Anemia and Cost-Effectiveness of Complete Blood Count Testing Among Pregnant Women at King Abdulaziz University Hospital: A Single Tertiary Center Experience

Background Iron deficiency is the most common etiology of anemia among pregnant women. Many studies showed that anemia during pregnancy had been associated with adverse outcomes such as intrauterine growth retardation, preterm delivery, and maternal mortality. However, screening for those pregnant remains controversial. Objectives To find the prevalence of anemia among pregnant women and pregnancy outcomes. Also, to find the cost-effectiveness of running complete blood count (CBC) tests among them. Methods This is a retrospective record review done on pregnant women who delivered at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 1, 2018, and December 31, 2018. They were screened for eligibility, with the exclusion of those with hemoglobinopathies such as sickle cell anemia and thalassemia. Data were collected from their electronic medical records. Results A total of 5,120 pregnant women had delivered from January 1, 2017, to August 31, 2018, and 2,845 (55.6%) developed anemia during pregnancy. Out of 2,822, 2,301 were mild, 471 moderate, 50 severe, and 2,185 were normal. A total of 3,656 (71.4%) women were Saudis, and 1,464 (28.6%) were non-Saudis. The mean age was 29.85±6 years, and their first hemoglobin reading mean was 10.6±1.3g/dl. Out of 2,822, 546 developed undesired pregnancy outcomes. History of anemia, blood transfusion, intrauterine fetal demise, and stillbirth was significantly associated with abnormal hemoglobin levels (p<0.05). Complete blood count (CBC) testing for these pregnant women cost 422,990.92 US dollars. Conclusion Although the cut-off point of diagnosing anemia level during pregnancy isn't fully understood, pregnant women with mild to moderate levels appeared to have lesser adverse pregnancy outcomes in comparison to women with severe level. Therefore, screening during prenatal visits or antenatal for anemia should be tailored to each pregnant based on her condition and the overall clinical judgment.