Abstract
Introduction. Anemia during pregnancy accounts for a significant portion of the avoidable nutritional burden in low- and middle-income countries, and its persistence until delivery increases surgical risk. Objective. To determine the risk factors associated with anemia and its relationship with perioperative complications in pregnant women treated at the Montero Tertiary Hospital during 2024-2025. Methods. Observational, analytical, cross-sectional, and prospective study of 317 pregnant women in their third trimester and immediate postpartum women. Data were obtained from structured interviews and medical records. Analysis was performed using EPI INFO 7.2 with bivariate tests and logistic regression, with odds ratios (OR), 95% confidence intervals, and significance at p < 0.05. Results. The prevalence of anemia was 24.3% (77/317; 95% CI 19.9-29.3), with mild forms predominating. Inadequate adherence to ferrous sulfate supplementation (OR 1.9; p = 0.02) and discontinuation due to nausea (OR 1.8; p = 0.04) were associated with anemia. Anemia was also associated with perioperative complications (OR 2.5; p < 0.001) and blood component transfusion (OR 9.2; p < 0.001). In the multivariate model, postpartum hemorrhage (OR 5.95; 95% CI 2.86–12.39), premature rupture of membranes (OR 3.24; 95% CI 1.33–7.89), and surgical site infection (OR 3.47; 95% CI 1.03–11.67) remained significant. Conclusions. Anemia was present in 24.3% of the pregnant women studied, predominantly mild and moderate forms, indicating a significant clinical burden in the third trimester of pregnancy. Inadequate adherence to ferrous sulfate and its discontinuation due to nausea were significantly associated with the presence of anemia, highlighting specific opportunities to improve adherence and prenatal follow-up. The complete absence of preconception care in the sample, rather than being a quantifiable risk factor, reflects a gap in the care continuum that simply does not exist in this setting.References
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