Association between maternal anemia and long-term risk for pediatric infectious morbidity in the offspring

Anika Toma, Eyal Sheiner, Tamar Wainstock

Research output: Contribution to journalMeeting Abstract

Abstract

Objective
Anemia of pregnancy, defined as hemoglobin (Hb) concentration less than 11 g/dL during pregnancy, is associated with immediate adverse obstetric outcomes such as low birth weight and preterm delivery. Our objective was to evaluate a possible association between anemia during pregnancy and long-term infectious morbidity of the offspring.

Study Design
A population-based retrospective study was conducted, comparing women with hemoglobin (Hb) values above and below 11 g/dL. Incidence of long-term pediatric hospitalizations due to various infectious diseases was compared between the two groups. The study population included all singletons born in a tertiary medical center between 1991-2014, including 224,490 infants.

A Kaplan Meier survival curve was constructed to compare cumulative infectious morbidity, and a Cox regression model was used to control for confounders.

Results
The study included 224490 newborns; 117,999 (52.6%) infants were born to mothers with anemia. The rate of infectious morbidity leading to hospitalizations was significantly higher in infants to anemic mothers (11.8% vs. 11.3%, OR = 1.1, CI 1.03-1.08, p < 0.0001, Table). Specifically, anemia during pregnancy was significantly associated with respiratory infections (6.1% vs. 5.7%, OR = 1.07, CI 1.03-1.11, p < 0.0001). The Kaplan-Meier survival curve showed a significantly increased cumulative risk for hospitalizations due to infectious disease in offspring to anemic mothers (log rank p < 0.0001, Figure). When controlling for confounders such as gestational age, maternal age and maternal smoking, using the Cox proportional hazards model, anemia of pregnancy was noted as an independent risk factor for long-term infectious morbidity of the offspring (adjusted HR = 1.1, 95% CI 1.06-1.11, p < 0.001).

Conclusion
Anemia during pregnancy may influence offspring susceptibility to pediatric infections, as it was found to be an independent risk factor for long-term infectious morbidity of the offspring. Our findings expand the knowledge about the impact of maternal anemia on future child health.
Original languageEnglish GB
Pages (from-to)S87-S87
JournalAmerican Journal of Obstetrics and Gynecology
Volume222
Issue number1
DOIs
StatePublished - Jan 2020

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