Iron deficiency anemia, cigarette smoking and risk of abruptio placentae

Aim:  A higher frequency of abruptio placentae among anemic patients has been documented in some, but not all previously published studies. Altered feto‐placental angiogenesis during early pregnancy in anemic women may partially explain this increased risk. The present study assesses the iron defici...

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Veröffentlicht in:The journal of obstetrics and gynaecology research 2009-06, Vol.35 (3), p.446-452
Hauptverfasser: Arnold, Dodie L., Williams, Michelle A., Miller, Raymond S., Qiu, Chunfang, Sorensen, Tanya K.
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container_issue 3
container_start_page 446
container_title The journal of obstetrics and gynaecology research
container_volume 35
creator Arnold, Dodie L.
Williams, Michelle A.
Miller, Raymond S.
Qiu, Chunfang
Sorensen, Tanya K.
description Aim:  A higher frequency of abruptio placentae among anemic patients has been documented in some, but not all previously published studies. Altered feto‐placental angiogenesis during early pregnancy in anemic women may partially explain this increased risk. The present study assesses the iron deficiency anemia‐abruptio placentae association in pregnant women from the Pacific Northwest. Methods:  A retrospective case‐control study of 145 abruptio placentae cases and 1710 control subjects was conducted. The diagnosis of abruptio placentae was based on routine clinical examination performed by attending physicians. Iron deficiency anemia was assessed in early pregnancy and defined as hemoglobin level
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Altered feto‐placental angiogenesis during early pregnancy in anemic women may partially explain this increased risk. The present study assesses the iron deficiency anemia‐abruptio placentae association in pregnant women from the Pacific Northwest. Methods:  A retrospective case‐control study of 145 abruptio placentae cases and 1710 control subjects was conducted. The diagnosis of abruptio placentae was based on routine clinical examination performed by attending physicians. Iron deficiency anemia was assessed in early pregnancy and defined as hemoglobin level &lt;10 g/dL or by physician diagnosis. Information on maternal sociodemographic characteristics, cigarette smoking status during pregnancy and reproductive history was ed from medical records. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Results:  Eleven percent of abruptio placentae cases and 3.3% of controls were diagnosed with iron deficiency anemia. Maternal iron deficiency anemia in early pregnancy was associated with a 3.60‐fold increased risk of abruptio placentae (95% CI 2.01–6.04). After adjusting for maternal age, gravidity, smoking during pregnancy, Medicaid payment status, and pre‐gestational hypertension, the association was attenuated but remained statistically significant (adjusted OR = 2.40; 95% CI 1.22–4.73). Maternal smoking during pregnancy was associated with a 2.40‐fold increased risk of abruptio placentae (95% CI 1.19–3.52). The iron deficiency anemia–abruptio placentae association was not modified by maternal smoking. Conclusion:  Our results support the hypothesis that maternal iron deficiency anemia is associated with an increased risk of abruptio placentae.</description><identifier>ISSN: 1341-8076</identifier><identifier>EISSN: 1447-0756</identifier><identifier>DOI: 10.1111/j.1447-0756.2008.00980.x</identifier><identifier>PMID: 19527381</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>abruptio placentae ; Abruptio Placentae - epidemiology ; Abruptio Placentae - etiology ; Adult ; Anemia, Iron-Deficiency - complications ; Case-Control Studies ; Female ; Humans ; iron deficiency anemia ; placenta ; Pregnancy ; Pregnancy Complications ; Retrospective Studies ; Risk Factors ; smoking ; Smoking - adverse effects</subject><ispartof>The journal of obstetrics and gynaecology research, 2009-06, Vol.35 (3), p.446-452</ispartof><rights>2009 The Authors. 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Altered feto‐placental angiogenesis during early pregnancy in anemic women may partially explain this increased risk. The present study assesses the iron deficiency anemia‐abruptio placentae association in pregnant women from the Pacific Northwest. Methods:  A retrospective case‐control study of 145 abruptio placentae cases and 1710 control subjects was conducted. The diagnosis of abruptio placentae was based on routine clinical examination performed by attending physicians. Iron deficiency anemia was assessed in early pregnancy and defined as hemoglobin level &lt;10 g/dL or by physician diagnosis. Information on maternal sociodemographic characteristics, cigarette smoking status during pregnancy and reproductive history was ed from medical records. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Results:  Eleven percent of abruptio placentae cases and 3.3% of controls were diagnosed with iron deficiency anemia. Maternal iron deficiency anemia in early pregnancy was associated with a 3.60‐fold increased risk of abruptio placentae (95% CI 2.01–6.04). After adjusting for maternal age, gravidity, smoking during pregnancy, Medicaid payment status, and pre‐gestational hypertension, the association was attenuated but remained statistically significant (adjusted OR = 2.40; 95% CI 1.22–4.73). Maternal smoking during pregnancy was associated with a 2.40‐fold increased risk of abruptio placentae (95% CI 1.19–3.52). The iron deficiency anemia–abruptio placentae association was not modified by maternal smoking. Conclusion:  Our results support the hypothesis that maternal iron deficiency anemia is associated with an increased risk of abruptio placentae.