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Maternal haemoglobin concentrations before and during pregnancy and stillbirth risk: A population-based case-control study

Maghsoudlou, S. and Cnattingius, S. and Stephansson, O. and Aarabi, M. and Semnani, S. and Montgomery, S.M. and Bahmanyar, S. (2016) Maternal haemoglobin concentrations before and during pregnancy and stillbirth risk: A population-based case-control study. BMC Pregnancy and Childbirth, 16 (1).

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Abstract

Background: Results of previous studies on the association between maternal haemoglobin concentration during pregnancy and stillbirth risk are inconclusive. It is not clear if haemoglobin concentration before pregnancy has a role. Using prospectively collected information from pre-pregnancy and antenatal visits, we investigated associations of maternal haemoglobin concentrations before and during pregnancy and haemoglobin dilution with stillbirth risk. Methods: In a population-based case-control study from rural Golestan, a province in northern Iran, we identified 495 stillbirths (cases) and randomly selected 2,888 control live births among antenatal health-care visits between 2007 and 2009. Using logistic regression, we estimated associations of maternal haemoglobin concentrations, haemoglobin dilution at different stages of pregnancy, with stillbirth risk. Results: Compared with normal maternal haemoglobin concentration (110-120g/l) at the end of the second trimester, high maternal haemoglobin concentration (≥140g/l) was associated with a more than two-fold increased stillbirth risk (OR = 2.31, 95% CI [1.30-4.10]), while low maternal haemoglobin concentration (<110g/l) was associated with a 37% reduction in stillbirth risk. Haemoglobin concentration before pregnancy was not associated with stillbirth risk. Decreased haemoglobin concentration, as measured during pregnancy (OR = 0.61, 95% CI [0.46, 0.80]), or only during the second trimester (OR = 0.75, 95% CI [0.62, 0.90]), were associated with reduced stillbirth risk. The associations were essentially similar for preterm and term stillbirths. Conclusions: Haemoglobin concentration before pregnancy is not associated with stillbirth risk. High haemoglobin level and absence of haemoglobin dilution during pregnancy could be considered as indicators of a high-risk pregnancy. © 2016 The Author(s).

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: hemoglobin, adult; Article; controlled study; female; first trimester pregnancy; hemoglobin determination; high risk pregnancy; human; Iran; major clinical study; population based case control study; pregnancy; risk reduction; second trimester pregnancy; stillbirth
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 07 Sep 2016 09:45
Last Modified: 13 Sep 2016 09:39
URI: http://eprints.goums.ac.ir/id/eprint/4542

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