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Meta-Analysis
. 2013:2013:769057.
doi: 10.1155/2013/769057. Epub 2013 Jul 25.

Hemoglobin concentration and pregnancy outcomes: a systematic review and meta-analysis

Bunyarit Sukrat  1 , Chumpon Wilasrusmee, Boonying Siribumrungwong, Mark McEvoy, Chusak Okascharoen, John Attia, Ammarin Thakkinstian
Affiliations
Meta-Analysis

Hemoglobin concentration and pregnancy outcomes: a systematic review and meta-analysis

Bunyarit Sukrat et al. Biomed Res Int. 2013.

Abstract

Objective: To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy outcomes.

Methods: We searched MEDLINE and SCOPUS from January 1, 1990 to April 10, 2011. Observational studies addressing association between hemoglobin and adverse pregnancy outcomes were selected. Two reviewers independently extracted data. A mixed logistic regression was applied to assess the effects of hemoglobin on preterm birth, low birth weight, and small for gestational age.

Results: Seventeen studies were included in poolings. Hemoglobin below 11 g/dL was, respectively, 1.10 (95% CI: 1.02-1.19), 1.17 (95% CI: 1.03-1.32), and 1.14 (95% CI: 1.05-1.24) times higher risk of preterm birth, low birth weight, and small for gestational age than normal hemoglobin in the first trimester. In the third trimester, hemoglobin below 11 g/dL was 1.30 (95% CI: 1.08-1.58) times higher risk of low birth weight. Hemoglobin above 14 g/dL in third trimester decreased the risk of preterm term with ORs of 0.50 (95% CI: 0.26-0.97), but it might be affected by publication bias.

Conclusions: Our review suggests that hemoglobin below 11 g/dl increases the risk of preterm birth, low birth weight, and small gestational age in the first trimester and the risk of low birth weight in the third trimester.

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Figures

Figure 1
Figure 1
Flow of study selection.
Figure 2
Figure 2
Pooling effects of hemoglobin concentration on pregnancy outcomes in the first trimester.
Figure 3
Figure 3
Pooling effects of hemoglobin concentration on pregnancy outcomes in the third trimester.
See this image and copyright information in PMC

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