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Association between maternal haemoglobin at 27-29weeks gestation and intrauterine growth restriction.
Pregnancy Hypertension 2015 October
OBJECTIVE: To examine the relationship between maternal haemoglobin concentration (Hb) at 27-29weeks' gestation and fetal growth restriction (FGR).
DESIGN: This was a retrospective, case control study.
SETTING: A University hospital in London, UK.
POPULATION: Pregnant women attending for routine antenatal care at 27-29weeks of pregnancy.
METHODS: Maternal Hb, measured routinely at 27-29weeks in pregnancies complicated by FGR (n=491) was compared to normal controls (n=491). Multiple regression analysis was used to examine the association between Hb and maternal characteristics.
MAIN OUTCOME MEASURES: Birthweight z-score, admission to the Neonatal Unit (NNU) and adverse perinatal outcome.
RESULTS: Increased Hb at 27-29weeks gestation is associated with reduced birthweight, with an inverse relationship between maternal Hb and fetal birthweight z-score (R(2)=0.10, p<0.0001). In addition, for the prediction of admission to the NNU (R(2)=0.24, p<0.0001) and serious adverse neonatal outcome (R(2)=0.10, p<0.0001), maternal Hb is an independent predictor with a linear and quadratic relationship, respectively. Therefore, both increased and decreased maternal Hb levels increase the risk of serious neonatal complications.
CONCLUSIONS: Raised Hb at 27-29weeks gestation is associated with FGR and with an increased risk of admission to the NNU and adverse fetal outcome.
DESIGN: This was a retrospective, case control study.
SETTING: A University hospital in London, UK.
POPULATION: Pregnant women attending for routine antenatal care at 27-29weeks of pregnancy.
METHODS: Maternal Hb, measured routinely at 27-29weeks in pregnancies complicated by FGR (n=491) was compared to normal controls (n=491). Multiple regression analysis was used to examine the association between Hb and maternal characteristics.
MAIN OUTCOME MEASURES: Birthweight z-score, admission to the Neonatal Unit (NNU) and adverse perinatal outcome.
RESULTS: Increased Hb at 27-29weeks gestation is associated with reduced birthweight, with an inverse relationship between maternal Hb and fetal birthweight z-score (R(2)=0.10, p<0.0001). In addition, for the prediction of admission to the NNU (R(2)=0.24, p<0.0001) and serious adverse neonatal outcome (R(2)=0.10, p<0.0001), maternal Hb is an independent predictor with a linear and quadratic relationship, respectively. Therefore, both increased and decreased maternal Hb levels increase the risk of serious neonatal complications.
CONCLUSIONS: Raised Hb at 27-29weeks gestation is associated with FGR and with an increased risk of admission to the NNU and adverse fetal outcome.
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