Association of hemoglobin values at booking with adverse maternal outcomes among Peruvian populations living at different altitudes

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• 作者：Gustavo F. Gonzales^a ; ^b ; ^{gustavo.gonzales@upch.pe} ; Vilma Tapia^b ; Manuel Gasco^a ; Carlos E. Carrillo^b ; Alfredo L. Fort^c
• 关键词：Altitude ; Anemia ; Hemoglobin ; Pre-eclampsia ; Premature rupture of membranes ; Postpartum hemorrhage
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2012
• 期刊代码：130_00207292
• 类别：med
• 出版时间：May, 2012
• 卷：117
• 期：2
• 页码：134-139
• 文件大小：317 K

摘要

Objective

To determine hemoglobin values associated with adverse maternal outcomes among Peruvian populations at different altitudes.

Methods

A retrospective cohort study was conducted using data from the Perinatal Information System. Adverse maternal outcomes were assessed.

Results

Risk of pre-eclampsia increased at maternal hemoglobin levels above 14.5 g/dL (OR 1.27; 95%CI, 1.18-1.36) or below 7.0 g/dL (OR 1.52; CI 95%, 1.08-2.14). Altitude above 2000 m reduced risk (OR 0.65; 95%CI 0.62-0.68). Risk of postpartum hemorrhage (PPH) increased with moderate/severe anemia (OR 6.15; 95%CI, 3.86-9.78) and at moderate altitudes (OR 1.26; 95%CI, 1.12-1.43). Mild anemia at any altitude was associated with reduced risk of pre-eclampsia (OR 0.85, 95%CI, 0.81-0.89) and PPH (OR 1.01; 95%CI, 0.88-1.15). Risk of premature rupture of membranes was reduced at high hemoglobin values. Maternal mortality increased at hemoglobin levels below 9.0 g/dL (OR 5.68; 95%CI, 2.97-10.80) and above 14.5 g/dL (OR 2.18; 95%CI, 1.22-3.91). Maternal mortality increased at moderate altitudes (OR 29.2; 95%CI, 2.62-324.60) and high altitudes (OR 66.4; 95%CI, 6.65-780.30) when hemoglobin levels were below 9.0 g/dL.

Conclusion

Elevated altitude and hemoglobin levels influence maternal outcomes.