Abstract
Objective
Maternal anemia (Hemoglobin, Hb<11mg/dl) has been shown to affect fetal growth, and specifically head circumference. We aimed to study the association between maternal anemia and the risk for neurological morbidity in the offspring, during a follow- up period of up to 18 years.
Study Design
A population based cohort analysis was performed comparing total and specific subtypes of neurological morbidities leading to hospitalizations among children stratified by three maternal immediate post-partum Hb categories: ≥11mg/dl (no anemia); < 11mg/dl (without blood transfusion) and < 11mg/dl (following blood transfusion). Data on pregnancy course and outcome, mode of delivery, and later offspring hospitalizations were collected from a single regional tertiary center. All singleton deliveries between the years 1991-2014 were included in the analysis, and congenital malformations were excluded. Kaplan-Meier survival curve was used to compare cumulative hospitalization incidence based on maternal anemia status, and a Weibull survival hazard model was constructed to control for confounders.
Results
During the study period, 238,622 newborns met the inclusion criteria: 132,619 (55.6%) were born to mothers who were not anemic; 102,997 (43.2%) of anemic mothers with no blood transfusion; and 3,006 (1.3%) were of anemic mothers with blood transfusion. During the follow up period (0-18 years, median 10.22 years), 3.0% were hospitalized with a neurological diagnosis among the non-anemic mothers, 3.3% among the anemic - no blood transfusion and 3.6% among the anemic with blood transfusion (p<0.001). Selected neurological diagnoses are presented in the table. The survival curve showed significantly different cumulative incidences of neurological hospitalizations in the different groups (Log rank p<0.001, Figure). The association between maternal anemia and offspring long-term pediatric neurological morbidities remained significant in a Weibull hazards model, controlling for maternal age, preterm births, diabetes and hypertension (adjusted HR 1.28; 95% CI 1.22-1.34; and adjusted HR 1.20; 1.0-1.46; among anemic without and with blood transfusion, as compared to non-anemic mothers, respectively).
Conclusion
Children born to anemic mothers appear to be at an increased risk for pediatric neurological related hospitalizations.
Maternal anemia (Hemoglobin, Hb<11mg/dl) has been shown to affect fetal growth, and specifically head circumference. We aimed to study the association between maternal anemia and the risk for neurological morbidity in the offspring, during a follow- up period of up to 18 years.
Study Design
A population based cohort analysis was performed comparing total and specific subtypes of neurological morbidities leading to hospitalizations among children stratified by three maternal immediate post-partum Hb categories: ≥11mg/dl (no anemia); < 11mg/dl (without blood transfusion) and < 11mg/dl (following blood transfusion). Data on pregnancy course and outcome, mode of delivery, and later offspring hospitalizations were collected from a single regional tertiary center. All singleton deliveries between the years 1991-2014 were included in the analysis, and congenital malformations were excluded. Kaplan-Meier survival curve was used to compare cumulative hospitalization incidence based on maternal anemia status, and a Weibull survival hazard model was constructed to control for confounders.
Results
During the study period, 238,622 newborns met the inclusion criteria: 132,619 (55.6%) were born to mothers who were not anemic; 102,997 (43.2%) of anemic mothers with no blood transfusion; and 3,006 (1.3%) were of anemic mothers with blood transfusion. During the follow up period (0-18 years, median 10.22 years), 3.0% were hospitalized with a neurological diagnosis among the non-anemic mothers, 3.3% among the anemic - no blood transfusion and 3.6% among the anemic with blood transfusion (p<0.001). Selected neurological diagnoses are presented in the table. The survival curve showed significantly different cumulative incidences of neurological hospitalizations in the different groups (Log rank p<0.001, Figure). The association between maternal anemia and offspring long-term pediatric neurological morbidities remained significant in a Weibull hazards model, controlling for maternal age, preterm births, diabetes and hypertension (adjusted HR 1.28; 95% CI 1.22-1.34; and adjusted HR 1.20; 1.0-1.46; among anemic without and with blood transfusion, as compared to non-anemic mothers, respectively).
Conclusion
Children born to anemic mothers appear to be at an increased risk for pediatric neurological related hospitalizations.
| Original language | English |
|---|---|
| Pages (from-to) | S437-S438 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |