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Placental abruption and neonatal anemia
Sarah M Tweddell1, Timothy M Bahr2,3, Erick Henry3
1Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. Sarah.Tweddell@hsc.utah.edu.
Objective:
Placental abruption can cause maternal blood loss and maternal anemia. It is less certain whether abruption can cause fetal blood loss and neonatal anemia.
Study Design:
Retrospective multi-hospital 24-month analysis of women with placental abruption and their neonates.
Results:
Of 55,111 births, 678 (1.2%) had confirmed abruption; 83% of these neonates (564) had one or more hemoglobins recorded in the first day. Four-hundred-seventy (83.3%) had a normal hemoglobin (≥5th% reference interval) while 94 (16.7%) had anemia, relative risk 3.26 (95% CI, 2.66-4.01) vs. >360,000 neonates from previous reference interval reports. The relative risk of severe anemia (<1st% interval) was 4.96 (3.44-7.16). When the obstetrician identified the abruption as "small" or "marginal" the risk of anemia was insignificant.
Conclusions:
Most abruptions do not cause neonatal anemia but approximately 16% do. If an abruption is not documented as small, it is important to surveille the neonate for anemia.
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