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. 2022 Dec;35(26):10472-10480.
doi: 10.1080/14767058.2022.2130237. Epub 2022 Oct 23.

Maternal hemoglobin levels and neonatal outcomes: the Japan Environment and Children's Study

Hayato Go  1 , Koichi Hashimoto  1   2 , Hyo Kyozuka  2   3 , Hajime Maeda  1 , Hidekazu Nishigori  4 , Akiko Sato  2 , Yuka Ogata  2 , Masahito Kuse  2 , Keiya Fujimori  2   3 , Seiji Yasumura  2   5 , Mitsuaki Hosoya  1   2 ; Japan Environment and Children’s Study (JECS) Group
Collaborators, Affiliations
Free article

Maternal hemoglobin levels and neonatal outcomes: the Japan Environment and Children's Study

Hayato Go et al. J Matern Fetal Neonatal Med. 2022 Dec.
Free article

Abstract

Background: Low birth weight (LBW), small for gestational age (SGA), and preterm birth (PTB) are important neonatal outcomes that may affect infant morbidity and mortality. The aim of this study is to investigate associations between maternal hemoglobin (Hb) concentrations and pregnancy outcomes of LBW, SGA, and PTB.

Methods: This was a prospective birth cohort study using data of the Japan Environment and Children's Study. Participants were divided into five groups according to maternal Hb (g/dL) in the first and second trimesters: group 1, Hb < 9; group 2, 9 ≤ Hb < 11.0; group 3, 11.0 ≤ Hb < 13.0; group 4, 13.0 < Hb < 14.0; and group 5, 14.0 ≤ Hb. We examined the relationships between LBW, PTB, SGA, and maternal Hb in the first and second trimesters.

Results: Excluding 29,673, a total of 74,392 newborns (first trimester: n = 39,084, second trimester: n = 35,308) were included. We obtained adjusted odds ratios (aORs) (95% confidence intervals (CIs)) using multivariate analysis; compared with group 3 in the first trimesters, women in group 1 were at increased risk of PTB (aOR, 3.20; 95% CI, 1.69-6.09), LBW (aOR, 2.21; 95% CI, 1.19-4.09). In the second trimester, multivariate analysis revealed that, compared with group 3 in the second trimester, women in group 1 were at increased risk of PTB (aOR, 2.30; 95% CI, 1.19-4.42) and women in group 5 were at increased risk of LBW (aOR, 1.87; 95% CI, 1.24-2.81) and PTB (aOR, 1.73; 95% CI, 1.06-2.83).

Conclusions: Elevated maternal Hb in the second trimester was associated with risks of PTB and LBW.

Keywords: Japan; low birth weight; maternal hemoglobin; neonatal outcomes; preterm infants; small for gestational age.

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