Maternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study

Ruramayi Rukuni; Sohinee Bhattacharya; Michael F Murphy; David Roberts; Simon J Stanworth; Marian Knight

doi:10.1111/aogs.12862

Maternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study

Ruramayi Rukuni, Sohinee Bhattacharya, Michael F Murphy, David Roberts, Simon J Stanworth, Marian Knight

University of Oxford

Research output: Contribution to journal › Article › peer-review

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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 ≤10g/dl during pregnancy. Incidence was calculated with 95% confidence intervals (CI) 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 (aORs) with 95% CI.

RESULTS: The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95%CI 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 (aOR 1.26, 95%CI 1.17-1.36), postpartum infection (aOR 1.89, 95%CI 1.39-2.57), transfusion (aOR 1.87, 95%CI 1.65-2.13) and stillbirth (aOR 1.42, 95%CI 1.04-1.94), reduced odds of postpartum hemorrhage (aOR 0.92, 95%CI 0.86-0.98) and low birthweight (aOR 0.77, 95%CI 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. This article is protected by copyright. All rights reserved.

Original language	English
Pages (from-to)	555-564
Number of pages	10
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	95
Issue number	5
Early online date	4 Feb 2016
DOIs	https://doi.org/10.1111/aogs.12862
Publication status	Published - May 2016

Bibliographical note

Funding
RR has an academic clinical fellowship supported by the National Institute of Health Research (NIHR). MK is funded by an NIHR Research Professorship. The views expressed in this publication are those of the author(s), and not necessarily those of the NHS, the NIHR, or the Department of Health. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the article.

This article is protected by copyright. All rights reserved.

Keywords

anemia
pregnancy outcome
neonatal outcome
haemorrhage
postpartum infection

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/aogs.12862Licence: Unspecified

Aberdeen Maternity and Neonatal Databank
Bhattacharya, S. (Data Manager) & Wilde, K. (Supervisor), University of Aberdeen, 1986
http://www.abdn.ac.uk/iahs/research/obsgynae/amnd/overview.php and one more link, http://www.abdn.ac.uk/iahs/research/obsgynae/amnd/access.php (show fewer)
Dataset

Cite this

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title = "Maternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study",

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 ≤10g/dl during pregnancy. Incidence was calculated with 95% confidence intervals (CI) 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 (aORs) with 95% CI.RESULTS: The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95%CI 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 (aOR 1.26, 95%CI 1.17-1.36), postpartum infection (aOR 1.89, 95%CI 1.39-2.57), transfusion (aOR 1.87, 95%CI 1.65-2.13) and stillbirth (aOR 1.42, 95%CI 1.04-1.94), reduced odds of postpartum hemorrhage (aOR 0.92, 95%CI 0.86-0.98) and low birthweight (aOR 0.77, 95%CI 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. This article is protected by copyright. All rights reserved.",

keywords = "anemia, pregnancy outcome, neonatal outcome, haemorrhage, postpartum infection",

author = "Ruramayi Rukuni and Sohinee Bhattacharya and Murphy, {Michael F} and David Roberts and Stanworth, {Simon J} and Marian Knight",

note = "Funding RR has an academic clinical fellowship supported by the National Institute of Health Research (NIHR). MK is funded by an NIHR Research Professorship. The views expressed in this publication are those of the author(s), and not necessarily those of the NHS, the NIHR, or the Department of Health. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the article. This article is protected by copyright. All rights reserved.",

year = "2016",

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doi = "10.1111/aogs.12862",

language = "English",

volume = "95",

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journal = "Acta Obstetricia et Gynecologica Scandinavica",

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T1 - Maternal and neonatal outcomes of antenatal anemia in a Scottish population

T2 - a retrospective cohort study

AU - Rukuni, Ruramayi

AU - Bhattacharya, Sohinee

AU - Murphy, Michael F

AU - Roberts, David

AU - Stanworth, Simon J

AU - Knight, Marian

N1 - Funding RR has an academic clinical fellowship supported by the National Institute of Health Research (NIHR). MK is funded by an NIHR Research Professorship. The views expressed in this publication are those of the author(s), and not necessarily those of the NHS, the NIHR, or the Department of Health. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the article. This article is protected by copyright. All rights reserved.

PY - 2016/5

Y1 - 2016/5

N2 - 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 ≤10g/dl during pregnancy. Incidence was calculated with 95% confidence intervals (CI) 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 (aORs) with 95% CI.RESULTS: The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95%CI 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 (aOR 1.26, 95%CI 1.17-1.36), postpartum infection (aOR 1.89, 95%CI 1.39-2.57), transfusion (aOR 1.87, 95%CI 1.65-2.13) and stillbirth (aOR 1.42, 95%CI 1.04-1.94), reduced odds of postpartum hemorrhage (aOR 0.92, 95%CI 0.86-0.98) and low birthweight (aOR 0.77, 95%CI 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. This article is protected by copyright. All rights reserved.

AB - 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 ≤10g/dl during pregnancy. Incidence was calculated with 95% confidence intervals (CI) 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 (aORs) with 95% CI.RESULTS: The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95%CI 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 (aOR 1.26, 95%CI 1.17-1.36), postpartum infection (aOR 1.89, 95%CI 1.39-2.57), transfusion (aOR 1.87, 95%CI 1.65-2.13) and stillbirth (aOR 1.42, 95%CI 1.04-1.94), reduced odds of postpartum hemorrhage (aOR 0.92, 95%CI 0.86-0.98) and low birthweight (aOR 0.77, 95%CI 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. This article is protected by copyright. All rights reserved.

KW - anemia

KW - pregnancy outcome

KW - neonatal outcome

KW - haemorrhage

KW - postpartum infection

U2 - 10.1111/aogs.12862

DO - 10.1111/aogs.12862

M3 - Article

C2 - 26846870

SN - 0001-6349

VL - 95

SP - 555

EP - 564

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 5

ER -

Maternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study

Abstract

Bibliographical note

Keywords

UN SDGs

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Datasets

Aberdeen Maternity and Neonatal Databank

Cite this