Influence of Hemoglobin and Platelet Levels on Maternal Health Across Trimesters in Pregnant Women in Ramadi City, Iraq

Abstract

Background: Anaemia during pregnancy remains a major public health problem in developing countries. This burden may be intensified in conflict-affected areas such as Ramadi City, Iraq, where access to healthcare services and adequate nutrition may be limited. However, evidence from Anbar Governorate remains scarce. Objectives: This study aimed to evaluate haemoglobin concentrations and platelet counts among pregnant women during the three trimesters of pregnancy, assess their relationships with maternal symptoms, and identify factors associated with anaemia in Ramadi City, Iraq. Methods: A cross-sectional study was conducted among 114 pregnant women attending antenatal clinics in Ramadi City between January and April 2025. Blood samples were analysed for haemoglobin concentration and platelet count using an automated haematology analyser. Demographic, clinical, and obstetric data were collected using a structured questionnaire and analysed with IBM SPSS Statistics, version 26. Results: Mean haemoglobin concentration declined significantly from 12.12 ± 1.40 g/dL during the first trimester to 10.45 ± 1.45 g/dL during the third trimester [F(2,111) = 9.60; p < 0.001]. Platelet counts did not differ significantly among the three trimesters (p = 0.798). Women with a previous history of anaemia had significantly lower haemoglobin concentrations than those without such a history (9.86 versus 11.76 g/dL; p < 0.001). Women receiving iron supplementation also had significantly lower haemoglobin concentrations than those who were not receiving supplementation (10.48 versus 11.54 g/dL; t(112) = −3.82; p < 0.001). Haemoglobin concentration was negatively correlated with fatigue (r = −0.239; p = 0.011), shortness of breath (r = −0.187; p = 0.047), and pallor (r = −0.257; p = 0.006). Conclusion: Haemoglobin concentrations declined significantly with advancing pregnancy and were associated with greater maternal symptom burden among pregnant women in Ramadi City. Platelet counts remained relatively stable across the three trimesters. The lower haemoglobin concentrations observed among women receiving iron supplementation may reflect supplementation prescribed in response to pre-existing anaemia rather than an adverse effect of supplementation. Routine antenatal screening, timely management of anaemia, appropriate iron supplementation, and improved access to prenatal healthcare are needed to reduce the burden of maternal anaemia in this population.