Does maternal anemia affect the newborn?

Abstract

Aim: In this study we aimed to evaluate the effect of maternal anemia on the newborn Material and Method: We determined hemoglobin Hb hematocrit Hct levels of 307 pregnant women who delivered in our clinic and Hb Hct bilirubin levels in the cord blood mode of delivery and Apgar scores of their newborns The pregnant women were evaluated in two groups according to their Hb levels with the ones with a Hb value above 11 1 mg dl as the nonanemic group and a Hb value below 11mg dl as the anemic group We also created four groups with Hb levels ge;11 1 mg dl between 11 10 1 mg dl between 10 9 1mg dl and le;9 mg dl Results: We We included 146 anemic and 161 nonanemic patients in the study The rate of delivery of babies with low birth weight was significantly higher in the anemic group 11 6 vs 4 3 P=0 029 The rate of low birth weight was significantly higher in the patients with Hb level lt;10 mg dl 62 5 sensitivity 74 7 specificity The cord blood Hb 17 49 plusmn;2 4 g dl vs 18 1 plusmn;2 4; P=0 026 and Hct level 53 3 plusmn;7 4 vs 55 6 plusmn;7 2 ; P=0 006 in the anemic group were significantly lower Conclusions: Anemia in pregnancy increases the risk of low birth weight and lowers the levels of Hb and Hct of the newborn Anemia should be screened and treated before delivery Turk Arch Ped 2013; 48: 195 199

Keywords

• Anemia, hemoglobin, low birth weight, newborn

Annede anemi yenidoğanı etkiler mi?

Abstract

Amaç: Çalışmamızın amacı gebelikte mevcut olan aneminin ve yenidoğanda etkilerini değerlendirmekti.

Gereç ve Yöntem: Kliniğimizde doğum yapan 307 gebenin hemoglobin Hb hematokrit Hct değerleri ve yenidoğanların kordon kanında bakılan Hb Hct bilirübin değerleri ile doğum şekli yenidoğan kilosu Apgar skorlarını belirledik Gebeler Hb değerinin 11 1 mg dL ve üzerinde anemik olmayan Hb değeri 11 mg dL altında olan anemik grup olmak üzere iki grupta değerlendirildi Ayrıca Hb değerinin ge;11 1 mg dL 11 10 1 mg dL arasında 10 9 1mg dL arasında ve le;9 mg dL olması şeklinde dört grup oluşturuldu.

Bulgular: Çalışmaya 146 anemik 161 anemik olmayan olgu dahil edildi Anemik gebelerin düşük doğum ağırlıklı bebek doğurma oranı anlamlı olarak yüksek idi 11 6 rsquo;ya karşılık 4 3 p=0 029 Düşük doğum ağırlığı sıklığının anne Hb değeri 10 g dL ve altında olduğunda anlamlı olarak arttığı saptandı p=0 0045 Anemik gebelerin kordon kanı Hb 17 49 plusmn;2 4 g dL rsquo;ye karşılık 18 1 plusmn; 2 4; p=0 026 ve Hct 53 3 plusmn;7 4 rsquo;e karşılık 55 6 plusmn;7 2; p=0 006 değerleri anlamlı olarak düşük bulundu

Çıkarımlar: Gebelikteki anemi yenidoğanın düşük doğum kilosu ile doğma riskini artırmakta ve Hb ve Hct değerlerini azaltmaktadır Anemi taranmalı ve doğum öncesinde tedavi edilmelidir.

Keywords

• Anemi
• düşük doğum ağırlığı
• hemoglobin
• yenidoğan

References

1. Breymann C, Bian XM, Blanco-Capito LR, Chong C, Mahmud G, Rehman R. Expert recommendations for the diagnosis and treatment of iron-deficiency anemia during pregnancy and the postpartum period in the Asia-Pacific region. J Perinat Med 2011; 39(2): 113-21.
2. 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(2): 124Levy A, Fraser D, Katz M, Mazor M, Sheiner E. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol 2005; 122(2): 182-6.
3. Guyer B, Freedman MA, Strobino DM, Sondik EJ. Annual summary of vital statistics: trends in the health of Americans during the 20th century. Pediatrics 2000; 106(6): 1307-17.
4. Sumits T, Bennett R, Gould J. Maternal risks for very low birth weight infant mortality. Pediatrics 1996; 98: 236-41.
5. Ribot B, Aranda N, Viteri F, Hernández-Martínez C, Canals J, Arija V. Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron. Hum Reprod 2012; 27(5): 1260-6.
6. Persson LÅ, Arifeen S, Ekström EC, et al. Effects of prenatal micronutrient and early food supplementation on maternal hemoglobin, birth weight, and infant mortality among children in Bangladesh: the MINIMat randomized trial. JAMA 2012; 307(19): 2050Singla PN, Tyagi M, Shankar R, Dash D, Kumar A. Fetal iron status in maternal anemia. Acta Paediatr 1996; 85(11): 1327-30.
7. Kumar A, Rai AK, Basu S, Dash D, Singh JS. Cord blood and breast milk iron status in maternal anemia. Pediatrics 2008; 121(3): 673-7.
8. El-Farrash RA, Ismail EA, Nada AS. Cord blood iron profile and breast milk micronutrients in maternal iron deficiency anemia. Pediatr Blood Cancer 2012; 58(2): 233-8.

