TY - JOUR
T1 - Maternal anemia and long-term respiratory morbidity of the offspring—Results of a population-based cohort
AU - Alcalay, Idan
AU - Wainstock, Tamar
AU - Sheiner, Eyal
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Purpose: To evaluate the association between prenatal maternal anemia (hemoglobin, Hb < 11 g/dl) and long-term respiratory morbidity of the offspring. Methods: A retrospective population-based cohort analysis was performed at a single tertiary medical center. We include all singletons born between 1991–2014 and discharged alive. Offspring with congenital malformations were excluded. The 3 study groups were defined on maternal Hb levels on discharge: severe anemia (< 7.0 g/dl), mild to moderate anemia (7.0–11.0 g/dl) and unexposed (≥ 11.0 g/dl). Offspring respiratory morbidity was predefined on ICD-9 codes and recruited from the hospitalized medical records. A Kaplan–Meier survival curve was formed to compare the cumulative hospitalization and a multivariable Cox survival analysis was used to control for cofounders (gestational age, maternal age, diabetes, hypertensive disorders, post-partum hemorrhage and transfusion of blood products). Results: 214,305 deliveries met the inclusion criteria: 807 (0.3%) mothers had severe anemia, 105,196 (49.1%) mothers had mild-moderate anemia, and the remaining were not anemic (108,302, 50.5%). Respiratory hospitalization was significantly higher among the offspring born to anemic mothers (6.2%; 5.3% and 5.1%; p = 0.020, in the study groups). However, association between maternal anemia and respiratory-related hospitalization remained significant only among the mild-moderate anemic group (adjusted Cox hazard ratio = 1.1; 95% CI 1.05–1.14; p < 0.01). The Kaplan–Meier survival analysis showed significant higher total respiratory hospitalizations in offspring according to maternal anemia status (Log Rank p-value = <.001). Conclusion: Maternal anemia was associated with long-term respiratory morbidity of the offspring.
AB - Purpose: To evaluate the association between prenatal maternal anemia (hemoglobin, Hb < 11 g/dl) and long-term respiratory morbidity of the offspring. Methods: A retrospective population-based cohort analysis was performed at a single tertiary medical center. We include all singletons born between 1991–2014 and discharged alive. Offspring with congenital malformations were excluded. The 3 study groups were defined on maternal Hb levels on discharge: severe anemia (< 7.0 g/dl), mild to moderate anemia (7.0–11.0 g/dl) and unexposed (≥ 11.0 g/dl). Offspring respiratory morbidity was predefined on ICD-9 codes and recruited from the hospitalized medical records. A Kaplan–Meier survival curve was formed to compare the cumulative hospitalization and a multivariable Cox survival analysis was used to control for cofounders (gestational age, maternal age, diabetes, hypertensive disorders, post-partum hemorrhage and transfusion of blood products). Results: 214,305 deliveries met the inclusion criteria: 807 (0.3%) mothers had severe anemia, 105,196 (49.1%) mothers had mild-moderate anemia, and the remaining were not anemic (108,302, 50.5%). Respiratory hospitalization was significantly higher among the offspring born to anemic mothers (6.2%; 5.3% and 5.1%; p = 0.020, in the study groups). However, association between maternal anemia and respiratory-related hospitalization remained significant only among the mild-moderate anemic group (adjusted Cox hazard ratio = 1.1; 95% CI 1.05–1.14; p < 0.01). The Kaplan–Meier survival analysis showed significant higher total respiratory hospitalizations in offspring according to maternal anemia status (Log Rank p-value = <.001). Conclusion: Maternal anemia was associated with long-term respiratory morbidity of the offspring.
KW - Maternal anemia
KW - Offspring long-term outcome
KW - Offspring respiratory morbidity
KW - Pediatric morbidity
KW - Pregnancy outcome
UR - http://www.scopus.com/inward/record.url?scp=85138557032&partnerID=8YFLogxK
U2 - 10.1007/s00404-022-06780-1
DO - 10.1007/s00404-022-06780-1
M3 - Article
C2 - 36129519
AN - SCOPUS:85138557032
SN - 0932-0067
VL - 308
SP - 1189
EP - 1195
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 4
ER -