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Abstract

Background: Anemia in pregnancy is a prevalent maternal health issue in low- and middle-income countries, contributing significantly to maternal morbidity and mortality. It increases the risk of postpartum hemorrhage (PPH), a leading cause of maternal deaths, particularly in resource-limited settings like Mardan. While the link between anemia and PPH is well established, region-specific data remain scarce. Objective: To determine the frequency of post-partum hemorrhage among pregnant women with anemia. Study Design: Cross-sectional study. Duration and Place of Study: This study was conducted at the Department of Obstetrics and Gynecology, Mardan Medical Complex, from October 2024 to April 2025. Methodology: A total of 157 pregnant women with third-trimester anemia (Hb <12.0 g/dL) were enrolled. Women with renal disease, hepatitis B/C, or irregular menstrual cycles were excluded. Blood loss was assessed after delivery using pad weight method, with PPH defined as blood loss >500 mL. Demographic and clinical data were recorded. Results: The mean age was 29.41±6.51 years, with a mean hemoglobin level of 10.05±0.97 g/dL and blood loss of 373.59±122.21 mL. PPH occurred in 17 out of 157 women (10.8%). A statistically significant association was observed between BMI and PPH (p<0.001), with lower BMI (≤25 kg/m²) showing higher risk. Conclusion: Postpartum hemorrhage occurs in approximately one in ten anemic pregnant women, with lower BMI emerging as a significant risk factor.