Relation between maternal haemoglobin concentration and birth weight in different ethnic groups.

Academic Department of Obstetrics and Gynaecology, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, London.
BMJ Clinical Research (Impact Factor: 14.09). 02/1995; 310(6978):489-91. DOI: 10.1016/0020-7292(95)96757-L
Source: PubMed

ABSTRACT To assess the relation of the lowest haemoglobin concentration in pregnancy with birth weight and the rates of low birth weight and preterm delivery in different ethnic groups.
Retrospective analysis of 153,602 pregnancies with ethnic group and birth weight recorded on a regional pregnancy database during 1988-91. The haemoglobin measurement used was the lowest recorded during pregnancy.
North West Thames region.
115,262 white women, 22,206 Indo-Pakistanis, 4570 Afro-Caribbeans, 2642 mediterraneans, 3905 black Africans, 2351 orientals, and 2666 others.
Birth weight and rates of low birth weight (< 2500 g) and preterm delivery (< 37 completed weeks).
Maximum mean birth weight in white women was achieved with a lowest haemoglobin concentration in pregnancy of 85-95 g/l; the lowest incidence of low birth weight and preterm labour occurred with a lowest haemoglobin of 95-105 g/l. A similar pattern occurred in all ethnic groups.
The magnitude of the fall in haemoglobin concentration in pregnancy is related to birth weight; failure of the haemoglobin concentration to fall below 105 g/l indicates an increased risk of low birth weight and preterm delivery. This phenomenon is seen in all ethnic groups. Some ethnic groups have higher rates of low birth weight and preterm delivery than white women, and they also have higher rates of low haemoglobin concentrations. This increased rate of "anaemia," however, does not account for their higher rates of low birth weight, which occurs at all haemoglobin concentrations.

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    ABSTRACT: Background. Over half of all women in the world experience anemia during their pregnancy. Our aim was to investigate the relation between hemoglobin and iron status examined in second trimester and pregnancy outcome. Methods. In a prospective longitudinal study, 382 pregnant women were included. Blood samples were examined for hematological status and serum ferritin between 16 and 20 weeks and for hemoglobin before delivery. The adverse maternal and perinatal outcomes were determined. Regression analysis was performed to establish if anemia and low serum ferritin are risk factors for pregnancy complications. Results. There was no increase of complications in women with mild anemia and in women with depleted iron stores. The finding showed that mild iron deficiency anemia and depleted iron stores are not risk factors for adverse outcomes in iron supplemented women. Conclusions. Mild anemia and depleted iron stores detected early in pregnancy were not associated with adverse maternal and perinatal outcomes in iron supplemented women.
    Journal of pregnancy 01/2014; 2014:307535.
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    ABSTRACT: This manuscript includes an opportunistic analysis of haemoglobin changes during pregnancy as recorded in the medical records of 600 pregnancies (to 300 women). It has not been published since it was critiqued by reviewers as not representing new information (despite a lack of Australian data) and because it included women experiencing postpartum haemorrhage. However, only half of the pregnancies were followed by a postpartum haemorrhage and a comparison of pregnancies with and without postpartum haemorrhage revealed no differences in haemoglobin profiles across pregnancy. In the absence of other Australian data on haemoglobin change during pregnancy we think it is important that these data be made available.
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    ABSTRACT: Fetal growth restriction is an important predictor of infant mortality and morbidity. Maternal iron status and iron supplementation during pregnancy have been related to fetal growth with contrasting results. Therefore, indication of iron supplementation, doses, and timing is still controversial. humans since 1991 assessing iron status or supplementation in the periconceptional period or at any time during pregnancy. Evidence suggests that iron deficiency in early pregnancy has an adverse effect on fetal growth. On the other hand, high levels of maternal iron markers have shown a deleterious effect at different stages of pregnancy. The mechanisms underlying such effect are unclear. It is important to acknowledge the need to assess markers of iron status adequately in order to reach reliable conclusions regarding their relationship with fetal growth. In regard to supplementation, it has been shown that low or moderate doses of iron in early pregnancy have a positive effect on fetal growth, regardless of maternal iron status. No such effect has been seen in trials of supplementation later in pregnancy, with low or high doses. Nevertheless, results should be interpreted with caution as some randomized controlled trials lack adequate methodology. Studies assessing the effect of iron supplementation in early pregnancy on fetal growth in iron-deficient and iron-sufficient women are needed in order to establish the most appropriate indications for doses and timing.


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