The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes


Autoři: Deborah A. Randall aff001;  Jillian A. Patterson aff001;  Felicity Gallimore aff001;  Jonathan M. Morris aff001;  Therese M. McGee aff003;  Jane B. Ford aff001
Působiště autorů: The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia aff001;  Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia aff002;  Women’s and Newborn Health, Westmead Hospital, Westmead NSW, Australia aff003;  The University of Sydney, Sydney NSW, Australia aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225123

Souhrn

Background

Low haemoglobin has been linked to adverse pregnancy outcomes. Our study aimed to assess the association of haemoglobin (Hb) in the first 20 weeks of pregnancy, and restoration of low Hb levels, with pregnancy outcomes in Australia.

Methods

Clinical data for singleton pregnancies from two tertiary public hospitals in New South Wales were extracted for 2011–2015. The relationship between the lowest Hb result in the first 20 weeks of pregnancy and adverse outcomes was determined using adjusted Poisson regression. Those with Hb <110 g/L were classified into ‘restored’ and ‘not restored’ based on Hb results from 21 weeks onwards, and risk of adverse outcomes explored with adjusted Poisson regression.

Results

Of 31,906 singleton pregnancies, 4.0% had Hb <110 and 10.2% had ≥140 g/L at ≤20 weeks. Women with low Hb had significantly higher risks of postpartum haemorrhage, transfusion, preterm birth, very low birthweight, and having a baby transferred to higher care or stillbirth. High Hb was also associated with higher risks of preterm, very low birthweight, and transfer to higher care/stillbirth. Transfusion was the only outcome where risk decreased with increasing Hb. Risk of transfusion was significantly lower in the ‘restored’ group compared with the ‘not restored’ group (OR 0.39, 95% CI 0.22–0.70), but restoration of Hb did not significantly affect the other outcomes measured.

Conclusions

Women with both low and high Hb in the first 20 weeks of pregnancy had higher risks of adverse outcomes than those with normal Hb. Restoring Hb after 20 weeks did not improve most adverse outcome rates but did reduce risk of transfusion.

Klíčová slova:

anémia – Birth – Blood transfusion – Hypertensive disorders in pregnancy – Postpartum hemorrhage – Pregnancy – Preterm birth – Stillbirths


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Článek vyšel v časopise

PLOS One


2019 Číslo 11