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Association between maternal haemoglobin concentration and stillbirth: A cohort study among a multi-ethnic population in England
Nair, Manisha Nelson-Piercy, Cathy Stanworth, Simon J Knight, Marian
Nair, Manisha
Nelson-Piercy, Cathy
Stanworth, Simon J
Knight, Marian
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2017-03-28
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Abstract
Introduction There have been many calls for action to reduce stillbirths including the need to understand the determinants. Low maternal haemoglobin concentrations have been explored as a risk factor for stillbirth and perinatal death, but evidence is weak. The objective of this work was to examine the association of maternal haemoglobin concentration with stillbirth and perinatal death in a multi-ethnic population in England. Methods A retrospective cohort analysis was conducted using anonymised data from 14 001 women with singleton pregnancies ≥24 weeks of gestation giving birth in two hospitals in 2013–15. Multivariable logistic regression models were built to analyse associations between maternal haemoglobin at first visit and at 28 weeks with stillbirth and perinatal death, adjusting for 11 other risk factors. Results Almost half of the study population had anaemia at some point during their pregnancy. The risk of stillbirth and perinatal death decreased linearly per unit increase in haemoglobin concentration at first visit (adjusted odds ratio [aOR] stillbirth = 0.70, 95% CI 0.58–0.85; aOR perinatal death = 0.71, 95% CI 0.60–0.84) and at 28 weeks (aOR stillbirth = 0.83, 95% CI 0.62–1.11; aOR perinatal death = 0.86, 95% CI 0.67–1.12). Compared with women with normal haemoglobin concentrations, the risk of stillbirth and perinatal death was five-fold and three-fold higher in women with moderate-severe maternal anaemia at first visit and 28 weeks, respectively. Conclusion These findings are of clinical and public health importance. If the observed association is causal, iron supplementation during pregnancy could have an incremental benefit on reducing the risk of stillbirth and perinatal death for all women.
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Nair, M., Churchill, D., Nelson-Piercy, C., Stanworth, S.J. and Knight, M. (2017) Association between maternal haemoglobin concentration and stillbirth: A cohort study among a multi-ethnic population in England. BJOG: An International Journal of Obstetrics and Gynaecology, 124(S2), P.PO.65
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en
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This is an accepted manuscript of an article published by Wiley on 28/03/2017, in the Special Issue: Abstracts of the British Maternal & Fetal Medicine Society (BMFMS) 19th Annual Conference 2017. 30–31 March 2017, Amsterdam, The Netherlands, available online: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.14589 The accepted version of the publication may differ from the final published version.
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1470-0328
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1471-0528