Objective: The
study was conducted to investigate the influence of initial hemoglobin (Hb)
concentration of Sri Lankan pregnant mothers on baby’s birth weight and preterm
delivery. Methods: For this retrospective study, 3867 primigravid
pregnant women in Sri Lanka were followed till they deliver the baby. Sampling
method was cluster sampling where all the pregnant mothers giving singleton
birth in the selected 15 health division were followed for three years.
Mothers’ initial Hb concentration, weight gain during the pregnancy and neonatal outcomes were
assessed. Results: Severe iron deficiency anemia at the initial stage of
pregnancy had 3.9 - 14.4 folder
higher relative risk of low birth weight (LBW) and 3.0 - 8.1 folder higher
relative risk of preterm delivery at 95% confidence interval. The minimum
incidence of preterm delivery and maximum weight gain of mothers occurs in
association with an initial Hb concentration of 105 - 125 g/L. Conclusion: The excess level of initial iron content at pregnancy does not contribute for
any adverse effect on pregnancy outcome as like in the later part of pregnancy
and therefore supplement of iron during the initial pregnancy for mothers can
be carried out regardless of whether the mother is anemic.
Cite this paper
Razmy, A. M. (2016). Significance of Initial Maternal Hemoglobin Concentration during Pregnancy in Birth Weight and Preterm Delivery in Sri Lanka. Open Access Library Journal, 3, e2725. doi: http://dx.doi.org/10.4236/oalib.1102725.
Scholl, T.O. and Hediger, M.L. (1994) Anemia and Iron-Deficiency
Anemia: Compilation of Data on Pregnancy Outcome. American Journal of Clinical Nutrition, 59, 492S-500S.
Huddy, C.L.,
Johnson, A.
and
Hope, P.L. (2001) Educational
and Behavioral Problems in Babies of 32 - 35 Weeks Gestation. Archives
of Disease in Childhood. Fetal and Neonatal Edition, 85, 23-28. https://doi.org/10.1136/fn.85.1.F23
Murphy, J.F.,
O’Riordan, J.,
Newcombe, R.J.,
Coles, E.C.
and
Pearson, J.F. (1986) Relation
of Hemoglobin Levels in First and Second Trimesters to Outcome of Pregnancy. Lancet, 1, 992-995. https://doi.org/10.1016/S0140-6736(86)91269-9
Hemminki, E. and Rimpela, U.
(1991) Iron
Supplementation, Maternal Packed Cell Volume, and Fetal Growth. Archives of Disease in Childhood, 66, 422-425. https://doi.org/10.1136/adc.66.4_Spec_No.422
Agarwal, K.N., Agarwal, D.K. and
Mishra, K.P. (1991) Impact
of Anemia Prophylaxis in Pregnancy on Maternal Hemoglobin, Serum Ferritin and Birth
Weight. Indian Journal of Medical Research, 94, 277-280.
Singla, P.N.,
Tyagi, M.,
Kumar, A.,
Dash, D.
and Shankar, R.
(1997) Fetal
Growth in Maternal Anemia. Journal of
Tropical Pediatrics, 43, 89-92. https://doi.org/10.1093/tropej/43.2.89
Yip, R. (2000) Significance of an Abnormally Low or High Hemoglobin
Concentration during Pregnancy: Special Consideration of Iron Nutrition. American
Journal of Clinical Nutrition, 72, 272-279.
Steer, P., Alam, M.A., Wadsworth, J. and Welch, A. (1995) Relation between Maternal Haemoglobin
Concentration and Birth Weight in Different Ethnic Groups. BMJ, 310,
489- 491. https://doi.org/10.1136/bmj.310.6978.489
Goldenberg, R.L.,
Tamura, T.,
DuBard, M.,
Johnston, K.E., Copper, R.L.
and
Neggers, Y. (1996)
Plasma Ferritin and Pregnancy Outcome. American
Journal of Obstetrics and Gynecology, 175, 1356-1359. https://doi.org/10.1016/S0002-9378(96)70054-6
Rondo, P.H., Abbott, R., Rodrigues, L.C.
and
Tomkins, A.M. (1997)
The Influence of Maternal Nutritional Factors on Intrauterine Growth
Retardation in Brazil. Paediatric and Perinatal
Epidemiology, 11, 152-166. https://doi.org/10.1046/j.1365-3016.1997.d01-16.x
Murphy, J.F., O’Riordan, J., Newcombe, R.J.,
Coles, E.C.
and
Pearson, J.F.
(1986) Relation of Hemoglobin Levels in First and Second Trimesters to
Outcome of Pregnancy. Lancet, 1, 992-995. https://doi.org/10.1016/S0140-6736(86)91269-9
Scholl, T.O., Hediger, M.L., Fischer, R.L.
and
Shearer, J.W. (1992)
Anemia vs Iron Deficiency: Increased Risk of Preterm Delivery in a Prospective
Study. American Journal of Clinical Nutrition, 55,
985-988.
Hemminki, E.
and
Starfield, B. (1978)
Routine Administration of Iron and Vitamins during Pregnancy:
Review of Controlled Clinical Trials. British
Journal of Obstetrics and Gynaecology, 85, 404-410. https://doi.org/10.1111/j.1471-0528.1978.tb14905.x
