Open AccessMaternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study
Author(s) -
Rukuni Ruramayi,
Bhattacharya Sohinee,
Murphy Michael F.,
Roberts David,
Stanworth Simon J.,
Knight Marian
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12862
Subject(s) - medicine , odds ratio , confidence interval , obstetrics , population , anemia , incidence (geometry) , retrospective cohort study , pregnancy , physics , environmental health , biology , optics , genetics
Abstract Introduction Antenatal anemia is a major public health problem in the UK , yet there is limited high quality evidence for associated poor clinical outcomes. The objectives of this study were to estimate the incidence and clinical outcomes of antenatal anemia in a Scottish population. Material and methods A retrospective cohort study of 80 422 singleton pregnancies was conducted using data from the Aberdeen Maternal and Neonatal Databank between 1995 and 2012. Antenatal anemia was defined as haemoglobin ≤10 g/dl during pregnancy. Incidence was calculated with 95% confidence intervals and compared over time using a chi‐squared test for trend. Multivariable logistic regression was used to adjust for confounding variables. Results are presented as adjusted odds ratios with 95% confidence interval. Results The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95% confidence interval 9.1–9.5), decreasing from 16.9/100 to 4.1/100 singleton pregnancies between 1995 and 2012 ( p < 0.001). Maternal anemia was associated with antepartum hemorrhage (adjusted odds ratio 1.26, 95% confidence interval 1.17–1.36), postpartum infection (adjusted odds ratio 1.89, 95% confidence interval 1.39–2.57), transfusion (adjusted odds ratio 1.87, 95% confidence interval 1.65–2.13) and stillbirth (adjusted odds ratio 1.42, 95% confidence interval 1.04–1.94), reduced odds of postpartum hemorrhage (adjusted odds ratio 0.92, 95% confidence interval 0.86–0.98) and low birthweight (adjusted odds ratio 0.77, 95% confidence interval 0.69–0.86). No other outcomes were statistically significant. Conclusions This study shows the incidence of antenatal anemia is decreasing steadily within this Scottish population. However, given that anemia is a readily correctable risk factor for major causes of morbidity and mortality in the UK , further work is required to investigate appropriate preventive measures.