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KMID : 0892720090130010038
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Journal of the Korean Society of Maternal and Child Health
2009 Volume.13 No. 1 p.38 ~ p.50
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Influence of Maternal Pre-pregnancy Hemoglobin Concentration on Stillbirth, Preterm Birth, and Low Birthweight
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Chun Byung-Wha
Ohrr Hee-Choul
Han Young-Ja
Yi Sang-Wook
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Abstract
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Objective: To examine the influence of the maternal pre-pregnancy hemoglobin concentration on the perinatal outcome.
Methods: Population based retrospective cohort study was conducted on 41,975 mothers who received health examination in 1997, and delivered a singleton live baby in 1999 or a singleton stillbirth in 1999. Rate and odds ratio of stillbirth, preterm birth, and low birthweight in accord with the level of pre-pregnancy hemoglobin level was examined. Results were adjusted for maternal age at delivery and pre-pregnancy body mass index using logistic regression model.
Results:Adjusted odds ratio of stillbirth was found to be 4.25 times higher for mothers with less than 100 g/L hemoglobin concentration (95% CI, 1.82~9.92) and subsequently 1.79 times for those with 150 g/L or above (95% CI, 1.02~3.16) compared to those with 130~139 g/L. Adjusted odds ratio of preterm birth was higher among mothers with 100 g/L(Odds ratio: 2.10, 95% CI, 1.35~3.27) and 100~109 g/L (Odds ratio: 1.51, 95% CI, 1.10~2.07). Moreover, risk was not significantly elevated with mothers with high hemoglobin concentration. Adjusted odds ratio of low birthweight was 1.86 times, 1.48 times, and 1.07 times higher for the mothers with less than 100g/L (95% CI, 1.16~2.98), 100-109 g/L (95% CI, 1.07~2.05), and 150 g/L or above (95% CI, 0.82~ 1.39), respectively than for those with the 130~139 g/L pre-pregnancy hemoglobin level.
Conclusion:A U-shape relationship between pre-pregnancy hemoglobin concentration and stillbirth was observed in this study. Low maternal pre-pregnancy hemoglobin concentration rather than high hemoglobin concentration increases the risk of preterm birth and low birthweight.
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KEYWORD
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high-risk pregnancy, stillbirth, hemoglobin, preterm birth, low Birth weight
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