Cord gas parameters in infants born to women with sickle cell disease: a retrospective matched cohort study

Malinowski, Ann Kinga; Cheung, Patrina; Yang, Junmin; D’Souza, Rohan; Shehata, Nadine; Ward, Richard A.; Kuo, Kevin H.M.; Murphy, Kellie

doi:10.1111/bjh.15142

Cited by 4 publications

(4 citation statements)

References 11 publications

(18 reference statements)

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“…This was hypothesized to be secondary to the high affinity of fetal hemoglobin to O 2 compared with the poor affinity of hemoglobin S, leading to increased transfer of O 2 to the fetus, particularly in cases of fetal acidemia. 21,22 However, they did find that sickle cell disease was associated with a substantially lower UA and vein pH and higher base excess. 21 Another study by Ramirez-Cardich et al 23 investigated maternal anemia and neonatal oxygenation at high altitudes.…”

Section: Discussionmentioning

confidence: 94%

“…21,22 However, they did find that sickle cell disease was associated with a substantially lower UA and vein pH and higher base excess. 21 Another study by Ramirez-Cardich et al 23 investigated maternal anemia and neonatal oxygenation at high altitudes. The authors found that infants born to anemic mothers at high altitudes had no change in arterial O 2 saturation or respiratory rate and had higher hematocrits compared with nonanemic mothers.…”

Section: Discussionmentioning

confidence: 94%

“…20 However, previous studies looking at the relationship between maternal anemia and fetal oxygenation have yielded mixed results. Malinowski et al 21 looked specifically at patients with sickle cell disease and found no difference in intrapartum fetal O 2 saturation between patients with and without sickle cell disease. This was hypothesized to be secondary to the high affinity of fetal hemoglobin to O 2 compared with the poor affinity of hemoglobin S, leading to increased transfer of O 2 to the fetus, particularly in cases of fetal acidemia.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between maternal anemia and umbilical cord oxygen content at delivery

Watkins

Frolova

Stout

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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BACKGROUND: Anemia is one of the most commonly diagnosed comorbidities in pregnancy and is known to increase the risk of obstetrical complications. However, little is known about the effect of anemia on placental oxygen transfer and fetal oxygenation. OBJECTIVE: This study examined the relationship between maternal anemia and fetal oxygenation status at delivery as measured by umbilical cord partial pressure of oxygen. STUDY DESIGN: This is a secondary analysis of a prospective cohort study of singleton term deliveries with universal admission complete blood count and umbilical cord gases between 2010 and 2014. Maternal anemia was defined as hemoglobin of 10 g/dL on admission. The primary outcomes were umbilical artery and vein partial pressure of oxygen; the secondary outcomes were acidemia (umbilical artery pH of <7.1), hypoxemia (umbilical artery or umbilical vein partial pressure of oxygen at the <5th percentile), and hyperoxemia (umbilical artery/umbilical vein partial pressure of oxygen at the >90th percentile). Outcomes were compared between patients with and without anemia. RESULTS: Maternal anemia was associated with a significantly higher umbilical artery partial pressure of oxygen (median [interquartile range], 20 [16e24] vs 19 [15e24] mm Hg; P¼.01) and umbilical vein partial pressure of oxygen (median [interquartile range], 30 [25e36] vs 29 [23e34] mm Hg; P<.01).Neonates born to anemic mothers were more likely to have umbilical vein hyperoxemia (15.7% vs 10.9%; adjusted odds ratio, 1.51; 95% confidence interval, 1.26e1.81) with no difference in umbilical artery hyperoxemia. There was no difference in the rates of umbilical artery or umbilical vein hypoxemia. Although maternal anemia was associated with a significant difference in umbilical artery pH (7.28AE0.060 vs 7.27AE0.065; P<.01), there was no difference in the rate of neonatal acidemia between groups (1.6% vs 1.9%; adjusted odds ratio, 0.93; 95% confidence interval, 0.55e1.55). CONCLUSION: Umbilical cord oxygen content is higher in anemic mothers. Maternal anemia may lead to adaptations in maternal, placental, and fetal physiology, allowing for easier unloading of oxygen to the placenta and increased oxygen transfer to the fetus.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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The relationship between maternal anemia and umbilical cord oxygen content at delivery

Watkins

Frolova

Stout

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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show abstract

“…Pregnancy in patients with SCD has been associated with increased rates of maternal and fetal morbidity and mortality. 1 , 2 , 3 Although pregnancy in this population is becoming more common, evidence-based care is hampered by small sample sizes, scarcity of prospective investigations, methodological limitations of available studies, 4 , 5 and absence or heterogeneity of outcome definitions. This nonuniform outcome reporting subverts meaningful data synthesis; positioning research standardization as the sensible way forward, 6 , 7 , 8 , 9 , 10 , 11 with development of common data elements (CDEs).…”

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confidence: 99%

Systematic review of outcome reporting in studies of SCD and pregnancy: marked heterogeneity hinders meaningful data synthesis

et al. 2023

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Placental histopathology in sickle cell disease: A descriptive and hypothesis-generating study

et al. 2020

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Cord gas parameters in infants born to women with sickle cell disease: a retrospective matched cohort study

Cited by 4 publications

References 11 publications

The relationship between maternal anemia and umbilical cord oxygen content at delivery

The relationship between maternal anemia and umbilical cord oxygen content at delivery

Systematic review of outcome reporting in studies of SCD and pregnancy: marked heterogeneity hinders meaningful data synthesis

Placental histopathology in sickle cell disease: A descriptive and hypothesis-generating study

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