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Association of Maternal Hemoglobin Levels and Chorioamnionitis with Small Vulnerable Newborns: A Cohort Study
41 Pages Posted: 25 Sep 2024
More...Abstract
Background: We aimed to find out the impact of maternal Hb levels, alone or in conjunction with chorioamnionitis, on the risk of preterm birth or low birth weight.
Methods: This retrospective cohort study included 54,300 pregnant women who delivered from 2018.01 to 2023.12 and had antenatal examination records available at a university-affiliated hospital in Shanghai, China. The primary outcomes was birth weight and gestational week.
Findings: In this cohort study, maternal Hb levels below 100 g/L were associated with an increased risk of chorioamnionitis, preterm birth, and low birth weight. Furthermore, the presence of chorioamnionitis exacerbated the detrimental effects of maternal anemia on the risk of small vulnerable newborns.
Interpretation: Maternal anemia, particularly in the third trimester, is associated with an increased risk of chorioamnionitis, PTB, and LBW. Moreover, the presence of both anemia and chorioamnionitis exacerbates these risks synergistically.
Funding: This work is supported by National Key Research and Development Program of China (2021YFC2700700， 2022YFC2703500), National Natural Science Foundation of China (82088102, 82171686), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-064), Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01), Key Discipline Construction Project（2023-2025）of Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai (GWVI-11.1-35), Clinical research program of Shanghai Municipal Health Commission (202340222), Natural Science Foundation of Shanghai (20ZR1463100), Clinical Research Plan of Shanghai Shenkang Hospital Development Center (SHDC2023CRD001, SHDC2020CR1008A), Shanghai Clinical Research Center for Gynecological Diseases (22MC1940200), Shanghai Urogenital System Diseases Research Center (2022ZZ01012) and Shanghai Frontiers Science Research Center of Reproduction and Development.
Declaration of Interest: The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this study.
Ethical Approval: This study was approved by the Institutional Review Board (IRB) of the Obstetrics & Gynecology Hospital of Fudan University (ref. no. 2021-90) and the requirement for informed consent was waived because the data were retrospective and de-identified.
Keywords: Maternal hemoglobin, Anemia, Chorioamnionitis, Birth weight, LBW, Preterm birth, Birth outcome
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