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Maternal haemoglobin concentrations before and during pregnancy and stillbirth risk: a population-based case-control study
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden; Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden; Division of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
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2016 (Engelska)Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, nr 1, artikel-id 135Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Results of previous studies on the association between maternal haemoglobin concentration during pregnancy and stillbirth risk are inconclusive. It is not clear if haemoglobin concentration before pregnancy has a role. Using prospectively collected information from pre-pregnancy and antenatal visits, we investigated associations of maternal haemoglobin concentrations before and during pregnancy and haemoglobin dilution with stillbirth risk.

Methods: In a population-based case-control study from rural Golestan, a province in northern Iran, we identified 495 stillbirths (cases) and randomly selected 2,888 control live births among antenatal health-care visits between 2007 and 2009. Using logistic regression, we estimated associations of maternal haemoglobin concentrations, haemoglobin dilution at different stages of pregnancy, with stillbirth risk.

Results: Compared with normal maternal haemoglobin concentration (110-120 g/l) at the end of the second trimester, high maternal haemoglobin concentration (≥140 g/l) was associated with a more than two-fold increased stillbirth risk (OR = 2.31, 95 % CI [1.30-4.10]), while low maternal haemoglobin concentration (<110 g/l) was associated with a 37 % reduction in stillbirth risk. Haemoglobin concentration before pregnancy was not associated with stillbirth risk. Decreased haemoglobin concentration, as measured during pregnancy (OR = 0.61, 95 % CI [0.46, 0.80]), or only during the second trimester (OR = 0.75, 95 % CI [0.62, 0.90]), were associated with reduced stillbirth risk. The associations were essentially similar for preterm and term stillbirths.

Conclusions: Haemoglobin concentration before pregnancy is not associated with stillbirth risk. High haemoglobin level and absence of haemoglobin dilution during pregnancy could be considered as indicators of a high-risk pregnancy.

Ort, förlag, år, upplaga, sidor
London, United Kingdom: BioMed Central, 2016. Vol. 16, nr 1, artikel-id 135
Nyckelord [en]
Stillbirth, maternal anaemia, haemoglobin concentration, haemoglobin dilution, adverse pregnancy outcome
Nationell ämneskategori
Reproduktionsmedicin och gynekologi
Forskningsämne
Obstetrik och gynekologi
Identifikatorer
URN: urn:nbn:se:oru:diva-50592DOI: 10.1186/s12884-016-0924-xISI: 000377159600003PubMedID: 27259282Scopus ID: 2-s2.0-84973176757OAI: oai:DiVA.org:oru-50592DiVA, id: diva2:934188
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Funding Agency:

Karolinska Institute

Tillgänglig från: 2016-06-08 Skapad: 2016-06-08 Senast uppdaterad: 2018-07-20Bibliografiskt granskad

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Montgomery, Scott M.

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