Anaemia flagged in maternal deaths

A new analysis tied to the WOMAN-2 study says anaemia may be driving many maternal deaths in Nigeria and similar settings more than bleeding alone. (premiumtimesng.com) The report, published on April 21, 2026, drew on data from more than 15,000 women with moderate or severe anaemia giving birth in hospitals in Nigeria, Tanzania, Zambia and Pakistan. It said anaemia could account for up to half of severe postpartum haemorrhage cases in sub-Saharan Africa and South Asia. (thebloodtrials.org) Postpartum haemorrhage means heavy bleeding after birth, and it has long been treated as the main emergency to stop in the delivery room. The new report argues that low haemoglobin before labour can leave women so fragile that even smaller blood loss can trigger shock, organ failure or death. (thebloodtrials.org) That argument lands hard in Nigeria, where a 2025 review cited a maternal mortality ratio of 1,047 deaths per 100,000 live births and said the country accounts for 28.3% of estimated global maternal deaths. The same review said only 43% of births are assisted by a skilled provider and 39% take place in a health facility. (pmc.ncbi.nlm.nih.gov) Anaemia is already widespread in pregnancy in Nigeria. An analysis of the 2018 Nigeria Demographic and Health Survey found 61.1% of pregnant women in its sample were anaemic, with higher odds in the North Central and South South zones and among women with less schooling. (pmc.ncbi.nlm.nih.gov) Nigeria has spent years building policy around haemorrhage as the immediate killer. The Federal Ministry of Health and Social Welfare’s October 2024 postpartum haemorrhage guideline says postpartum haemorrhage accounts for about one-third of hospital maternal deaths in Nigeria. (health.gov.ng) The newer evidence does not say bleeding is unimportant; it says the woman’s condition before bleeding starts can determine whether that blood loss becomes fatal. A 2023 Lancet Global Health cohort study reported that maternal anaemia was strongly associated with postpartum haemorrhage and with death or near miss. (thelancet.com) Global guidance is also shifting. World Health Organization-backed postpartum haemorrhage guidance released on October 5, 2025, said fragmented standards had slowed uptake of evidence-based care, while the WOMAN-2 report says women with anaemia can deteriorate after blood loss that may look modest on paper. (who.int, thebloodtrials.org) That pushes prevention earlier than the labour ward: screening women before and during pregnancy, treating iron deficiency and other causes of anaemia, and reaching women who never make it to a hospital birth. In Nigeria, where anaemia and maternal death are both common, the report’s central claim is that survival may depend on raising haemoglobin long before delivery begins. (thebloodtrials.org, pmc.ncbi.nlm.nih.gov)