Maternal Altitude-Corrected Hemoglobin and at Term Neonatal Anthropometry at 3400 m of Altitude

Villamonte-Calanche, Wilfredo; Lam-Figueroa, Nelly; Jerí-Palomino, María; De-La-Torre, Cleto; Villamonte-Jerí, Alexandra A

doi:10.1089/ham.2019.0127

Cited by 3 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12 Several research groups have argued against the recommendation to correct Hb concentrations for altitude on the grounds of a seemingly disproportionate increase in the rate of anemia, particularly at altitudes over 3000 meters. [8][9][10][11][12]19,30,46 The recent findings of Sherpa demonstrating a larger plasma volume than Andeans, resulting in a comparable total blood volume at a lower Hb concentration, confirmed the hypothesis that the lower Hb concentration is the result of a greater plasma volume, rather than a lack of increased Hb production. 47 In these circumstances, subjects should be considered as having hemodilution, rather than genuine anemia.…”

Section: Discussionmentioning

confidence: 74%

“…An observational study that assessed Hb levels, iron status, and the suitability of altitude‐adjusted Hb values for defining IDA in PSC living at high altitudes in the Southern Andes of Peru showed that the prevalence of anemia was 66% after adjustment for altitude, whereas it was only 4.8% without such adjustment 12 . Several research groups have argued against the recommendation to correct Hb concentrations for altitude on the grounds of a seemingly disproportionate increase in the rate of anemia, particularly at altitudes over 3000 meters 8–12,19,30,46 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

Gonzáles

Tapia

Vásquez‐Velásquez

2020

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

According to the World Health Organization, the cutoff hemoglobin (Hb) value for defining anemia is 11 g/dL in preschool‐aged children, and Hb measurements should be corrected above an altitude of 1000 meters. This study sought to determine the altitude at which the Hb value increases compared with that at sea level, Hb changes with age and region in Peru, the prevalence of anemia according to three different models used to correct Hb for altitude, and the association of the Hb value with stunting. Two individual‐based Peruvian national databases were analyzed. Hb increased from an altitude of 375 meters. Hb concentration was lower at younger ages and higher at older ages. The increase in Hb with increasing altitude was lower in southern Peru. Implementing the different models for Hb measurement correction resulted in a higher and lower prevalence of anemia at altitudes >2500 and <2500 m, respectively, using the CDC adjustment. In children aged 6–23 months, the rate of stunting was lower in those with an Hb level of 10–12 g/dL (including mild anemia). In conclusion, the adjustment of Hb values for altitude should be considered before 1000 m and reference ranges should be adjusted to smaller groups of children instead of the same reference range for children aged 6–59 months.

show abstract

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

Gonzáles

Tapia

Vásquez‐Velásquez

2020

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

show abstract

“…Anemia during pregnancy is considered an adverse condition that can affect the health of the maternal–fetal unit according to the World Health Organization (WHO), generally defined with hemoglobin values <11 g/dL. Several studies have demonstrated that hemoglobin values in pregnant women between 9 g/dL and 13 g/dL are not associated with adverse neonatal outcomes [ 12 , 13 , 14 , 15 ]. This is an important question for populations living at HA since they have normally increased Hb levels [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

A Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status

Figueroa-Mujica

Ccahuantico

Ccorahua-Ríos

et al. 2022

Life

View full text Add to dashboard Cite

The objectives of the study were to determine differences in the parameters of red blood cells (RBC), white blood cells (WBC), and platelets at low altitude (LA) and at high altitude (HA) and with the gestation being advanced, and to determine correlations between parameters of RBC and platelets. We also studied the association of RBC and platelets with markers of iron status. In addition, markers of iron status and inflammation were measured and compared at each trimester of gestation in pregnant women at LA and HA. A cross-sectional comparative study was conducted at Lima (150 m above sea level) and Cusco at 3400 m above sea level from May to December 2019. Hematological parameters in pregnant women (233 at LA and 211 at HA) were analyzed using an automated hematology analyzer. Serum ferritin levels, soluble transferrin receptor (sTfR), hepcidin, erythropoietin, testosterone, estradiol, and interleukin-6 (IL6) levels were measured by ELISA. One-way ANOVA supplemented with post hoc test, chi-square test, and Pearson correlation test statistical analyses were performed. p < 0.05 was considered significant. Pregnant woman at HA compared to LA had significantly lower WBC (p < 0.01), associated with higher parameters of the RBC, except for the mean corpuscular volume (MCV) that was no different (p > 0.05). Platelets and mean platelet volume (MPV) were higher (p < 0.01), and platelet distribution width (PDW) was lower at HA than at LA (p < 0.01). A higher value of serum ferritin (p < 0.01), testosterone (p < 0.05), and hepcidin (p < 0.01) was observed at HA, while the concentration of sTfR was lower at HA than at LA (p < 0.01). At LA, neutrophils increased in the third trimester (p < 0.05). RBC parameters decreased with the progress of the gestation, except RDW-CV, which increased. The platelet count decreased and the MPV and PDW were significantly higher in the third trimester. Serum ferritin, hepcidin, and serum testosterone decreased, while sTfR and serum estradiol increased during gestation. At HA, the WBC and red blood cell distribution width- coefficient of variation (RDW-CV), PCT, and serum IL-6 did not change with gestational trimesters. RBC, hemoglobin (Hb), hematocrit (Hct), mean corpuscular hemoglobin concentration (MCHC), and platelet count were lower as gestation advanced. MCV, MPV, and PDW increased in the third trimester. Serum ferritin, testosterone, and hepcidin were lower in the third trimester. Serum estradiol, erythropoietin, and sTfR increased as gestation progressed. Direct or inverse correlations were observed between RBC and platelet parameters and LA and HA. A better number of significant correlations were observed at HA. Hb, Hct, and RDW-CV showed a significant correlation with serum ferritin at LA and HA. Of these parameters, RDW-CV and PDW showed an inversely significant association with ferritin (p < 0.05). In conclusion, a different pattern was observed in hematological markers as well as in iron status markers between pregnant women at LA and HA. In pregnant women a significant correlation between several RBC parameters with platelet marker parameters was also observed. Data suggest that pregnant women at HA have adequate iron status during pregnancy as reflected by higher serum ferritin levels, lower sTfR levels, and higher hepcidin values than pregnant women at LA.

show abstract

“…Por esta razón, sería recomendable establecer puntos de corte propios de Hb para cada población, debido a que este no tiene el mismo comportamiento a diferentes edades, niveles de altura, embarazo, entre otros factores 30h . Además, la forma como se obtuvo el FCA proviene de un modelo matemático 21,31 .…”

Section: Discussionunclassified

“…ses de edad el punto de corte establecido para definir An es < 13,4 g/dL 8 . Existe controversia respecto a este punto de corte, debido a que la Hb presenta variaciones fisiológicas durante los primeros tres años de vida 20 , así como no hay evidencia clínica que lo respalde 21 , lo cual generaría un sobrediagnóstico de An.…”

Section: Introductionunclassified

Correlación entre ferritina sérica, índices eritrocitarios y hemoglobina en lactantes que viven a 3400 m de altitud

Villamonte-Calanche,

Orccosupa-Quispe,

Mendoza-Cabrera

et al. 2023

Andes pediatr

View full text Add to dashboard Cite

La anemia (An) es un problema de salud pública en Sudamérica, siendo su principal causa la deficiencia de hierro (DH). En las ciudades de altura, la hipoxia hipobárica condiciona un aumento en el nivel de hemoglobina (Hb) en sus residentes. Para el diagnóstico de An se mide la Hb, la cual se modifica después de los índices eritrocitarios (IE). Hay evidencia de que existe una sobrestimación de la prevalencia de An en altura.Objetivo:Correlacionar la ferritina sérica (FS) con la Hb e IE, y determinar el punto de corte de Hb para predecir DH en lactantes de 6 meses a 3400 m de altitud. Sujetos y Método: Se evaluaron 128 lactantes de 6 meses a 3.400 m de altitud. Se consideró variable independiente a la FS. Los IE y la Hb fueron las variables dependientes. La An en el lactante fue definida con una Hb < 13,4 g/dl. La DH se definió por FS < 12 ug/dL. Los datos se procesaron en el programa SPSS® versión 25. Se usó la correlación Spearman para el análisis bivariado. Se construyó la curva ROC para determinar el punto de corte de Hb para DH.Resultados: La mayor correlación de FS se observó con la hemoglobina corpuscular media (HCM), rho = 0,449 (p < 0,001) y el volumen corpuscular medio (VCM) rho = 0,423 (p < 0,001). El punto de corte de la Hb, según la FS, que define DH fue de 12,15 g/dL (curva ROC: 0,704; IC 95%: 0,597-0,811; p < 0,001).Conclusión: El VCM y la HCM presentaron mejor correlación con la FS. El modelo cúbico y logarítmico son los que representaron mejor estas relaciones respectivamente. La Hb < 12,15 g/dL permite diagnosticar DH en lactantes de 6 meses a 3400 m de altura.

show abstract

Maternal Altitude-Corrected Hemoglobin and at Term Neonatal Anthropometry at 3400 m of Altitude

Cited by 3 publications

References 18 publications

Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

A Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status

Correlación entre ferritina sérica, índices eritrocitarios y hemoglobina en lactantes que viven a 3400 m de altitud

Contact Info

Product

Resources

About