Correlation Between First-Trimester Anemia in Pregnancy and the Incidence of Preeclampsia: A Retrospective Cohort Study

Muhammad Hairul Umam (Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital – Universitas Padjadjaran, Bandung, Indonesia)
Marta Isyana Dewi (Department of Obstetrics and Gynecology, Prof. Dr. Margono Soekarjo Regional General Hospital – Universitas Jenderal Soedirman, Purwokerto, Indonesia)
M. Rizkar Arev Sukarsa (Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital – Universitas Padjadjaran, Bandung, Indonesia)

Indonesian Journal of Obstetrics & Gynecology Science
Volume 9 Number 2 July 2026

Introduction: Preeclampsia affects 2 – 4% of pregnancies worldwide and is a leading cause of maternal and perinatal morbidity and mortality. Anemia in pregnancy—defined as hemoglobin <11 g/dL in the first or third trimester—remains prevalent, affecting 48.9% of Indonesian pregnant women (Riskesdas 2018). First-trimester anemia may contribute to preeclampsia through oxidative stress, endothelial dysfunction, and impaired placentation.Objective: To analyze the association between first-trimester anemia and preeclampsia at Prof. Dr. Margono Soekarjo Regional General Hospital (January – December 2023).Methods: This retrospective cohort study used total sampling of pregnant women treated at the hospital from January to December 2023. Variables included first-trimester hemoglobin and preeclampsia status. Logistic regression analysis was performed using SPSS 27.0.Results: The model showed good fit (Hosmer–Lemeshow = 2.491, p=0.778; Nagelkerke R²=0.367). First-trimester hemoglobin was significantly associated with preeclampsia (p<0.001; OR=0.884, 95% CI: 0.849–0.921). Each 1 g/dL increase in hemoglobin was associated with an 11.6% reduction in the odds of preeclampsia.Conclusion: First-trimester anemia was significantly associated with preeclampsia. Adequate early hemoglobin levels were associated with lower odds of preeclampsia, underscoring the importance of early hematologic monitoring and iron–folate supplementation in antenatal care.Korelasi antara Anemia Trimester-Pertama pada Kehamilan dan Kejadian Preeklampsia: Studi Kohort RetrospektifAbstrakPendahuluan: Preeclampsia memengaruhi 2 – 4% kehamilan di seluruh dunia dan merupakan penyebab utama morbiditas serta mortalitas maternal dan perinatal. Anemia pada kehamilan—didefinisikan sebagai hemoglobin <11 g/dL pada trimester pertama atau ketiga—masih banyak terjadi, memengaruhi 48,9% ibu hamil Indonesia (Riskesdas 2018). Anemia trimester pertama dapat berkontribusi terhadap preeclampsia melalui oxidative stress, disfungsi endotel, dan gangguan plasentasi.Tujuan: Penelitian ini bertujuan menganalisis korelasi antara anemia trimester pertama dan preeclampsia di Rumah Sakit Umum Daerah Prof. Dr. Margono Soekarjo (Januari – Desember 2023).Metode: Penelitian ini merupakan studi retrospektif bersifat kohort dengan teknik total sampling terhadap ibu hamil yang dirawat di rumah sakit dari Januari hingga Desember 2023. Variabel yang diteliti meliputi hemoglobin trimester pertama dan status preeclampsia. Analisis logistic regression dilakukan menggunakan SPSS 27.0.Hasil: Model menunjukkan kecocokan yang baik (Hosmer–Lemeshow = 2.491, p=0.778; Nagelkerke R²=0.367). Hemoglobin trimester pertama berhubungan signifikan dengan preeclampsia (p<0.001; OR=0.884, 95% CI: 0.849–0.921). Kenaikan hemoglobin sebesar 1 g/dL berhubungan dengan penurunan peluang preeclampsia sebanyak 11,6%.Kesimpulan: Anemia trimester pertama berhubungan secara signifikan dengan preeclampsia. Kadar hemoglobin awal yang memadai berhubungan dengan penurunan peluang terjadinya preeclampsia, sehingga menekankan pentingnya pemantauan hematologi dini dan suplementasi zat besi–folat dalam pelayanan antenatal.