, anemia in the postpartum period is likely to be a globally widespread yet neglected condition,” Dr Davidson said.
Burnet Deputy Program Director, Maternal, Child and Adolescent Health, Professor Freya Fowkes, said the study comes at a time when the world is looking at efforts to reduce maternal anemia globally.
The World Health Organization has set a target to decrease anemia by 50 per cent among women of reproductive age by 2025.
“Our research indicates that achieving this target in resource-limited settings such as Papua New Guinea will require new intervention strategies,” Professor Fowkes said.
The Healthy Mothers Healthy Babies is a collaborative research initiative with a focus on enhancing maternal, newborn, and infant health outcomes in PNG.
Professor Fowkes said the ongoing work of the study was likely to reveal further insights that would contribute to advancing health outcomes for women and their children.
“We hope our research will help improve the wellbeing of mothers and their children in Papua New Guinea and the broader region,” Professor Fowkes said.