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Haemoglobin Concentrations and Maternal and Neonatal Outcomes: Identifying Optimal Haemoglobin Ranges.

Hong-Zhao Yu1,2, Chang-Dong Dong3,4, Yang Liu1,2

  • 1Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.

Paediatric and Perinatal Epidemiology
|March 30, 2026
PubMed
Summary
This summary is machine-generated.

Optimal maternal hemoglobin (Hb) levels during pregnancy are crucial for preventing adverse outcomes. This study identified U-shaped relationships between Hb concentrations and risks, suggesting specific ranges for improved maternal and neonatal health.

Keywords:
anaemiahaemoglobinspregnancypregnancy complicationspregnancy outcome

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Clinical Chemistry

Background:

  • Maternal hemoglobin (Hb) concentration is linked to pregnancy complications.
  • Optimal Hb levels for favorable maternal and neonatal outcomes are not well-established.

Purpose of the Study:

  • To investigate the association between maternal Hb levels and maternal/neonatal outcomes.
  • To determine optimal Hb concentration ranges during the second and third trimesters of pregnancy.

Main Methods:

  • Analysis of 120,263 Hb measurements from 41,956 singleton births in China (2018-2023).
  • Utilized Poisson regression with restricted cubic splines and generalized estimating equations.
  • Optimal ranges determined via low-risk subgroup analysis and combined risk curve method.

Main Results:

  • U-shaped associations observed between Hb concentration and preeclampsia, postpartum hemorrhage (PPH), preterm birth (PTB), small for gestational age (SGA), and neonatal asphyxia.
  • Gestational diabetes mellitus (GDM) showed a nearly linear relationship with Hb.
  • Optimal ranges suggested: 10.6-11.8 g/dL (2nd trimester) and 10.7-12.1 g/dL (3rd trimester) by one method, and 9.6-11.7 g/dL (2nd) and 9.9-12.0 g/dL (3rd) by another.

Conclusions:

  • Maternal Hb concentrations exhibit U-shaped relationships with adverse maternal and neonatal outcomes.
  • Recommended optimal Hb range of 10.5-12.5 g/dL for second and third trimesters, balancing risks and clinical feasibility.
  • Further multicenter studies are needed to validate these findings in diverse populations.