</description><subject>abruptio placentae</subject><subject>Abruptio Placentae - epidemiology</subject><subject>Abruptio Placentae - etiology</subject><subject>Adult</subject><subject>Anemia, Iron-Deficiency - complications</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Humans</subject><subject>iron deficiency anemia</subject><subject>placenta</subject><subject>Pregnancy</subject><subject>Pregnancy Complications</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>smoking</subject><subject>Smoking - adverse effects</subject><issn>1341-8076</issn><issn>1447-0756</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1u2zAQhImiRe26fYWCp54qZSlKFgn0EgSpnSBoLgnqG0FSK4O2fhxSRuy3L1UbzjV72QV2Zjn8CKEMUhbrapOyPC8TKIt5mgGIFEAKSA8fyPSy-BhnnrNEQDmfkC8hbABYKZn4TCZMFlnJBZuS5Z3vO1ph7azDzh6p7rB1-ie1bq09DgPS0PZb163jpqLehS3ta6qN3-8G19Ndoy12g8av5FOtm4Dfzn1Gnn_fPt0sk4fHxd3N9UNii4xDYgXjgKyQyJBLWRutEQtTmdLEzFyavJCWS1YDExUXnNcGIZfFPDfaZBL5jPw43d35_mWPYVCtCxabJgbv90HN47_yPONRKE5C6_sQPNZq512r_VExUCNFtVEjLDXCUiNF9Z-iOkTr9_Mbe9Ni9WY8Y4uCXyfBq2vw-O7D6v5xEYdoT052FwY8XOzab8f4ZaH-_lkoxpdyla1AAf8HnPKPBw</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Arnold, Dodie L.</creator><creator>Williams, Michelle A.</creator><creator>Miller, Raymond S.</creator><creator>Qiu, Chunfang</creator><creator>Sorensen, Tanya K.</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200906</creationdate><title>Iron deficiency anemia, cigarette smoking and risk of abruptio placentae</title><author>Arnold, Dodie L. ; Williams, Michelle A. ; Miller, Raymond S. ; Qiu, Chunfang ; Sorensen, Tanya K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5230-c8130e159e1e399fbaaee5bdb7b75639b459c391f018d3833fbe049564bab29e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>abruptio placentae</topic><topic>Abruptio Placentae - epidemiology</topic><topic>Abruptio Placentae - etiology</topic><topic>Adult</topic><topic>Anemia, Iron-Deficiency - complications</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Humans</topic><topic>iron deficiency anemia</topic><topic>placenta</topic><topic>Pregnancy</topic><topic>Pregnancy Complications</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>smoking</topic><topic>Smoking - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arnold, Dodie L.</creatorcontrib><creatorcontrib>Williams, Michelle A.</creatorcontrib><creatorcontrib>Miller, Raymond S.</creatorcontrib><creatorcontrib>Qiu, Chunfang</creatorcontrib><creatorcontrib>Sorensen, Tanya K.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of obstetrics and gynaecology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arnold, Dodie L.</au><au>Williams, Michelle A.</au><au>Miller, Raymond S.</au><au>Qiu, Chunfang</au><au>Sorensen, Tanya K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iron deficiency anemia, cigarette smoking and risk of abruptio placentae</atitle><jtitle>The journal of obstetrics and gynaecology research</jtitle><addtitle>J Obstet Gynaecol Res</addtitle><date>2009-06</date><risdate>2009</risdate><volume>35</volume><issue>3</issue><spage>446</spage><epage>452</epage><pages>446-452</pages><issn>1341-8076</issn><eissn>1447-0756</eissn><abstract>Aim:  A higher frequency of abruptio placentae among anemic patients has been documented in some, but not all previously published studies. Altered feto‐placental angiogenesis during early pregnancy in anemic women may partially explain this increased risk. The present study assesses the iron deficiency anemia‐abruptio placentae association in pregnant women from the Pacific Northwest. Methods:  A retrospective case‐control study of 145 abruptio placentae cases and 1710 control subjects was conducted. The diagnosis of abruptio placentae was based on routine clinical examination performed by attending physicians. Iron deficiency anemia was assessed in early pregnancy and defined as hemoglobin level &lt;10 g/dL or by physician diagnosis. Information on maternal sociodemographic characteristics, cigarette smoking status during pregnancy and reproductive history was ed from medical records. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Results:  Eleven percent of abruptio placentae cases and 3.3% of controls were diagnosed with iron deficiency anemia. Maternal iron deficiency anemia in early pregnancy was associated with a 3.60‐fold increased risk of abruptio placentae (95% CI 2.01–6.04). After adjusting for maternal age, gravidity, smoking during pregnancy, Medicaid payment status, and pre‐gestational hypertension, the association was attenuated but remained statistically significant (adjusted OR = 2.40; 95% CI 1.22–4.73). Maternal smoking during pregnancy was associated with a 2.40‐fold increased risk of abruptio placentae (95% CI 1.19–3.52). The iron deficiency anemia–abruptio placentae association was not modified by maternal smoking. Conclusion:  Our results support the hypothesis that maternal iron deficiency anemia is associated with an increased risk of abruptio placentae.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>19527381</pmid><doi>10.1111/j.1447-0756.2008.00980.x</doi><tpages>7</tpages></addata></record>
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subjects abruptio placentae
Abruptio Placentae - epidemiology
Abruptio Placentae - etiology
Adult
Anemia, Iron-Deficiency - complications
Case-Control Studies
Female
Humans
iron deficiency anemia
placenta
Pregnancy
Pregnancy Complications
Retrospective Studies
Risk Factors
smoking
Smoking - adverse effects
title Iron deficiency anemia, cigarette smoking and risk of abruptio placentae
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