Anthropometric Measurements in Term Neonates at Birth in Pregnant Patients with and without Anemia

Abstract

Background: Maternal anemia is a significant global health problem, particularly in low- and middle-income countries, contributing to impaired fetal growth and adverse neonatal outcomes. While its association with low birth weight is well documented, less is known about its impact on a broader range of neonatal anthropometric measurements (AMs) in term neonates, particularly in South Asian populations where anemia prevalence is high. Objective: To compare AMs at birth between term neonates of anemic and non-anemic mothers to assess the impact of maternal anemia on neonatal growth patterns in a local Pakistani population. Methods: This cross-sectional observational study was conducted from October 2024 to March 2025 at the Divisional Headquarters Teaching Hospital, Mirpur, AJK. We enrolled 100 pregnant women aged 18–40 years delivering singleton term neonates (≥38 weeks), classified into anemic (hemoglobin <11 g/dL, n=50) and non-anemic (hemoglobin ≥11 g/dL, n=50) groups. Neonatal AMs—birth weight (BW), crown-heel length (CHL), head circumference (HC), chest circumference (CC), mid-upper arm circumference (MUAC), and ponderal index (PI)—were measured within 24 hours of birth using standardized techniques. Group differences were analyzed using independent t-tests and chi-square tests with adjustment for potential confounders. Results: Neonates of anemic mothers had significantly lower mean BW (2265.2±113.2 g vs. 2353.9±222.4 g, p=0.01), CHL (46.22±0.42 cm vs. 46.56±1.05 cm, p=0.04), HC (31.56±1.05 cm vs. 32.26±1.44 cm, p=0.01), CC (29.76±0.80 cm vs. 31.50±0.99 cm, p<0.0001), and MUAC (8.5±0.51 cm vs. 9.9±0.79 cm, p<0.0001). The proportion of neonates with PI <2.2 was higher in the anemic group (20% vs. 6%, p=0.04). Conclusion: Maternal anemia is associated with significantly reduced neonatal anthropometric parameters and an increased frequency of disproportional growth restriction at birth, underscoring the importance of early identification and correction of anemia in pregnancy to optimize neonatal outcomes.