The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes.
BACKGROUND:Low haemoglobin has been linked to adverse pregnancy outcomes. Our study aimed to assess the association of haemoglobin (Hb) in the first 20 weeks of pregnancy, and restoration of low Hb levels, with pregnancy outcomes in Australia. METHODS:Clinical data for singleton pregnancies from two...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0225123 |
| _version_ | 1818590731667767296 |
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| author | Deborah A Randall Jillian A Patterson Felicity Gallimore Jonathan M Morris Therese M McGee Jane B Ford Obstetric Transfusion Steering Group |
| author_facet | Deborah A Randall Jillian A Patterson Felicity Gallimore Jonathan M Morris Therese M McGee Jane B Ford Obstetric Transfusion Steering Group |
| author_sort | Deborah A Randall |
| collection | DOAJ |
| description | BACKGROUND:Low haemoglobin has been linked to adverse pregnancy outcomes. Our study aimed to assess the association of haemoglobin (Hb) in the first 20 weeks of pregnancy, and restoration of low Hb levels, with pregnancy outcomes in Australia. METHODS:Clinical data for singleton pregnancies from two tertiary public hospitals in New South Wales were extracted for 2011-2015. The relationship between the lowest Hb result in the first 20 weeks of pregnancy and adverse outcomes was determined using adjusted Poisson regression. Those with Hb <110 g/L were classified into 'restored' and 'not restored' based on Hb results from 21 weeks onwards, and risk of adverse outcomes explored with adjusted Poisson regression. RESULTS:Of 31,906 singleton pregnancies, 4.0% had Hb <110 and 10.2% had ≥140 g/L at ≤20 weeks. Women with low Hb had significantly higher risks of postpartum haemorrhage, transfusion, preterm birth, very low birthweight, and having a baby transferred to higher care or stillbirth. High Hb was also associated with higher risks of preterm, very low birthweight, and transfer to higher care/stillbirth. Transfusion was the only outcome where risk decreased with increasing Hb. Risk of transfusion was significantly lower in the 'restored' group compared with the 'not restored' group (OR 0.39, 95% CI 0.22-0.70), but restoration of Hb did not significantly affect the other outcomes measured. CONCLUSIONS:Women with both low and high Hb in the first 20 weeks of pregnancy had higher risks of adverse outcomes than those with normal Hb. Restoring Hb after 20 weeks did not improve most adverse outcome rates but did reduce risk of transfusion. |
| first_indexed | 2024-12-16T10:01:12Z |
| format | Article |
| id | doaj.art-a6c74c2007ee41019dd5081ca5e0d70c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T10:01:12Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a6c74c2007ee41019dd5081ca5e0d70c2022-12-21T22:35:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011411e022512310.1371/journal.pone.0225123The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes.Deborah A RandallJillian A PattersonFelicity GallimoreJonathan M MorrisTherese M McGeeJane B FordObstetric Transfusion Steering GroupBACKGROUND:Low haemoglobin has been linked to adverse pregnancy outcomes. Our study aimed to assess the association of haemoglobin (Hb) in the first 20 weeks of pregnancy, and restoration of low Hb levels, with pregnancy outcomes in Australia. METHODS:Clinical data for singleton pregnancies from two tertiary public hospitals in New South Wales were extracted for 2011-2015. The relationship between the lowest Hb result in the first 20 weeks of pregnancy and adverse outcomes was determined using adjusted Poisson regression. Those with Hb <110 g/L were classified into 'restored' and 'not restored' based on Hb results from 21 weeks onwards, and risk of adverse outcomes explored with adjusted Poisson regression. RESULTS:Of 31,906 singleton pregnancies, 4.0% had Hb <110 and 10.2% had ≥140 g/L at ≤20 weeks. Women with low Hb had significantly higher risks of postpartum haemorrhage, transfusion, preterm birth, very low birthweight, and having a baby transferred to higher care or stillbirth. High Hb was also associated with higher risks of preterm, very low birthweight, and transfer to higher care/stillbirth. Transfusion was the only outcome where risk decreased with increasing Hb. Risk of transfusion was significantly lower in the 'restored' group compared with the 'not restored' group (OR 0.39, 95% CI 0.22-0.70), but restoration of Hb did not significantly affect the other outcomes measured. CONCLUSIONS:Women with both low and high Hb in the first 20 weeks of pregnancy had higher risks of adverse outcomes than those with normal Hb. Restoring Hb after 20 weeks did not improve most adverse outcome rates but did reduce risk of transfusion.https://doi.org/10.1371/journal.pone.0225123 |
| spellingShingle | Deborah A Randall Jillian A Patterson Felicity Gallimore Jonathan M Morris Therese M McGee Jane B Ford Obstetric Transfusion Steering Group The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. PLoS ONE |
| title | The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. |
| title_full | The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. |
| title_fullStr | The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. |
| title_full_unstemmed | The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. |
| title_short | The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes. |
| title_sort | association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes |
| url | https://doi.org/10.1371/journal.pone.0225123 |
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