Can anemia predict perinatal outcomes in different stages of pregnancy?

Vural, Tayfun; Töz, Emrah; Özcan, Aykut; Biler, Alper; İleri, Alper; İnan, Abdurrahman Hamdi

doi:10.12669/pjms.326.11199

Cited by 24 publications

(29 citation statements)

References 20 publications

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“…The characteristics of all 117 included studies are presented in Table S6 (online only, see this Table for Refs. 111–125) . The selected studies were published between 1977 and 2018.…”

Section: Resultsmentioning

confidence: 99%

Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta‐analysis

Jung

Rahman

et al. 2019

Annals of the New York Academy of Sciences

109

101

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Maternal anemia affects approximately 56 million women worldwide and increases the risk of adverse pregnancy outcomes. Our study aimed to summarize the evidence for the association between maternal hemoglobin (Hb) concentrations and maternal or infant outcomes, evaluating it in a continuous manner. In this systematic review and meta-analysis, we conducted an electronic search on PubMed, Embase, CINAHL, and Web of Science from inception to April 19, 2017, and further updated to November 21, 2018, applying subject heading terms related to pregnant women with anemia. We included 117 studies with 4,127,430 pregnancies. Maternal anemia increased the risk of low birth weight (odds ratio (OR), 1.65; 95% confidence interval (CI): 1.45−1.87), preterm birth (PTB) (OR, 2.11; 95% CI: 1.76-2.53), perinatal mortality (PNM) (OR, 3.01; 95% CI: 1.92−4.73), stillbirth (OR, 1.95; 95% CI: 1.15−3.31), and maternal mortality (OR, 3.20; 95% CI: 1.16−8.85). A nonlinear relationship was found between maternal Hb and adverse maternal and infant outcomes. The OR of outcomes such as PTB, small-for-gestational age, PNM, preeclampsia, gestational hypertension, and postpartum hemorrhage was increased by two to three times. Assessing Hb as a continuous variable is important to determine the associated risk of adverse outcomes with decreasing or increasing levels.

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“…The characteristics of all 117 included studies are presented in Table S6 (online only, see this Table for Refs. 111–125) . The selected studies were published between 1977 and 2018.…”

Section: Resultsmentioning

confidence: 99%

Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta‐analysis

Jung

Rahman

et al. 2019

Annals of the New York Academy of Sciences

109

101

View full text Add to dashboard Cite

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“… Meta-analysis with crude effect measurement for the evaluated studies and 95% confidence intervals [ 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , ...…”

Section: Figurementioning

confidence: 99%

Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis

et al. 2018

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Objective: To systematically analyze the relationship between maternal anemia and low birth weight. Methods: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles. Cohort and case-control studies that met the eligibility criteria were included in the review. There was no limitation on the language or date of publication. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects, subgroup analyses and meta-regressions were performed. Publication bias was measured using Egger regression and visual funnel plot inspection. Results: A total of 7243 articles were found, of which 71 comprised the systematic review and 68 were included in the meta-analyses. Maternal anemia was associated with low birth weight with an adjusted OR: 1.23 (95% CI: 1.06–1.43) and I2: 58%. The meta-regressions confirmed that the sample size and the methodological quality may partially explain the statistical heterogeneity. Conclusions: Maternal anemia was considered a risk factor for low birth weight.

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“…Recently, there was a supported opinion about the relationship between anemia and adverse pregnancy outcomes. Several studies claimed that maternal anemia was risk factor for adverse pregnancy outcomes such as low birth weight (LBW), postpartum hemorrhage (PPH), cesarean section (CS), and preterm birth (PB) ( 3 ) . Unfortunately, there are conflicting results about this issue.…”

Section: Introductionmentioning

confidence: 99%

The effect of first trimester hemoglobin levels on pregnancy outcomes

Çakmak¹,

Türker²,

Öztaş³

et al. 2018

tjod

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Objective:The relationship between hemoglobin levels and pregnancy outcomes is still a challenging issue. There is a supported opinion about the increased adverse pregnancy outcomes both with low and high hemoglobin levels. In this study, we aimed to evaluate this association for first trimester hemoglobin levels in a Turkish population.Materials and Methods:In this retrospective study, 1306 women who were followed up during their pregnancy and gave birth in our clinic were enrolled. The patients were divided into three groups: hemoglobin <11 g/dL (n=490), 11≤ hemoglobin <13 g/dL (n=673), and hemoglobin ≥13 g/dL (n=143). The hemoglobin <11 g/dL group was classified into two subgroups as hemoglobin ≤9 g/dL (n=64) and hemoglobin >9 g/dL (n=426). Demographic characteristics, first trimester hemoglobin levels, gestational age at delivery and mode, birth weight, Apgar scores, and pregnancy outcomes were recorded and compared between the groups.Results:Pregnancy-induced hypertension, preterm birth, neonatal intensive care unit admission, birth weight, gestational age at delivery, Apgar scores, and postpartum hemorrhage were significantly different between the three groups. In the pairwise comparison, gestational age at delivery, birth weight, and first minute Apgar scores were higher in the 11≤ hemoglobin <13 g/dL group, and pregnancy-induced hypertension was more common in the hemoglobin ≥13 g/dL group as compared with the others. Moreover, the preterm delivery rate was highest in the hemoglobin ≥13 g/dL (26.6%) group and lowest (7.3%) in the 11≤ hemoglobin <13 g/dL group. The neonatal intensive care unit admission rate was higher both the hemoglobin <11 g/dL and hemoglobin ≥13 g/dL groups. Postpartum hemorrhage was more common in the hemoglobin <11 g/dL group as compared with the other groups. Furthermore, pregnancy-induced hypertension was more common in the hemoglobin ≤9 g/dL subgroup (p=0.012).Conclusion:In conclusion, both low and high hemoglobin levels are related with adverse pregnancy outcomes. We suggest that hemoglobin levels must be screened during pregnancy to provide maternal and fetal well-being.

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Can anemia predict perinatal outcomes in different stages of pregnancy?

Cited by 24 publications

References 20 publications

Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta‐analysis

Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta‐analysis

Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis

The effect of first trimester hemoglobin levels on pregnancy outcomes

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