Association between maternal haemoglobin concentrations and maternal and neonatal outcomes: the prospective, observational, multinational, INTERBIO-21st fetal study

作者：Eric O. Ohuma, Nusrat Jabin, Melissa Young, Terrence Epie, Reynaldo Martorell, Juan Pablo Peña‐Rosas, Maria Nieves García‐Casal, Stephen H Kennedy, César G. Victora, Rachel Craik, Stephen Ash, Fernando C. Barros, Hellen C. Barsosio, James A. Berkley, Maria Carvalho, Michelle Fernandes, Leila Cheikh Ismail, Ann Lambert, Cecilia M. Lindgren, Rose McGready, Shama Munim, Christoffer Nellåker, J. Alison Noble, Shane A. Norris, François Nosten, Eric O. Ohuma, Aris T Papageorghiou, Alan Stein, William Stones, Chrystelle O.O. Tshivuila-Matala, Eleonora Staines Urias, Manu Vatish, Katharina Wulff, Ghulam Zainab, Krina T. Zondervan, Ricardo Uauy, Zulfiqar A Bhutta, José R. Villar, Aris T Papageorghiou, Stephen H Kennedy, José Villar · 发表于：The Lancet Haematology · 年份：2023 · DOI：10.1016/s2352-3026(23)00170-9 · 被引用次数：47 · 研究领域：Iron Metabolism and Disorders、Pregnancy and preeclampsia studies、Blood transfusion and management

BACKGROUND: Anaemia in pregnancy is a global health problem with associated maternal and neonatal morbidity and mortality. We aimed to investigate the association between maternal haemoglobin concentrations during pregnancy and the risk of adverse maternal and neonatal outcomes. METHODS: , natural conception, and singleton pregnancy) who initiated antenatal care before 14 weeks' gestation. At each 5±1 weekly visit until delivery, information was collected about the pregnancy, as well as the results of blood tests taken as part of routine antenatal care, including haemoglobin values. The outcome measures were maternal (gestational diabetes, pregnancy-induced hypertension, and preterm premature rupture of membranes) and neonatal outcomes (small for gestational age, preterm birth, and acute respiratory distress syndrome). FINDINGS: Between Feb 8, 2012, and Nov 30, 2019, 2069 women (mean age 30·7 years [SD 5·0]) had at least one routinely haemoglobin concentration measured at 14-40 weeks' gestation, contributing 4690 haemoglobin measurements for the analysis. Compared with a haemoglobin cutoff of 110 g/L, the risk was increased more than two-fold for pregnancy-induced hypertension at haemoglobin concentrations of 170 g/L (risk ratio [RR] 2·29 [95% CI 1·19-4·39]) and higher, for preterm birth at haemoglobin concentrations of 70 g/L (RR 2·04 [95% CI 1·20-3·48]) and 165 g/L (RR 2·06 [95% CI 1·41-3·02]), and for acute respiratory distress syndrome at haemoglobin concentrations of 165...