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Association between gestational anemia in different trimesters and neonatal outcomes: a retrospective longitudinal cohort study

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Abstract

Background

Previous studies investigated the association between gestational anemia and neonatal outcomes. However, few studies explored whether the effects of gestational anemia could be eliminated by subsequent correction of anemia in the later stages of pregnancy. This study aimed to investigate the relationship between anemia in different trimesters and neonatal outcomes.

Methods

The study was conducted in Shanghai, China, with a sample of 46,578 pregnant women who delivered between January 1, 2016 and July 1, 2019. A multivariable logistic regression model was adopted to analyse the associations between maternal anemia and neonatal outcomes.

Results

The incidence of gestational anemia was 30.2%, including 4.4% in the first trimester, 9.6% in the second trimester, and 16.2% in the third trimester. Only 24.5% (507/2066) of anemia that occurred in the first trimester and 29.6% (1320/4457) that occurred in the second trimester could be corrected in the later stages of pregnancy. Anemia occurring in the first trimester was associated with small for gestational age [odds ratio (OR) 1.46; 95% confidence interval (CI) 1.20–1.78] and with fetal distress (OR 1.23; 95% CI 1.08–1.40). Anemia corrected in the first trimester also was associated with a higher risk of small for gestational age.

Conclusions

Gestational anemia is a public health problem in China impacting neonatal health. Anemia in pregnancy could be corrected in only about a quarter of the women. Anemia in the first trimester, whether corrected or not, still led to lower birth weight; therefore, the prevention of anemia prior to pregnancy is important.

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Acknowledgements

The authors would like to thank Lei Chen and Ping Wang in International Peace Maternity and Child Health Hospital for their efforts in data collection.

Funding

This work was supported by the Special Fund for the National Key Research and Development Plan Grant (2017YFC1001300), the International Cooperation Project of China and Canada NSFC (81661128010), the Major Program of National Natural Science Foundation of China (81490742), the Natural Science Foundation of China (31571556), Innovative research team of high-level local universities in Shanghai, and Shanghai Municipal Key Clinical Speciality, Shanghai, China.

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Authors and Affiliations

  1. The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China

    Chang-Fa Sun, Han Liu, Yan-Hui Hao, Hong-Tao Hu, Zhi-Yang Zhou, Ke-Xin Zou, Xin-Mei Liu, Guo-Lian Ding & He-Feng Huang

  2. Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China

    Chang-Fa Sun, Han Liu, Yan-Hui Hao, Zhi-Yang Zhou, Ke-Xin Zou, Xin-Mei Liu, Guo-Lian Ding & He-Feng Huang

  3. Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Hangzhou, China

    Jian-Zhong Sheng

  4. Department of Gynecology and Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Hong-Tao Hu

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  1. Chang-Fa Sun
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Contributions

HFH, GLD, CFS, XML, and ZYZ participated in the conceptualization of the study. HHF had full access to all data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. CFS wrote the original draft. CFS and HL conducted the formal analysis. GLD, HFH, and JZS reviewed and edited the manuscript. YHH, KXZ, and HTH provided supports on methodology. All authors commented on the drafts and approved the final draft.

Corresponding author

Correspondence to He-Feng Huang.

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Ethical approval

This study was approved by the Ethics Committee of the International Peace Maternity and Child Health Hospital (GKLW) 2017–81.

Conflict of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Sun, CF., Liu, H., Hao, YH. et al. Association between gestational anemia in different trimesters and neonatal outcomes: a retrospective longitudinal cohort study. World J Pediatr 17, 197–204 (2021). https://doi.org/10.1007/s12519-021-00411-6

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  • DOI: https://doi.org/10.1007/s12519-021-00411-6

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