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Racial disparities in maternal hemoglobin concentrations and pregnancy outcomes

  • Mohamed A. Mohamed EMAIL logo , Tahmina Ahmad , Charles Macri and Hany Aly
Published/Copyright: January 10, 2012
Journal of Perinatal Medicine
From the journal Volume 40 Issue 2

Abstract

Objective: To examine the association of maternal hemoglobin (Hb) concentrations with preterm and low birth weight (LBW) deliveries in African Americans compared to Caucasians.

Methods: We conducted a retrospective analysis of perinatal data on 17,338 African-American and Caucasian pregnant women who delivered at the George Washington University Hospital (GWUH) between January 1990 and December 2003. We used univariate and logistic regression analyses to examine for associations.

Results: Compared to Caucasians (n=9432), African American mothers (n=7906) had a higher incidence of anemia (26.9% vs. 7.1%, P<0.001), preterm (22.1% vs. 12.8%, P<0.001) and LBW (18.6% vs. 9.7%, P<0.001) outcomes. This association increased with decreasing Hb concentrations in each race. Risk for preterm and LBW outcomes were higher in African Americans compared to Caucasians at Hb concentration ≥12 g/dL (P<0.007); however, there were no race-specific risk at Hb concentration <11 g/dL (P>0.05).

Conclusions: The association of race with preterm and LBW outcomes relates to maternal Hb. Our findings suggest: a) anemia is a strong risk factor that masks the influence of race, b) African American race could be a surrogate for other factors that contribute to adverse outcomes, and c) Caucasian race could be less adaptive to anemia.

Keywords: Low birth weight; maternal anemia; pregnancy outcome; premature infants; racial disparity
Corresponding author: Mohamed A. Mohamed, MD The George Washington University Medical Center Newborn Services Department 900 23rd Street NW Suite G-2092, Washington, DC 20037 Tel.: +1(202) 378-6911 Fax: +1(202) 715-5350
Received: 2011-5-17
Revised: 2011-8-16
Accepted: 2011-11-28
Published Online: 2012-01-10
Published in Print: 2012-02-01

©2012 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpm.2011.137
Keywords for this article
Low birth weight; maternal anemia; pregnancy outcome; premature infants; racial disparity

Articles in the same Issue

  1. Review Article
  2. Cardiac morbidity in twin-twin transfusion syndrome?
  3. Original Articles – Obstetrics
  4. Risk factors for postpartum hypertension in women with twin pregnancies
  5. Serum levels of the adipokine chemerin in preeclampsia
  6. Expression changes of sex hormone binding globulin in GDM placental tissues
  7. Evaluation of serum boron levels and lipid profile in pregnancies with or without gestational diabetes
  8. Racial disparities in maternal hemoglobin concentrations and pregnancy outcomes
  9. Prediction of imminent preterm delivery in women with preterm premature rupture of membranes
  10. Endocervical immune mediator production following successful rescue or ultrasound indicated cerclage placement
  11. Co-ordinate expression of Th1/Th2 phenotypes in maternal and fetal blood: evidence for a transplacental nexus
  12. Original Articles – Fetus
  13. How does the duration of active pushing in labor affect neonatal outcomes?
  14. Quantification of the subcutaneous fat layer with MRI in fetuses of healthy mothers with no underlying metabolic disease vs. fetuses of diabetic and obese mothers
  15. Original Article – Newborn
  16. Immediate clinical outcomes in preterm neonates receiving antenatal magnesium for neuroprotection
  17. Developmental delay in hypoxia-induced HO-1 expression predisposes to gut injury
  18. Short communication
  19. Correlation of Cyr61 and CTGF in placentas from the late pre-eclamptic pregnancy
  20. Letters to the Editor
  21. Cross-species transfer of group B streptococcus via ingestion?
  22. WAPM-Newsletter
  23. WAPM-Newsletter No 1/2012
  24. Congress Calender
  25. Congress Calendar
  26. Prelims
  27. Prelims
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