The effect of first trimester hemoglobin levels on pregnancy outcomes

Çakmak, Burcu Dinçgez; Türker, Ülkü Ayşe; Öztaş, Sonay; Arık, Melis; Üstünyurt, Emin

doi:10.4274/tjod.87269

Cited by 19 publications

(12 citation statements)

References 24 publications

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“…of pregnant women with thalassemia. In our study, we did not nd signi cant differences between maternal and fetal pregnancy outcomes in the three different Hb concentrations subgroups of the control group, which was not the same as previous ndings [22,36] . However, the incidence of GDM in Hb ≥ 130 g/L subgroup was signi cantly higher comparing with Hb < 110 g/L and 110 ≤ Hb < 130 g/L subgroups in pregnant women with thalassemia minor.…”

Section: Discussioncontrasting

confidence: 61%

“…Its measurement is a routine standard test for evaluating physical status among pregnant women in their rst visit to primary health care clinics. Anemia is often a concern, which may lead to adverse pregnancy outcomes, including low birth weight, postpartum hemorrhage, cesarean section, and preterm birth [21,22] . However, insu cient attention has been paid to high maternal Hb.…”

Section: Introductionmentioning

confidence: 99%

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Effect of different Hb concentrations on the risk of gestational diabetes mellitus in women with thalassemia minor

Wang

Xiao

et al. 2023

Preprint

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Backgrounds A few studies have focused on the effect of thalassemia and different Hb levels on pregnancy outcomes recently. However, to our knowledge, there are no studies on the effects of different levels of hemoglobin(Hb) on pregnancy outcomes in Chinese women with thalassemia minor. In the present research, we aimed to clarify the effect of different Hb levels on pregnancy outcomes and to further explore the association of different Hb levels and gestational diabetes mellitus (GDM) in pregnant women with thalassemia minor in Chinese populations. Methods A retrospective controlled study was conducted on 723 pregnant women who were followed up for delivery in our hospital from 2017 to 2021. They were grouped into thalassemia minor and control group. The two groups were further divided into three subgroups, including anmia, normal and high Hb subgroups. Pregnant complications were studied in two main groups and their three subgroups. All statistical analyses were performed using R version 4.1.0 and contributed packages. Results There were no significant differences regarding neonatal and maternal pregnancy outcomes in women with and without thalassemia except for postpartum anemia. Furthermore, in the thalassemia group, the prevalence of GDM in the high Hb subgroup was significantly higher than the other two subgroups. However, in the control group, no significant statistical differences were found among the three subgroups. Moreover, in the high Hb subgroup, the fetuses of women with thalassemia were more likely to develop jaundice after birth. In the normal Hb subgroup, the proportion of macrosomia in the thalassemia group was significantly higher than the control group, while the proportion of low birth weight infants was on the contrary. Lastly, in anemia subgroups, we found less pregnant women with thalassemia suffered from cesarean compared to pregnant women without thalassemia. Conclusion We concluded that high Hb concentration might be a trigger for GDM in Chinese pregnant women with thalassemia minor. Maternal iron and Hb levels should be monitored during antenatal care and pregnancy management, as iron supplementation may lead to adverse pregnancy outcomes in women with thalassemia minor with normal or particularly high Hb concentrations.

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Section: Discussioncontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Effect of different Hb concentrations on the risk of gestational diabetes mellitus in women with thalassemia minor

Wang

Xiao

et al. 2023

Preprint

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“…All hemoglobin measurements were obtained prepartum, which ensured hemoglobin measurements were not a consequence of peri- and/or postpartum bleeding. Twenty-two of these studies defined anemia using the WHO-conformant threshold of <11 g/dl (Table 1), 9,10,12,14,16,30–46 the other 24 studies fell into the Lower or Unspecified Threshold groups and were analyzed separately (Table 2). 11,13,15,47–67…”

Section: Resultsmentioning

confidence: 99%

Prepartum Anemia and Risk of Postpartum Hemorrhage: A Meta-Analysis and Brief Review

