If an pregnant women is anemic, she is twice as likely to die during or shortly after pregnancy than those without the blood condition, according to an international study. Photo by ylerlson/Shutterstock

March 21 (UPI) -- Anemic pregnant women are twice as likely to die during or shortly after pregnancy than those without the blood condition, according to an international study.

Researchers led by Queen Mary University of London looked at World Health Organization data on 312,281 pregnancies in 29 countries across Latin America, Africa, Western Pacific, Eastern Mediterranean and South East Asia. The research was published Tuesday in the journal The Lancet Global Health.


Anemia, which is a blood count of less than 70 grams per liter of blood, affects 32 million pregnant women worldwide and up to half of all pregnant women in low and middle-income countries, according to research published in The Lancet Global Health in 2013.

In all, 99 percent of all maternal deaths occur in developing countries, according to the World Health Organization.

In those countries, women are at increased risk because of higher rates of dietary iron deficiency, inherited blood disorders, nutrient deficiencies and infections such as malaria, HIV and hookworm.

"Anemia in pregnancy is one of the most common medical problems pregnant women encounter both in low and high income countries," lead author Dr. Jahnavi Daru from Queen Mary University of London said in a press release. "We've now shown that if a woman develops severe anemia at any point in her pregnancy or in the seven days after delivery, she is at a higher risk of dying, making urgent treatment even more important."

Daru said the condition can be avoided.

"Anemia is a readily treatable condition but the existing approaches so far have not been able to tackle the problem," Daru said. "Clinicians, policy makers and healthcare professionals should now focus their attention on preventing anemia, using a multifaceted approach, not just hoping that iron tablets will solve the problem."

Daru told CNN that "providing iron tablets has been happening for 50-odd years now, but this is still a problem."

Improved access to antenatal care in remote areas, hookworm treatment and access to transfusion services are among the recommendations to reduce anemia and pregnant women's death risk from it.

In past research, it was suggested that anemia was linked to death because of other medical reasons. This is the first study to examine other factors: blood loss or malaria infection.

After excluding all other known contributing causes, the odds of maternal death are doubled in mothers with severe anemia.

In the study, 4,189 women had severe anemia and there were 341 maternal deaths. They were were matched with 8,218 women without severe anemia.

The authors used two statistical models and found that both showed a link between severe anemia and maternal death.

"We are confident that our findings are a robust demonstration of an independent link between severe anemia and maternal death," the researchers wrote in the study. "Although our data cannot explain a direct causal relation between severe anemia and maternal death, examination of the extent to which causal criteria have been met by our work is worthwhile."