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Maternal hemoglobin concentrations across pregnancy and maternal and child health: a systematic review and meta‐analysis

Published on Apr 17, 2019in Annals of the New York Academy of Sciences4.295
· DOI :10.1111/nyas.14093
Melissa Young9
Estimated H-index: 9
(Emory University),
Brietta M Oaks7
Estimated H-index: 7
(URI: University of Rhode Island)
+ 3 AuthorsAmanda Wendt7
Estimated H-index: 7
(Heidelberg University)
Abstract
: Maternal anemia is a well-recognized global health problem; however, there remain questions on specific hemoglobin (Hb) thresholds that predict health risk or protection for mother and child. We conducted a systematic review and meta-analysis to examine the associations of maternal Hb concentrations with a range of maternal and infant health outcomes, accounting for the timing of measurement (preconception, and first, second, and third trimesters), etiology of anemia, and cutoff category. The systematic review included 272 studies and the meta-analysis included 95 studies. Low maternal Hb ( 130 g/L) was associated with increased odds of SGA, stillbirth, preeclampsia, and gestational diabetes. Relationships varied by the timing of measurement and cutoff category (stronger associations with lower cutoffs); limited data were available on anemia etiology. There were insufficient data for other maternal outcomes and long-term child health outcomes. Current data are insufficient for determining if revisions to current Hb cutoffs are required. Pooled high-quality individual-level data analyses, as well as prospective cohort studies, would be valuable to inform the reevaluation of Hb cutoffs.
  • References (128)
  • Citations (2)
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References128
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#1Masako Fujita (MSU: Michigan State University)H-Index: 9
#2Nerli Paredes Ruvalcaba (MSU: Michigan State University)H-Index: 2
Last. Eleanor Brindle (UW: University of Washington)H-Index: 16
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#1Yitbarek Kidane Woldetensay (University of Hohenheim)H-Index: 2
#2Tsion Assefa (College of Health Sciences, Bahrain)H-Index: 26
Last. Eva Johanna Kantelhardt (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 13
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Background Depression during pregnancy has far-reaching adverse consequences on mothers, children and the whole family. The magnitude and determinants of prenatal depressive symptoms in low-resource countries are not well established. This study aims to describe the prevalence of prenatal depressive symptoms and whether it is associated with maternal nutrition, intimate partner violence and social support among pregnant women in rural Ethiopia.
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#1Xiuli ZhangH-Index: 2
#2Qin XuH-Index: 2
Last. Zengli YuH-Index: 7
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: Evidence on the association between maternal Hb concentration and preterm birth (PTB) risk is inconclusive. This paper aimed to explore whether women with anaemia or high Hb level before pregnancy would be at higher risk of PTB. We conducted a population-based cohort study with 2 722 274 women aged 20-49 years, who participated in National Free Pre-Pregnancy Checkups Project between 2013 and 2015 and delivered a singleton before 2016 in rural China. Logistic models were used to estimate OR and...
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#1Archana PatelH-Index: 33
#2Amber PrakashH-Index: 3
Last. Patricia L Hibberd (BU: Boston University)H-Index: 6
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Objectives To study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes. Design Prospective observational cohort study. Setting Catchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India. Participants 72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH’s Global Network, enrolled from 2009 to 2016. Main outcome measur...
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#1Fenglian Xu (UTS: University of Technology, Sydney)H-Index: 11
#2Lynette Roberts (UTS: University of Technology, Sydney)H-Index: 6
Last. Caroline S.E. Homer (UTS: University of Technology, Sydney)H-Index: 37
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To investigate the rates of hospitalisation for anaemia and depression in women in the six-year period (3 years before and after birth). To compare hospital admissions for depression in women with and without anaemia. This is a population-based cohort study. Women’s birth records (New South Wales (NSW) Perinatal Data Collection) were linked with NSW Admitted Patients Data Collection records between 1 January 2001 and 31 December 2010, so that hospital admissions for mothers could be traced back ...
