Category: Epidemiology
Poster Session III
Traditional race-based cutoffs for anemia may lead to under-correction and potentially higher rates of anemia at delivery for Black women. We aimed to determine if racial/ethnic differences exist in persistence of anemia into the third trimester in patients with anemia earlier in pregnancy.
Study Design: Retrospective cohort study of all pregnant individuals who delivered at a single institution (April 01, 2017 - December 31, 2019) with a hemoglobin (Hb) < 11g/dL during any trimester of pregnancy and at least one Hb result in the third trimester. The primary outcome was persistent anemia, defined as: (1) Hb < 11 g/dL in the first or second trimesters, and then again in the third trimester or (2) any Hb < 11 g/dL in the third trimester, independent of first and second trimester Hb. We compared rates of persistent anemia between racial/ethnic groups in addition to other demographic variables. Univariable and multivariable regression models were used to compare groups. Variables found to be associated with outcomes in the univariable analysis were included in the multivariable analysis. Significance set at p < 0.05.
Results: During the study period, five-hundred twenty-one individuals had a Hb < 11 g/dL in pregnancy. Sixty patients (26.9%) had 1st trimester anemia, 360 patients (76.1%) had 2nd trimester anemia, and 279 patients (53.6%) had 3rd trimester anemia. Of those with 1st or 2nd trimester anemia, 61.7% and 37.8%, respectively, had persistent anemia in the 3rd trimester. Of patients who had Hb < 11 g/dL in 1st or 2nd trimesters, Black race, public insurance, and multiparity were associated with persistent anemia (Table 1). After adjustment for confounders, Black race and public insurance was associated with persistent anemia in individuals known have Hb < 11 g/dL earlier in pregnancy (Table 2).
Conclusion: Even when anemia is identified early in pregnancy, Black race and public insurance are associated with persistent anemia in the third trimester.
Rachel A. Newman, MBA, MD
Fellow
Cedars-Sinai Medical Center
Los Angeles, California, United States
Richard Burwick, MD, MPH
San Gabriel Valley Perinatal Medical Group
West Covina, California, United States
Mariam Naqvi, MD
Assistant Professor, Obstetrics and Gynecology
Cedars-Sinai Medical Center
Los Angeles, California, United States