Publication:

Correlation between maternal haemoglobin and Bishop score at admission, duration of active phase of labour, Apgar score and neonatal birth weight in normal vaginal delivery: a hospital-based observational cross-sectional study

Background Maternal anaemia is one of the most prevalent nutritional disorders complicating pregnancy, particularly in low- and middle-income countries. It is associated with adverse maternal and neonatal outcomes; however, its influence on intrapartum parameters such as Bishop score and duration of active phase of labour remains inadequately explored.

Methods A hospital-based observational cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, from May 2025 to April 2026. A total of 200 eligible term pregnant women undergoing normal vaginal delivery were enrolled. Maternal haemoglobin was measured at admission using an automated haematology analyser. Bishop score, duration of active phase of labour, Apgar scores at 1 and 5 minutes, and neonatal birth weight were recorded. Data were analysed using Chi-square test and ANOVA.

Results No statistically significant association was found between maternal haemoglobin levels and Bishop score (p=0.56) or duration of active phase of labour (p=0.38). Although lower Apgar scores at 1 minute were more frequent among severely anaemic mothers (53.85%), this did not reach statistical significance (p=0.06), and 5-minute scores showed no significant difference (p=0.41). A highly significant association was observed between maternal haemoglobin and neonatal birth weight (p<0.0001), with 88% of severely anaemic mothers delivering low birth weight (LBW) neonates. NICU admission rates were also significantly higher in anaemic mothers (p=0.004). An inverse relationship between Bishop score and labour duration was also demonstrated (p=0.01).

Conclusions Maternal haemoglobin levels do not significantly influence Bishop score or the duration of the active phase of labour but have a strong and significant impact on neonatal birth weight and NICU admission rates. Early detection, prevention, and effective management of maternal anaemia during antenatal care are essential to improve neonatal outcomes.