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#1M.A. ObadiH-Index: 1
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Last. Y.S. Khader (JUST: Jordan University of Science and Technology)H-Index: 1
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#1Chang Chen (SJTU: Shanghai Jiao Tong University)H-Index: 3
#2Jagteshwar Grewal (NIH: National Institutes of Health)H-Index: 13
Last. Jian Zhang (SJTU: Shanghai Jiao Tong University)H-Index: 93
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Abstract Objective Hypertensive disorders during pregnancy are one of main causes for maternal and perinatal morbidity and mortality in developing countries. This study is to determine whether specific types of anemia are risk factors for hypertensive disorders during pregnancy in developing countries. Methods Using data from the World Health Organization Global Survey for Maternal and Perinatal Health, collected in hospitals in six African and six Latin American countries from 2007 to 2008 and ...
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#1Chen Wang (PKU: Peking University)H-Index: 9
#2Li Lin (PKU: Peking University)H-Index: 6
Last. Huixia Yang (PKU: Peking University)H-Index: 25
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Hemoglobin (Hb) measurement is a standard test among pregnant women during the first perinatal visit that is used to evaluate physical status and anemia. However, studies focusing on Hb levels and pregnancy outcomes are scarce. This study aimed to determine whether Hb levels in early pregnancy were associated with the risk of gestational diabetes mellitus (GDM), pre-eclampsia (PE) and preterm birth. A hospital-based retrospective study was conducted among 21,577 singleton, non-smoking pregnancie...
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Objective: To systematically analyze the relationship between maternal anemia and low birth weight. Methods: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles. Cohort and case-control studies that met the eligibility criteria were included in the review. There was no limitation on the language or date of publication. Article selection and data extraction were per...
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#2Gudlavalleti V. S. Murthy (Public Health Foundation of India)H-Index: 33
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Background: The increasing recognition of antenatal depression is an emerging area of concern in developing countries. We conducted a study to estimate the prevalence of antenatal mental distress and its relation with socio-demographic factors, obstetric factors and physiological well-being in pregnant women attending public health facilities in Bengaluru, South India. Methods: Nested within a cohort study, we assessed the mental status in 823 pregnant women in two public referral hospitals. Kes...
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BACKGROUND: Iron deficiency in pregnancy is associated with inferior maternal and fetal outcomes. Postpartum depression, prematurity, intrauterine growth restriction, impaired childhood cognition and transfusion are all sequelae of maternal iron deficiency anemia. Transfusion to women of childbearing age has important consequences including increasing the risk of hemolytic disease of the fetus and newborn with future pregnancies. The relative contribution of iron deficiency to transfusion rates ...
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Purpose . To identify the effects of gestational iron deficiency anemia after treatment with iron-containing drugs during the perinatal period on the health status of full-term children during their 1st year of life. Patients and methods. The authors carried out a prospective observational cohort study of full-term infants of I & II health group from their birth to twelve months. The course of pregnancy and labor was analyzed retrospectively. Hemoglobin, serum ferritin and C-reactive protein wer...
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#1N Paredes Ruvalcaba (MSU: Michigan State University)
#2E Bignall (MSU: Michigan State University)
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Anemia, a leading health issue affecting mothers globally, is generally prevalent among agropastoral populations. Previous research has been inconclusive regarding maternal age as a risk factor of anemia. Drawing on the models that recognize the important interaction between age and wealth, (Age-as-Leveler (AGL) and Cumulative Advantage/Disadvantage (CAD)) we evaluated whether age was a predictor for anemia and whether the effect of age depended on socioeconomic status (SES) among sedentary Aria...
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Abstract To investigate the associations between prenatal exposure to single metal and multiple metals and the risk of low birth weight (LBW), we conducted a nested case-control study of 246 LBW and 406 NBW mother-infant pairs based on a prospective birth cohort study. 22 serum metals were detected by inductively coupled plasma quadruple mass spectrometry (ICP-MS). Categorical analyses showed serum Co and Ti were associated with LBW (Co: 3rd vs 4th. quartile: OR = 1.83, 95%CI: 1.14–2.92, P trend...
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