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Phenotyping in clinical nutrition

Iron deficiency anaemia associated with increased placenta praevia and placental abruption: a retrospective case-control study

European Journal of Clinical Nutrition volume 76, pages 1172–1177 (2022)Cite this article

Subjects

Abstract

Background/Objectives

A few studies reported association between placenta praevia (PP) and placental abruption (PA) with maternal iron deficiency anaemia (IDA), which is not an established risk factor for these conditions. This retrospective case-control study was performed to determine the relationship between IDA with PP and PA.

Methods

Maternal characteristics, risk factors for and incidence of antepartum haemorrhage overall, and PP and PA, were compared between women with IDA only and controls without IDA or haemoglobinopathies matched for exact age and parity (four controls to each index case), who carried singleton pregnancy to ≥22 weeks and managed under our care from 1997 to 2019.

Results

There were 1,176 women (0.8% of eligible women in the database) with IDA only, who exhibited slightly but significantly different maternal characteristics, and increased antepartum haemorrhage overall (3.4% versus 2.2%, p = 0.031, OR 1.522, 95% CI 1.037–2.234) and PP (1.8% versus 0.9%, p = 0.010, OR 1.953, 95% CI 1.164–3.279), but not PA (1.2% versus 1.1%, p = 0.804, OR 1.077, 95% CI 0.599–1.936). When stratified by parity status, increased PP was found in nulliparous women only. On multivariate analysis adjusting for parity, previous abortion history, overweight and obesity, short stature, other antenatal complications as a composite factor, preterm (<37) delivery, previous caesarean delivery, and infant gender, IDA was associated with PP (aOR 3.485, 95% CI 1.959–6.200) and PA (aOR 2.181, 95% CI 1.145–4.155).

Conclusions

Both PP and PA are increased in women with IDA, the prevention of which could be a means to reduce the occurrence of both PP and PA.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, and Prince of Wales Hospital, Shatin, Hong Kong, PRC

    Terence Tzu-hsi Lao, Shuk Yi Annie Hui, Lulu Lo Wong & Daljit Singh Sahota

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Contributions

TTL—conceived and designed the study, analysed and interpreted the data, performed the literature search and wrote the manuscript. SYAH—contributed to the design, obtained ethical approval, contributed to data interpretation, literature search, and preparation of the manuscript, approved the manuscript. LLW—assisted in data checking and literature search, contributed to interpretation of the results, and preparation and approval of the manuscript. DSS—set up the database, participated in data analysis and interpretation, contributed to the discussion and approved the manuscript.

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Correspondence to Terence Tzu-hsi Lao.

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Lao, T.Th., Hui, S.Y.A., Wong, L.L. et al. Iron deficiency anaemia associated with increased placenta praevia and placental abruption: a retrospective case-control study. Eur J Clin Nutr 76, 1172–1177 (2022). https://doi.org/10.1038/s41430-022-01086-6

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