Anemia in pregnancy and race in the United States: blacks at risk

Abstract

Objectives: This study's objectives were to determine the national prevalence of anemia in pregnancy (AIP) in the United States, compare racial differences in the prevalence, compare the AIP risk factor profiles between non-Hispanic whites and non-Hispanic blacks, and to analyze the associations between AIP and some maternal and fetal/neonatal complications between whites and blacks.

Methods: The data used were from the United States natality data files (1995 through 2000), which included 23,654,695 live births. All mothers diagnosed with AIP, defined as hemoglobin-concentration < 10 g/dl, were included. The cohorts were analyzed in two groups. The "whole group" (WG) comprised all women in the data set who had anemia status reported. The "low-risk group" (LRG) comprised women with low-risk factors for AIP. Race was determined by mothers' skin colors and racial self-identifications. Logistic regression was used to explore associations between race and AIP while controlling for other covariates.

Results: The national prevalence of AIP among the general population was 21.55/1,000 among the WG and 11.51/1,000 among the LRG. Among the WG, the prevalence of AIP was two times higher among non-Hispanic blacks (35.38/1,000) than among non-Hispanic whites (18.02/1,000). Among the LRG, the prevalence was 1.94 times higher among non-Hispanic blacks (20.44/1,000) than among non-Hispanic whites (10.63/1,000). The other risk factor profiles for AIP were similar among the races. Many serious maternal and fetal/neonatal complications occurred more frequently among anemic patients when compared with non-anemic patients.

Conclusions: The results of this study showed that black race was significantly associated with higher risk of AIP. The other risk factor profiles of AIP were significantly similar between whites and blacks. This study also confirmed that AIP was significantly associated with some serious maternal and fetal/neonatal complications. The findings of this study indicate that race is an important risk factor of AIP.