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

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)555-564
Number of pages10
JournalActa Obstetricia et Gynecologica Scandinavica
Volume95
Issue number5
Early online date4 Feb 2016
DOIs
Publication statusPublished - May 2016

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Anemia
Cohort Studies
Retrospective Studies
Mothers
Confidence Intervals
Population
Pregnancy
Incidence
Postpartum Hemorrhage
Confounding Factors (Epidemiology)
Stillbirth
Postpartum Period
Hemoglobins
Public Health
Logistic Models
Odds Ratio
Databases
Hemorrhage
Morbidity
Mortality

Keywords

  • anemia
  • pregnancy outcome
  • neonatal outcome
  • haemorrhage
  • postpartum infection

Cite this

Maternal and neonatal outcomes of antenatal anemia in a Scottish population : a retrospective cohort study. / Rukuni, Ruramayi; Bhattacharya, Sohinee; Murphy, Michael F; Roberts, David; Stanworth, Simon J; Knight, Marian.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 95, No. 5, 05.2016, p. 555-564.

Research output: Contribution to journalArticle

Rukuni, Ruramayi ; Bhattacharya, Sohinee ; Murphy, Michael F ; Roberts, David ; Stanworth, Simon J ; Knight, Marian. / Maternal and neonatal outcomes of antenatal anemia in a Scottish population : a retrospective cohort study. In: Acta Obstetricia et Gynecologica Scandinavica. 2016 ; Vol. 95, No. 5. pp. 555-564.
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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.",
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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

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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

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VL - 95

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JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

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