9. Pala K, Dundar N. Prevalence & risk factors of anaemia among women of reproductive age in Bursa, Turkey. Indian J Med Res 2008; 128(3): 282-6.
10. Kilinç M, Yüregir GT, Ekerbiçer H. Anaemia and iron-deficiency anaemia in south-east Anatolia. Eur J Haematol 2002; 69(5-6): 280Malhotra M, Sharma JB, Batra S, Sharma S, Murthy NS, Arora R. Maternal and perinatal outcome in varying degress of anemia. Int J Gynecol Obstet 2002; 79(2): 93-100.
11. Zhang Q, Li Z, Ananth CV. Prevalence and risk factors for anaemia in pregnant women: a population-based prospective cohort study in China. Paediatr Perinat Epidemiol 2009; 23(4): 282-91.
12. Sharma A, Patnaik R, Garg S; Prema Ramachandran. Detection & management of anaemia in pregnancy in an urban primary health care institution. Indian J Med Res 2008; 128(1): 45-51.
13. Kilbride J, Baker TG, Parapia LA, Khoury SA. Iron status, serum folate and B(12) values in pregnancy and postpartum: report from a study in Jordan. Ann Saudi Med 2000; 20(5-6): 371-6.
14. Okuyama T, Tawada T, Furuya H, Villee CA. The role of transferrin and ferritin in the fetal-maternal-placental unit. Am J Obstet Gynecol 1985; 152(3): 344-50.
15. Kozuki N, Lee AC, Katz J; Child Health Epidemiology Reference Group. Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes. J Nutr 2012; 142(2): 358-62.
16. Steer JP. Maternal hemoglobin concentration and birth weight. Am J Clin Nutr 2000; 71(Suppl 5): 1285-7.
17. Sekhavat L, Davar R, Hosseinidezoki S. Relationship between maternal hemoglobin concentration and neonatal birth weight. Hematology 2011; 16(6): 373-6.
18. Ervasti M, Sankilampi U, Heinonen S, Punnonen K. Early signs of maternal iron deficiency do not influence the iron status of the newborn, but are associated with higher infant birthweight. Acta Obstet Gynecol Scand 2009; 88(1): 83-90.
19. Peña-Rosas JP, Viteri FE. Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy. Cochrane Database Syst Rev 2009; CD004736.
20. Karaoglu L, Pehlivan E, Egri M, et al. The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey. BMC Public Health 2010;10: 329.
21. Guvenc B, Canataroglu A, Unsal C, et al. β-Thalassemia mutations and hemoglobinopathies in Adana, Turkey: results from a single center study. Arch Med Sci 2012; 8(3): 411-4.
22. De Pee S, Bloem MW, Sari M, Kiess L, Yip R, Kosen S. The high prevalence of low hemoglobin concentration among Indonesian infants aged 3-5 months is related to maternal anemia. J Nutr 2002; 132(8): 2215-21.
23. Kilbride J, Baker TG, Parapia LA, Khoury SA, Shuqaidef SW, Jerwood D. Anaemia during pregnancy as a risk factor for irondeficiency anaemia in infancy: a case-control study in Jordan. Int J Epidemiol 1999; 28(3): 461-8.
24. Lozoff B. Early iron deficiency has brain and behavior effects consistent with dopaminergic dysfunction. J Nutr 2011; 141(4): 740Roncagliolo M, Garrido M, Walter T, Peirano P, Lozoff B. Evidence of altered central nervous system development in infants with iron deficiency anemia at 6 mo: delayed maturation of auditory brainstem responses. Am J Clin Nutr 1998; 68(3): 683-90.