SHARE @ Advocate Health - Midwest - Scientific Day: The Impact of Maternal Anemia on Neonatal Outcomes: A Retrospective Cohort Study
 

Affiliations

Advocate Children's Hospital, Advocate Lutheran General Hospital

Abstract

Background/Significance:

The WHO reports anemia affects 37% of pregnant women globally, with significant racial disparities in the US: 26% in African American women, 17% in Hispanic women, and 8% in white women. It impacts neonatal outcomes by compromising oxygen and nutrient delivery. Despite its prevalence, few studies have examined these impacts within diverse U.S. demographics, and findings on the association between anemia severity and neonatal outcomes are inconsistent.

Purpose:

To investigate the association between maternal anemia during pregnancy and neonatal outcomes in a tertiary care center, focusing on how anemia severity affects these outcomes.

Methods:

We conducted a retrospective cohort study of 10,329 mother-infant dyads who delivered at our institution from July 2021 to June 2024. All pregnant women underwent anemia screening, with maternal anemia classified by WHO criteria for hemoglobin levels: mild (10.0-10.9 g/dL), moderate (7.0-9.9 g/dL), and severe (< 7 g/dL). Exclusion criteria included infants with birth defects, chromosomal anomalies, or incomplete medical records, and mothers without hemoglobin data within 300 days before delivery. Outcomes included birthweight (BW), low birth weight (LBW), gestational age, APGAR scores, NICU admission, length of stay (LOS), and mortality. Descriptive statistics and comparative analyses using Kruskal-Wallis rank sum tests and Fisher's exact tests evaluated differences in outcomes across anemia severity groups.

Results:

The cohort included non-anemic mothers (n=7,279), mild anemia (n=2,870), moderate anemia (n=179), and severe anemia (n=1). LBW (< 2.5kg) incidence significantly differed between anemic and non-anemic groups (p< 0.001). Median BW was 3.31kg (non-anemic), 3.23kg (mild anemia), and 3.40kg (moderate anemia). Gestational age at birth differed significantly across groups (p< 0.001). Significant differences were found in 1-minute and 5-minute APGAR scores (p=0.022, p=0.002) but not 10-minute scores. NICU LOS was significantly longer for infants born to anemic mothers (p< 0.001). No significant difference was observed in mortality rates (p=0.4).

Conclusion:

The study demonstrates significant associations between maternal anemia and adverse neonatal outcomes including LBW, lower gestational age, lower early APGAR scores, and longer NICU LOS. The observed severity-dependent relationship between maternal hemoglobin levels and neonatal outcomes highlights the clinical importance of routine antenatal screening and proper management of maternal anemia in diverse U.S. populations.

Presentation Notes

Presented at Scientific Day; May 21, 2025; Park Ridge, IL.

Full Text of Presentation

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Document Type

Oral/Podium Presentation


 

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May 21st, 11:36 AM May 21st, 11:41 AM

The Impact of Maternal Anemia on Neonatal Outcomes: A Retrospective Cohort Study

Background/Significance:

The WHO reports anemia affects 37% of pregnant women globally, with significant racial disparities in the US: 26% in African American women, 17% in Hispanic women, and 8% in white women. It impacts neonatal outcomes by compromising oxygen and nutrient delivery. Despite its prevalence, few studies have examined these impacts within diverse U.S. demographics, and findings on the association between anemia severity and neonatal outcomes are inconsistent.

Purpose:

To investigate the association between maternal anemia during pregnancy and neonatal outcomes in a tertiary care center, focusing on how anemia severity affects these outcomes.

Methods:

We conducted a retrospective cohort study of 10,329 mother-infant dyads who delivered at our institution from July 2021 to June 2024. All pregnant women underwent anemia screening, with maternal anemia classified by WHO criteria for hemoglobin levels: mild (10.0-10.9 g/dL), moderate (7.0-9.9 g/dL), and severe (< 7 g/dL). Exclusion criteria included infants with birth defects, chromosomal anomalies, or incomplete medical records, and mothers without hemoglobin data within 300 days before delivery. Outcomes included birthweight (BW), low birth weight (LBW), gestational age, APGAR scores, NICU admission, length of stay (LOS), and mortality. Descriptive statistics and comparative analyses using Kruskal-Wallis rank sum tests and Fisher's exact tests evaluated differences in outcomes across anemia severity groups.

Results:

The cohort included non-anemic mothers (n=7,279), mild anemia (n=2,870), moderate anemia (n=179), and severe anemia (n=1). LBW (< 2.5kg) incidence significantly differed between anemic and non-anemic groups (p< 0.001). Median BW was 3.31kg (non-anemic), 3.23kg (mild anemia), and 3.40kg (moderate anemia). Gestational age at birth differed significantly across groups (p< 0.001). Significant differences were found in 1-minute and 5-minute APGAR scores (p=0.022, p=0.002) but not 10-minute scores. NICU LOS was significantly longer for infants born to anemic mothers (p< 0.001). No significant difference was observed in mortality rates (p=0.4).

Conclusion:

The study demonstrates significant associations between maternal anemia and adverse neonatal outcomes including LBW, lower gestational age, lower early APGAR scores, and longer NICU LOS. The observed severity-dependent relationship between maternal hemoglobin levels and neonatal outcomes highlights the clinical importance of routine antenatal screening and proper management of maternal anemia in diverse U.S. populations.

 

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