| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH |
From the Division of Nutrition and Physical Activity and the Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia; and the United Nations Infant and Child Emergency Fund, Beijing, China.
Address reprint requests to: Kelley S. Scanlon, PhD Division of Nutrition & Physical Activity Centers for Disease Control & Prevention 4770 Buford Highway, NE, MS K-25 Atlanta, GA 30341-3717 E-mail: kxs5{at}cdc.gov
Objective: To examine the association of maternal hemoglobin during pregnancy with preterm birth and small for gestational age (SGA).
Methods: We performed a retrospective cohort analysis of hemoglobin and birth outcome among 173,031 pregnant women who attended publicly funded health programs in ten states and delivered a liveborn infant at 26–42 weeks’ gestation. We defined preterm as less than 37 weeks’ gestation and SGA as less than the tenth percentile of a US fetal growth reference.
Results: Risk of preterm birth was increased in women with low hemoglobin level in the first and second trimester. The odds ratio (OR) for preterm birth with moderate-to-severe anemia during the first trimester (more than three standard deviations [SD] below reference median hemoglobin, equivalent to less than 95 g/L at 12 weeks’ gestation) was 1.68 (95% confidence interval [CI] 1.29, 2.21). Anemia was not associated with SGA. High hemoglobin level during the first and second trimester was associated with SGA but not preterm birth. The ORs for SGA in women with very high hemoglobin level during the first and second trimester (more than three SDs above reference median hemoglobin, equivalent to greater than 149 g/L at 12 weeks’ gestation and greater than 144 g/L at 18 weeks’) were 1.27 (95% CI 1.02, 1.58) and 1.79 (95% CI 1.49, 2.15), respectively.
Conclusion: These data highlight the importance of considering anemia and high hemoglobin level as indicators for adverse pregnancy outcome. An elevated hemoglobin level (greater than 144 g/L) is an indicator for possible pregnancy complications associated with poor plasma volume expansion, and should not be mistaken for good iron status.
This article has been cited by other articles:
|
|
 |
|
  K. Raatikainen, N. Heiskanen, P. K. Verkasalo, and S. Heinonen Good outcome of teenage pregnancies in high-quality maternity care Eur J Public Health, April 1, 2006; 16(2): 157 - 161. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. L. Iannotti, K. O. O'Brien, S.-C. Chang, J. Mancini, M. Schulman-Nathanson, S. Liu, Z. L. Harris, and F. R. Witter Iron Deficiency Anemia and Depleted Body Iron Reserves Are Prevalent among Pregnant African-American Adolescents J. Nutr., November 1, 2005; 135(11): 2572 - 2577. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. O Scholl Iron status during pregnancy: setting the stage for mother and infant Am. J. Clinical Nutrition, May 1, 2005; 81(5): 1218S - 1222S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Pena-Rosas, M. C. Nesheim, M. N. Garcia-Casal, D. W. T. Crompton, D. Sanjur, F. E. Viteri, E. A. Frongillo, and P. Lorenzana Intermittent Iron Supplementation Regimens Are Able to Maintain Safe Maternal Hemoglobin Concentrations during Pregnancy in Venezuela J. Nutr., May 1, 2004; 134(5): 1099 - 1104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-C. Chang, K. O. O'Brien, M. S. Nathanson, J. Mancini, and F. R. Witter Hemoglobin Concentrations Influence Birth Outcomes in Pregnant African-American Adolescents J. Nutr., July 1, 2003; 133(7): 2348 - 2355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Rasmussen Is There a Causal Relationship between Iron Deficiency or Iron-Deficiency Anemia and Weight at Birth, Length of Gestation and Perinatal Mortality? J. Nutr., February 1, 2001; 131(2): 590S - 603. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
