Obstetric Anaesthesia Annual Scientific Meeting 2026

Background:

•Iron deficiency anaemia in pregnancy increases risk of maternal and neonatal morbidity and mortality.

•Pregnancy Anaemia Management Scotland (PrAMS) introduced to:

1.Improve antenatal testing for anaemia

2.Improve treatment of antenatal anaemia

We aimed to evaluate if the PrAMS intervention reduced the prevalence of anaemia at delivery.

Methods:

Data from 5 NHS Greater Glasgow and Clyde hospitals

P: All deliveries reaching 24 weeks gestation

I: post-PrAMS (deliveries after 1st October 2021)

C: pre-PrAMS (deliveries before 1st October 2021)

O: haemoglobin <105g/L at delivery

Statistics: Interrupted time series (logistic regression)

Results:

55,609 deliveries (12,853 pre-, 42,756 post-intervention)

Anaemia at delivery (Figure 1): 9.2% → 9.7%

Interrupted time series:

•Step change: OR 1.055, 95% CI 0.935–1.193, p=0.390

•Slope change OR: 1.000, 95% CI 0.999–1.000, p=0.865

Mean haemoglobin at delivery: 116.9 → 118.0 g/L

Results consistent when stratified by:

•Anaemia at booking (Figure 2)

•Ferritin at booking

•Women at all gestational ages

Data completeness improved:

•No delivery haemoglobin: 4.1% → 2.2%

•No delivery ferritin: 42.2% → 7.4%

Conclusions:

PrAMS intervention:

•Improved testing for antenatal anaemia

•Did not lower prevalence of anaemia at delivery

•Provided a baseline for future research / QI projects

Optimising anaemia management in the antenatal period: a quality improvement approach