High Hemoglobin Levels During Pregnancy and Fetal Risk

Koller, O; Sandvei, Roar; Sagen, Norvald

doi:10.1002/j.1879-3479.1980.tb00241.x

Cited by 55 publications

(27 citation statements)

References 11 publications

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“…Although high hemoglobin levels in midpregnancy are associated with fetal growth restriction and preeclampsia (Koller, Sandvei, & Sagen, 1980;Scanlon, Yip, Schieve, & Cogswell, 2000;Steer, 2000), achieving normal hemoglobin levels during pregnancy will be beneficial for the fetus. Smokeless tobacco use is widely prevalent among women in Southeast Asia (Gupta & Ray, 2003) and is slowly gaining acceptance across the world as a safe alternative to cigarette smoking.…”

Section: Discussionmentioning

confidence: 97%

Anemia in pregnant women who use smokeless tobacco

Subramoney

Gupta

2008

CNTR

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A significantly higher mean hemoglobin level in women smokers in comparison to nonsmokers with a generalized rightward shift of the hemoglobin distribution curve has been reported at the population level. Studies on pregnant women, however, have often associated smoking with decreased hemoglobin levels, although not consistently. We examined whether smokeless tobacco use during pregnancy influenced hemoglobin levels in a population-based cohort of 918 pregnant women in Mumbai, India. Mean hemoglobin levels (Hb) were significantly lower in users (10.00 g/dl) compared with nonusers (10.46 g/dl), p<.000. Anemia (Hb<10 g/dl) was significantly associated with smokeless tobacco in the univariate analysis (OR = 1.7, 95% CI 1.2-2.5). There was no change after adjusting odds ratios for potential confounders in multivariate analysis (OR = 1.7, 95% CI 1.2-2.5). The odds ratios for anemia were adjusted for age of mother, education, socioeconomic status, type of residence, lower body mass index, parity, vegetarian or nonvegetarian food habit, and hemodilution during pregnancy. The results suggest that smokeless tobacco use during pregnancy is associated with lower hemoglobin levels, as has often been observed with cigarette smoking. Smokeless tobacco use is widely prevalent among women in Southeast Asia and is gaining popularity across the world as a safe alternative to smoking. Further exploration and clarification of this association is therefore of considerable importance to public health.

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Section: Discussionmentioning

confidence: 97%

Anemia in pregnant women who use smokeless tobacco

Subramoney

Gupta

2008

CNTR

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“…In addition, failure of plasma volume expansion (or high Hgb) was associated with increased risk of fetal growth restriction. [30][31][32][33] Therefore, the plasma volume expansion and consequent "anemia" are associated with fewer low-birth-weight and preterm-birth deliveries.…”

Section: Discussionmentioning

confidence: 99%

Anemia During Pregnancy and Birth Outcome: A Meta-Analysis

Xiong¹,

Buekens²,

Alexander³

et al. 2000

Amer J Perinatol

162

114

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To determine the relationship between maternal anemia [hemoglobin (Hgb) < 10-11 g/dL] and various birth outcomes, a meta-analysis was conducted based on published literature identified by MEDLINE and manual search from 1966 through 1999. Odds ratios (OR) from selected studies were pooled according to the gestational age at anemia diagnosis. The meta-analysis shows that maternal anemia during early pregnancy was associated with slightly increased preterm birth [pooled adjusted OR (aOR): 1.32, 95% confidence interval (CI): 1.01-1.74], and nonstatistically significant increased low birth weight [pooled aOR: 1.39 (0.70-2.74)], and was not associated with fetal growth restriction [pooled aOR: 1.01 (0.73-1.38)]. However, there was a nonstatistically significant inverse relationship between anemia during late pregnancy and preterm birth [pooled aOR: 0.92 (0.54-1.84)] and low birth weight [pooled aOR: 0.80 (0.64-1.00)]. Anemia was not statistically significantly associated with hypertensive disorders of pregnancy regardless of stage of pregnancy [pooled OR: 0.80 (0.53-1.20)]. The relationship between anemia and perinatal mortality was inconclusive. A few studies indicated that severe maternal anemia (Hgb < 8-8.5 g/dL) was associated with increased risk of poor outcomes. We conclude that early pregnancy anemia is associated with slightly increased risk of preterm birth. The trend toward an inverse association of anemia determined during late pregnancy with preterm birth and low birth weight may reflect the benefit of plasma volume expansion.

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“…This suggests that hemoconcentration may have been present in the abortion group. Maternal hemoconcentration and high viscosity have been previously reported during severe pre-eclampsia; they may further impede the uteroplacental blood flow that is already compromised by pre-eclampsia, thereby contributing to placental infarction and growth retardation or fetal death (14,15). Blood viscosity reaches a level that impairs microcirculation, and an inadequate amount of oxygen is transported to tissues, similar to the situation with severe anemia (16).…”

Section: Discussionmentioning

confidence: 99%