Risk Factors and Consequences of Maternal Anaemia and Elevated Haemoglobin Levels during Pregnancy: a Population‐Based Prospective Cohort Study

作者：Romy Gaillard, Paul H.C. Eilers, Siham Yassine, Albert Hofman, Eric A.P. Steegers, Vincent W. V. Jaddoe · 发表于：Paediatric and Perinatal Epidemiology · 年份：2014 · DOI：10.1111/ppe.12112 · 被引用次数：86 · 研究领域：Iron Metabolism and Disorders、Pregnancy and preeclampsia studies、Blood transfusion and management

BACKGROUND: To determine sociodemographic and life style-related risk factors and trimester specific maternal, placental, and fetal consequences of maternal anaemia and elevated haemoglobin levels in pregnancy. METHODS: In a population-based prospective cohort study of 7317 mothers, we measured haemoglobin levels in early pregnancy [gestational age median 14.4 weeks (inter-quartile-range 12.5-17.5)]. Anaemia (haemoglobin ≤11 g/dl) and elevated haemoglobin levels (haemoglobin ≥13.2 g/dl) were defined according to the WHO criteria. Maternal blood pressure, placental function and fetal growth were measured in each trimester. Data on gestational hypertensive disorders and birth outcomes was collected from hospitals. RESULTS: Older maternal age, higher body mass index, primiparity and European descent were associated with higher haemoglobin levels (P < 0.05). Elevated haemoglobin levels were associated with increased systolic and diastolic blood pressure throughout pregnancy (mean differences 5.1 mmHg, 95% confidence interval [CI] 3.8, 6.5 and 4.1 mmHg, 95% CI 3.0, 5.2, respectively) and with a higher risk of third trimester uterine artery notching (RR 1.3, 95% CI 1.0, 1.7). As compared with maternal normal haemoglobin levels, not anaemia, but elevated haemoglobin levels were associated with fetal head circumference, length, and weight growth restriction from third trimester onwards (P < 0.05). Elevated haemoglobin levels were associated with increased risks of gestational hyperte...