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The relationship between maternal hematocrit and pregnancy outcome: black-white differences
M L Blankson1, R L Goldenberg, G Cutter
1Division of Maternal and Child Health, School of Public Health, University of Alabama, Birmingham 35294.
Journal of the National Medical Association
|February 1, 1993
Summary
High hematocrit levels (≥40%) during mid-pregnancy significantly increase the risk of intrauterine growth retardation in both Black and White women. Low hematocrit levels showed no significant association with adverse pregnancy outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Hematology
Background:
- Hematocrit levels during pregnancy can vary by race and may be associated with pregnancy outcomes.
- Previous studies suggested a link between low hematocrit and preterm delivery in Black women, but confounding factors may exist.
Purpose of the Study:
- To investigate racial differences in hematocrit levels.
- To examine the relationship between low and high hematocrit levels and adverse pregnancy outcomes like intrauterine growth retardation and preterm delivery.
Main Methods:
- Analysis of data from 17,149 low-income, iron- and folate-supplemented pregnant women.
- Hematocrit levels were measured during four distinct gestational periods.
- Pregnancy outcomes were evaluated in relation to hematocrit values at specific gestational ages.
Main Results:
- Low hematocrit levels (27%-30%) in Black women were not significantly associated with increased rates of intrauterine growth retardation or preterm delivery.
- Significantly higher odds ratios for intrauterine growth retardation were observed in both Black and White women with hematocrit levels ≥40% at 31-34 weeks gestation.
Conclusions:
- High hematocrit levels during mid-pregnancy warrant increased clinical attention due to their association with intrauterine growth retardation.
- Low hematocrit levels in pregnancy may be less concerning than previously thought, irrespective of race.