Preeclampsia development and neonatal outcomes in pregnant women who were anemic in the first trimester

Preeclampsia and maternal anemia

Authors

Keywords:

Preeclampsia, Anemia, Pregnancy problems

Abstract

Background/Aim: Anemia is a disease that can be easily treated, but it is still widespread worldwide. Anemia can affect nearly 40% of women. Anemia has been extensively studied and related to a variety of pregnancy complications. The primary purpose of our study was to discover the relationship between preeclampsia and anemia in the first trimester, and the secondary goal was to analyze the outcomes of newborns born to these mothers.

Methods: This study was compiled as a retrospective cohort study. Age, gravida, parity, and thyroid stimulating hormone (TSH) levels were recorded in a patient’s first visit file. Hemoglobin counts in the first trimester were analyzed as hemogram values. Those with a hemoglobin value <11 g/dl during pregnancy were classified as anemic. The patients' file records were reviewed to determine mode of delivery, birth weight, and Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores. To confirm a diagnosis of preeclampsia, the American Congress of Obstetricians and Gynecologists (ACOG) criteria were used.

Results: After the exclusion of 186 women due to comorbidities and multiple pregnancies, 364 women were evaluated. The number of anemic pregnant women in the first trimester was 87 (23.9%), and 277 non-anemic women were matched with the anemic group. No statistical difference between the groups in terms of demographic characteristics, such as age, gravida, body mass index (BMI), and TSH were found. No statistical difference between the groups in terms of delivery type, infant birth weight, and APGAR scores were found (P > 0.05). Preeclampsia frequency was statistically higher in pregnant women who were anemic in the first trimester (P = 0.032).

Conclusion: Preeclampsia was found to be more common in pregnant women who were anemic in the first trimester. Although it would seem that neonatal outcomes are unaffected, we believe that the unaffected outcomes are due to iron replacement. To avoid pregnancy complications, it is crucial for women not to be anemic prior to becoming pregnant.

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Author Biographies

Seçil İrem Arık Alpçetin, Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine, Yenimahalle, Ankara, Turkey

Department of Obstetrics and Gynecology

Erhan Demirdağ, Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine, Yenimahalle, Ankara, Turkey

Department of Obstetrics and Gynecology

Mehmet Erdem, Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine, Yenimahalle, Ankara, Turkey

Department of Obstetrics and Gynecology,

Ahmet Erdem, Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine, Yenimahalle, Ankara, Turkey

Department of Obstetrics and Gynecology,

References

World Health Organization (WHO). The Prevalence of Anemia in women: a tabulation of available information. Geneva, Switzerland: WHO; 1992/MCH/MSM/92.2.

Barroso F, Allard S, Kahan BC, Connolly C, Smethurst H, Choo L, et al. Prevalence of maternal anaemia and its predictors: a multi-centre study. Eur J Obstet Gynecol Reprod Biol. 2011;159:99–105. DOI: https://doi.org/10.1016/j.ejogrb.2011.07.041

Murphy JF, O’Riordan J, Newcombe RG, Coles EC, Pearson JF. Relation of haemoglobin levels in first and second trimester to outcomes of pregnancy. Lancet 1986;8488:992–5. DOI: https://doi.org/10.1016/S0140-6736(86)91269-9

Stoltzfus R, Mullany L, Black RE. Iron deficiency anaemia. In: Ezzati M, Lopez A, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva (Switzerland): World Health Organization; 2004:163–210.

Brabin BJ, Hakimi M, Pelletier D. An analysis of anemia and pregnancy-related maternal mortality. J Nutr 2001;131:604–14s. DOI: https://doi.org/10.1093/jn/131.2.604S

Klebanoff MA, Shiono PH, Selby JV, Trachtenberg AI, Graubard BI. Anemia and spontaneous preterm birth. Am J Obstet Gynecol 1991;164:59–63. DOI: https://doi.org/10.1016/0002-9378(91)90626-3

Ren A, Wang J, Ye RW, Li S, Liu JM, Li Z. Low first trimester hemoglobin and low birth weight, preterm birth and small for gestational age newborns. Int J Gynaecol Obstet 2007;98:124–8. DOI: https://doi.org/10.1016/j.ijgo.2007.05.011

