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About 60 % of the su b j ec t.s with postpartum anaemia h a d a
drop in their pre-delive ry haemoglobin levels, despite t he
hemoconcentrati ng effects of the early puerperium. The ave rage
change i n haemoglobin l ev e l in t hese SUbj ects W:.iS
- 0 . 7 gjdl. This ev idence strongly suggl1sts t hat labour blood
losses had negative effects on the haemoglob in levels of these
women even if t h i s difference was not statistically supported .
In i nterpreting t h e resu lts of t h e s t udy, one must a lso
remember that blood samples in SUbjects were c ollected a t a
median t i me of the 9th pos tpartum day . and at a time whe n ov e r
a third o f subjects (Js .4%) i n this stud y we r e still
experiencing some blood loss in their l och i a .
Literatur e f r om the developed world suqqeace that
haemoglobi n l ev e l s rema in relatively stable aft er the first
l, os t pa r t um wee k (256 ) . In this study pcpuLat.Lon pe l v ic
i n fection r at e s were high, uterine involutions were delayed
and cont i nu i ng blood losses ocurred in lochia . The i nc r ea s e d
blood losses, ther efor e, could lead to lowering in ha emog lobin
levels. Thus, t h e t r ue impacts of de livery on the haemoglobin
bl ood levels of t hese study women are probably still ye t to be
r ealis ed . It is l i ke l y therefore that a l a t e r blood investiga­
tion may have yielded higher prevalence a nd/or seve r ity of
postpartum anaemia , a nd t hus revealed a bigger impact o f
parturition .