Relationship between anaemia during pregnancy and preterm delivery

Ardıç, Cüneyt; Usta, Oğuzer; Omar, Esma; Yıldız, Cihangir; Memis, Erdem; Öztürk, Güzin Zeren

doi:10.1080/01443615.2019.1572726

Cited by 8 publications

(8 citation statements)

References 19 publications

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“…The wide confidence intervals across the null value in our study indicates that a larger sample is required to assess the effect of asthma on these selected pregnancy outcomes. Although, anaemia is independently associated with increased risk of low birthweight [ 28 ] and preterm delivery [ 29 ], comorbid anaemia did not further increase the risk of low birthweight and preterm delivery in this cohort.…”

Section: Discussionmentioning

confidence: 87%

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

Rajapakse

Wickramasinghe²,

Warnasekara³

et al. 2022

PLoS ONE

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Objectives To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography. Methods We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters. Results We recruited 3374 pregnant women aged 15–48 years at conception. Self-reported physician-diagnosed asthma prevalence was 6.6% (n = 223) with only 41.7% (n = 93) on regular medical follow-up for asthma. The prevalence of wheeze reduced from pre-pregnancy (67.0%) to the first (46.4%) and second trimesters (47.7%; p<0.01). Of the 73 asthmatic women who did not have wheeze in the last 3 months preceding pregnancy, new-onset wheeze was reported by 6(8.2%) and 12(16.4%) in the first and second trimester, respectively. Pregnant women who sought medical care for asthma in the private sector had a lower likelihood of developing new-onset wheeze in the first trimester (p = 0.03; unadjusted OR = 0.94;95%CI 0.89–0.99). Thirty-four (33.3%) pregnant women had at least one hospital admission due to exacerbation of wheeze during the first and second trimester. The prevalence of low birth weight (16.0%) was higher among pregnant asthmatic women. Conclusion This study reports the high prevalence of asthma and asthma-associated pregnancy outcomes in women from a rural geography signifying the importance of targeted management.

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Section: Discussionmentioning

confidence: 87%

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

Rajapakse

Wickramasinghe²,

Warnasekara³

et al. 2022

PLoS ONE

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“…In a study conducted in Turkey in 2020, the preterm labor rates were found to be significantly higher in pregnant women with anemia compared to pregnant women without anemia (p<0.05) (33). Another study in Turkey (provinces of Rize and Istanbul) found higher rates of preterm labor in pregnant women with lower hemoglobin levels (OR, 2.42; 95% CI: 1.07-5.49) (34).…”

Section: Discussionmentioning

confidence: 96%

Preterm Labor Conditions of Women With High-Risk Pregnancy and Related Factors: A Retrospective Cohort Study

Yavaş¹,

Baysan²

2022

jmed

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Objective: High-risk pregnancy is a situation associated with pregnancy involving a real or potential risk for the health and well-being of the mother and the fetus. Our study aimed to examine the preterm labor conditions of pregnant women followed up at a high-risk pregnancy outpatient clinic and related factors.Material and Methods: Designed as a retrospective cohort study, the study was carried out with the participation of 293 pregnant women who presented to a high-risk pregnancy outpatient clinic in the Batman province of Turkey and were followed up between March 2017 and January 2019. Results:The top three high-risk conditions determined in the pregnant women were pregnancy over the age of 35 (n=83, 28.3%), pregnancy in a shorter interval than two years (n=71, 24.2%) and consanguineous marriage (n=60, 20.5%), respectively. Twentypoint-one percent (n=59) of the pregnant women had preterm labor. It was determined that the rates of caesarean section births and births at a private hospital among the pregnant women who had preterm labor were significantly higher in comparison to the pregnant women who gave birth at term (p=0.001, p=0.037, respectively). It was determined that the risk of preterm labor increased ) times in the pregnant women with anemia, OR=12.5 (1.3-122.7) times in those with intrauterine fertilization and OR=32.6 (3.2-332.5) times in those with multiple pregnancies. Conclusion:Anemia, multiple pregnancy and intrauterine fertilization increase the risk of preterm labor. Quality prenatal care services are important in terms of protecting the health of the mother and the newborn.