Ali AA, Rayis DA, Abdallah TM, Elbashir MI, Adam I. Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala Hospital, eastern Sudan. BMC Res Notes 2011;4:311. DOI: https://doi.org/10.1186/1756-0500-4-311

Vural T, Toz E, Ozcan A, Biler A, Ileri A, Inan A. Can anemia predict perinatal outcomes in different stages of pregnancy? Pak J Med Sci. 2016;32:1354–9. DOI: https://doi.org/10.12669/pjms.326.11199

Drukker L, Hants Y, Farkash R, Ruchlemer R, Samueloff A, Grisaru-Granovsky S. Iron deficiency anemia at admission for labor and delivery is associated with an increased risk for cesarean section and adverse maternal and neonatal outcomes. Transfusion. 2015;55:2799–806. DOI: https://doi.org/10.1111/trf.13252

Kadyrov M, Kingdom JC, Huppertz B. Divergent trophoblast invasion and apoptosis in placental bed spiral arteries from pregnancies complicated by maternal anemia and early-onset preeclampsia/intrauterine growth restriction. Am J Obstet Gynecol. 2006 Feb;194(2):557-63. doi: 10.1016/j.ajog.2005.07.035. PMID: 16458661. DOI: https://doi.org/10.1016/j.ajog.2005.07.035

Xiong X, Buekens P, Alexander S, Demianczuk N, Wollast E. Anemia during pregnancy and birth outcome: a meta-analysis. Am J Perinatol. 2000;17(3):137–46. DOI: https://doi.org/10.1055/s-2000-9508

Pena-Rosas JP, De-Regil LM, Garcia-Casal MN, Dowswell T. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;7:CD004736. DOI: https://doi.org/10.1002/14651858.CD004736.pub5

Lin L, Wei Y, Zhu W, Wang C, Su R, Feng H, Yang H; Gestational diabetes mellitus Prevalence Survey (GPS) study Group. Prevalence, risk factors and associated adverse pregnancy outcomes of anaemia in Chinese pregnant women: a multicentre retrospective study. BMC Pregnancy Childbirth. 2018 Apr 23;18(1):111. doi: 10.1186/s12884-018-1739-8. PMID: 29685119; PMCID: PMC5914057. DOI: https://doi.org/10.1186/s12884-018-1739-8

Smith C, Teng F, Branch E, Chu S, Joseph KS. Maternal and Perinatal Morbidity and Mortality Associated With Anemia in Pregnancy. Obstet Gynecol. 2019 Dec;134(6):1234-1244. doi: 10.1097/AOG.0000000000003557. PMID: 31764734; PMCID: PMC6882541. DOI: https://doi.org/10.1097/AOG.0000000000003557

Bora R, Sable C, Wolfson J, Boro K, Rao R. Prevalence of anemia in pregnant women and its effect on neonatal outcomes in Northeast India. J Matern Fetal Neonatal Med. 2014 Jun;27(9):887-91. doi: 10.3109/14767058.2013.845161. Epub 2013 Oct 24. PMID: 24041147. DOI: https://doi.org/10.3109/14767058.2013.845161

Figueiredo ACMG, Gomes-Filho IS, Silva RB, Pereira PPS, Mata FAFD, Lyrio AO, Souza ES, Cruz SS, Pereira MG. Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis. Nutrients. 2018 May 12;10(5):601. doi: 10.3390/nu10050601. PMID: 29757207; PMCID: PMC5986481. DOI: https://doi.org/10.3390/nu10050601

Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW; Nutrition Impact Model Study Group (anaemia). Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013 Jun 21;346:f3443. doi: 10.1136/bmj.f3443. PMID: 23794316; PMCID: PMC3689887. DOI: https://doi.org/10.1136/bmj.f3443

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Published

2022-12-29

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Research Article

How to Cite

1.
Cevher Akdulum MF, Arık Alpçetin S İrem, Demirdağ E, Erdem M, Erdem A. Preeclampsia development and neonatal outcomes in pregnant women who were anemic in the first trimester : Preeclampsia and maternal anemia. J Surg Med [Internet]. 2022 Dec. 29 [cited 2023 Feb. 6];6(12):1004-6. Available from: https://jsurgmed.com/article/view/7614