Prediction of anemia at delivery.
Study Goal
The researchers aimed to identify risk factors for anemia at delivery and determine an optimal hemoglobin cutoff between 24 and 30 gestational weeks to predict anemia, as well as assess the impact of iron supplementation.
Results Summary
Hemoglobin levels and infrequent iron supplementation were independent risk factors for anemia at delivery. A hemoglobin cutoff of 10.6 g/dL between 24-30 weeks accurately predicted anemia (AUC 80%), and iron supplementation was beneficial regardless of hemoglobin value.
Population
1527 women who delivered vaginally at ≥36 gestational weeks.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
iron supplement treatment | decrease | anemia | women who delivered vaginally ≥ 36 gestational weeks | - | was beneficial to prevent | #1 |
iron supplement treatment | increase | anemia at delivery | women who delivered vaginally ≥ 36 gestational weeks | OR 2.4 95%CI [1.2-4.8] | was an independent risk factor for | #2 |
Hb | decrease | anemia at delivery | women who delivered vaginally ≥ 36 gestational weeks | OR 0.3 95%CI [0.2-0.4] | was an independent risk factor for | #3 |
- | neutral | anemia at delivery | women who delivered vaginally ≥ 36 gestational weeks | Hb 10.6 g/dL | was an accurate cutoff to predict | #4 |
We aimed to assess risk factors for anemia at delivery by conducting a secondary analysis of a prospective cohort study database including 1527 women who delivered vaginally ≥ 36 gestational weeks. Anemia (Hemoglobin (Hb) < 10.5 g/dL) was assessed at delivery. A complete blood count results during pregnancy as well as maternal and obstetrical characteristics were collected. The primary endpoint was to determine the Hb cutoff between 24 and 30 gestational weeks that is predictive of anemia at delivery by using the area under the curve (AUC) of the receiver operating characteristic curve. Independent risk factors for anemia at delivery were assessed using stepwise multivariable logistic regression. Hb and infrequent iron supplement treatment were independent risk factors for anemia at delivery (OR 0.3 95%CI [0.2-0.4] and OR 2.4 95%CI [1.2-4.8], respectively; C statistics 83%). Hb 10.6 g/dL was an accurate cutoff to predict anemia at delivery (AUC 80% 95%CI 75-84%; sensitivity 75% and specificity 74%). Iron supplement was beneficial to prevent anemia regardless of Hb value. Altogether, Hb should be routinely tested between 24 and 30 gestational weeks to screen for anemia. A flow chart for anemia screening and treatment during pregnancy is proposed in the manuscript.Trial registration: ClinicalTrials.gov Identifier: NCT02434653.