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“…Although our study described a high proportion of pregnant women with anemia, the type of anemia was not investigated, even though different types of anemia might be stronger determinants for preterm labor. In another research study, the anemia was primarily of the normocytic normochromic variation with a prevalence rate of more than 50% [ 27 ]. Similar results were reported earlier, showing significant normocytic normochromic anemia among pregnant women who gave birth prematurely [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hemoglobin readings in many research studies were most likely taken in the late second or third trimester, since the hemoglobin levels of pregnant women decline during the course of the pregnancy and reach their lowest levels in the late third trimester. Another noteworthy piece of research disregarded third-trimester hemoglobin readings because dilutional anemia, which occurs as a 50% increase in plasma volume during this time, is not compensated for by an increase in the number of red blood cells in the late third trimester of pregnancy [ 27 ]. The same research identified the impact of anemia on preterm delivery as determining a 2.42 times higher risk when the hemoglobin levels were below 10 mg/dL and 1.77 times higher when the hemoglobin levels were below 11 mg/dL, respectively.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Utility of Hemoglobin, HALP Score, FAR Ratio, and Coagulation Parameters as Predictors for Preterm Birth

et al. 2023

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Premature birth is a worldwide health issue, posing a high mortality risk for newborns, as well as causing emotional and financial difficulties, and long-term health issues for patients. Identifying effective predictors for preterm birth is essential for prolonging gestation or improving obstetric care. As invasive methods are costly, risky, and not universally available, we aim to assess the predictive capacity of various serum parameters in pregnant women during the third trimester, as a non-invasive alternative. Based on previous studies, it was hypothesized that hemoglobin, the association of hemoglobin, albumin, lymphocyte, and platelets’ (HALP) score, and coagulation parameters such as the prothrombin time (PT), activated partial thromboplastin clotting time (aPTT), D-dimers, and fibrinogen to albumin ratio (FAR) have significant prediction capabilities. With a retrospective design, a total of 161 patients with a history of preterm birth were included in the analysis, being matched 1:1 with a control group of women who gave birth at term. All laboratory samples were collected during the third trimester of pregnancy. The computed area under the curve (AUC) ranged between 0.600 and 0.700 in all six studied parameters, suggesting a fair discrimination. The highest predictive value for preterm birth was observed to be represented by the HALP score with AUC = 0.680 and the highest sensitivity (75%, p-value = 0.001). The highest specificity was achieved by the prothrombin time (69%), and the HALP score was also 69%. The FAR score had an AUC of 0.646, with a sensitivity of 68%, and specificity of 64% (p-value = 0.020). All other variables were significant estimates for the risk of preterm birth, although with lower accuracy. Pregnant women with a hemoglobin level below 12.0 g/dL had a 3.28 higher likelihood of giving birth prematurely. A prothrombin time below 12.5 s determined a 2.11 times higher risk of preterm birth. Similarly, the aPTT below 25 s was linked with 3.24 higher odds of giving birth prematurely. However, the strongest predictors were the D-dimers above 250 ng/mL (OR = 4.26), the FAR score below 0.1, with an odds ratio of 5.30, and the HALP score with a 6.09 OR for a cut-off value above 24. It is important to determine these parameters in pregnant women at risk for giving birth prematurely, but further external validation is required to confirm these findings.

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Relationship between anaemia during pregnancy and preterm delivery

Cited by 8 publications

References 19 publications

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

Preterm Labor Conditions of Women With High-Risk Pregnancy and Related Factors: A Retrospective Cohort Study

Assessing the Utility of Hemoglobin, HALP Score, FAR Ratio, and Coagulation Parameters as Predictors for Preterm Birth

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