Category: Medical/Surgical/Diseases/Complications
Poster Session III
To compare neonatal and maternal outcomes between pregnant patients with mild/moderate iron-deficiency anemia (MMIDA) who remain anemic at time of delivery despite iron treatment vs. those whose MMIDA is corrected.
Study Design:
This retrospective cohort study from 10/15/07–10/14/21 included singleton pregnancies affected by MMIDA (7.0–10.9 g/dL, per WHO) treated with PO and/or IV iron for at least 4 weeks prior to delivery. Patients with severe anemia ( < 7.0 g/dL) or comorbidities that predisposed to anemia (e.g., thalassemia) were excluded. All neonatal and maternal outcomes were assessed by persistence vs. correction of MMIDA by delivery. The primary outcome was a composite of neonatal morbidity, including stillbirth, preterm birth (PTB, < 37 weeks), APGAR < 7 at 5 mins, low birthweight ( < 2500 g), NICU admission, and neonatal death. Secondary outcomes included neonatal biometrics, severe neonatal morbidity (e.g., sepsis), and maternal prenatal and peripartum outcomes (e.g., preeclampsia).
Results:
Study criteria was met by 8833 patients; 60.9% had corrected MMIDA by delivery. Correction resulted in decreased composite neonatal morbidity (adjusted odds ratio [aOR] 0.87; 95% CI, 0.76–0.99; p=0.03). Correction was also associated with independent reductions in PTB (aOR 0.64; 95% CI, 0.54–0.76; p< 0.01), NICU admission (aOR 0.77, 95% CI, 0.67–0.89; p< 0.01), cesarean delivery (aOR 0.81; 95% CI, 0.69–0.95; p=0.01), preeclampsia (aOR 0.70; 95% CI, 0.55-0.88; p< 0.01) and maternal blood transfusion (aOR 0.33; 95% CI, 0.22–0.49; p< 0.01). Correction was not associated with changes in other outcomes. Patients diagnosed with MMIDA in later trimesters were more likely to achieve correction (53.1%, 58.5%, and 63.3% for first, second, and third trimester diagnosis, respectively; p< 0.01).
Conclusion:
Correction of MMIDA was associated with diagnosis later in gestation and a reduction in composite neonatal morbidity, preterm birth, NICU admission, preeclampsia, cesarean delivery, and maternal blood transfusion, while no benefit was shown for other neonatal and maternal outcomes.
Richard Vigh, MD
Fellow
Geisinger
Danville, Pennsylvania, United States
Amanda J. Young, MS
Geisinger Medical center
Danville, Pennsylvania, United States
Celia Gray, BS
Geisinger
Geisinger, Pennsylvania, United States
Michael J. Paglia, MD
Geisinger
Danville, Pennsylvania, United States
A. Dhanya Mackeen, MD,MPH
Geisinger Medical Center
Danville, Pennsylvania, United States