Glonnegger,

Glenzer,

Lancaster

et al. 2023

Clin Appl Thromb Hemost

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Postpartum hemorrhage (PPH) is responsible for 30% to 50% of maternal deaths. There is conflicting evidence if prepartum anemia facilitates PPH. A comprehensive analysis of studies describing their relation is missing. An extensive database search was conducted applying the terms “anemia” OR “hemoglobin” AND “postpartum hemorrhage.” We used a random-effects meta-analysis model to estimate an overall odds ratio (OR) for PPH and prepartum anemia, separating studies that were conformant and non-conformant with the World Health Organization (WHO) definitions for anemia. The search yielded 2519 studies, and 46 were appropriate for analysis. The meta-analyses of WHO-conformant ( n = 22) and non-conformant ( n = 24) studies showed that the risk of PPH was increased when anemia was present. The ORs were 1.45 (CL: 1.23-1.71) for WHO-conformant studies, 2.88 (CL: 1.38-6.02) for studies applying lower thresholds for anemia, and 3.28 (CL: 2.08-5.19) for undefined anemia thresholds. PPH risk appeared to increase with lower anemia thresholds. Prepartum anemia is associated with an increased risk of PPH, an observation that is important regarding improved anemia correction strategies such as iron supplementation.

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“…Studies have also investigated whether when anaemia appears in the pregnancy is associated with adverse outcomes. For example, some studies found a significant association of first‐trimester anaemia with adverse pregnancy outcomes, 9 whereas others found significant associations only in the second or third trimesters 8,10 . There is reasonable agreement that the severity of anaemia, especially when moderate or severe, is most strongly related to adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

Association of haemoglobin levels in the first trimester and at 26–30 weeks with fetal and neonatal outcomes: a secondary analysis of the Global Network for Women's and Children's Health's ASPIRIN Trial

Jessani

Saleem

Hoffman³

et al. 2021

BJOG

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Objective Limited data are available from low-and middleincome countries (LMICs) on the relationship of haemoglobin levels to adverse outcomes at different times during pregnancy. We evaluated the association of haemoglobin levels in nulliparous women at two times in pregnancy with pregnancy outcomes.Design ASPIRIN Trial data were used to study the association between haemoglobin levels measured at 6 +0 -13 +6 weeks and 26 +0 -30 +0 weeks of gestation with fetal and neonatal outcomes.Setting Obstetric care facilities in Pakistan, India, Kenya, Zambia, The Democratic Republic of the Congo and Guatemala.Population A total of 11 976 pregnant women.Methods Generalised linear models were used to obtain adjusted relative risks and 95% CI for adverse outcomes.Main outcome measures Preterm birth, stillbirth, neonatal death, small for gestational age (SGA) and birthweight <2500 g. ResultsThe mean haemoglobin levels at 6 +0 -13 +6 weeks and at 26-30 weeks of gestation were 116 g/l (SD 17) and 107 g/l (SD 15), respectively. In general, pregnancy outcomes were better with increasing haemoglobin. At 6 +0 -13 +6 weeks of gestation, stillbirth, SGA and birthweight <2500 g, were significantly associated with haemoglobin of 70-89 g/l compared with haemoglobin of 110-129 g/l The relationships of adverse pregnancy outcomes with various haemoglobin levels were more marked at 26-30 weeks of gestation.Conclusions Both lower and some higher haemoglobin concentrations are associated with adverse fetal and neonatal outcomes at 6 +0 -13 +6 weeks and at 26-30 weeks of gestation, although the relationship with low haemoglobin levels appears more consistent and generally stronger.

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The effect of first trimester hemoglobin levels on pregnancy outcomes

Cited by 19 publications

References 24 publications

Effect of different Hb concentrations on the risk of gestational diabetes mellitus in women with thalassemia minor

Effect of different Hb concentrations on the risk of gestational diabetes mellitus in women with thalassemia minor

Prepartum Anemia and Risk of Postpartum Hemorrhage: A Meta-Analysis and Brief Review

Association of haemoglobin levels in the first trimester and at 26–30 weeks with fetal and neonatal outcomes: a secondary analysis of the Global Network for Women's and Children's Health's ASPIRIN Trial

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