(1114) Does anemia impact pregnancy latency among patients with preterm pre-labor rupture of membranes (PPROM)?

Anemia has been associated with multiple adverse pregnancy outcomes, including preterm birth and maternal infections. Little is known about the association between anemia and outcomes after preterm pre-labor rupture of membranes (PPROM). The objective of this study was to explore the association between admission anemia on latency after PPROM.


Study Design:

Single-center retrospective cohort of pregnancies complicated by PPROM < 34 weeks from 2013-2019. Individuals with intrauterine fetal demise were excluded. Anemia was defined as admission hemoglobin < 10.5g/dL. Latency was defined as duration (days) from PPROM to delivery. The primary outcome was latency > 7days (or delivery at 34 weeks). Secondary outcomes included latency > 14 days (or delivery at 34wks), delivery at 34 weeks, and median latency. Bivariate statistics compared patients admitted with anemia to those with normal admission hemoglobin. Regression models were used to control for confounding.


Results:

Of 396 included pregnancies, 87 (22.0%) were anemic on presentation with PPROM. Median admission hemoglobin was 11.6g/dL (IQR 11.1,12.4) in the non-anemic cohort and 9.8g/dL (IQR 9.3,10.2) among anemic patients. Anemic patients were more likely to be Black, have Medicaid, and be treated with iron before or during admission (60.1% vs 16.5%) (Table 1).

The primary and secondary outcomes did not differ between groups (Table). After controlling for confounders, latency >7days (or delivery at 34 weeks) was less likely among patients admitted with anemia (aOR0.47, 95% CI 0.26-0.82). Other outcomes did not differ even after controlling for confounders (Table 2).


Conclusion:

Among patients admitted with PPROM, those who present with anemia may have shorter latency than those who are admitted without anemia. This may be an actionable area to improve latency in patients with PPROM.