Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8008-8019
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8008
Association of gestational anemia with pregnancy conditions and outcomes: A nested case-control study
Yin Sun, Zhong-Zhou Shen, Fei-Ling Huang, Yu Jiang, Ya-Wen Wang, Su-Han Zhang, Shuai Ma, Jun-Tao Liu, Yong-Le Zhan, Hang Lin, Yun-Li Chen, Ying-Jie Shi, Liang-Kun Ma
Yin Sun, Fei-Ling Huang, Su-Han Zhang, Jun-Tao Liu, Hang Lin, Liang-Kun Ma, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
Zhong-Zhou Shen, Yu Jiang, Ya-Wen Wang, Shuai Ma, Yong-Le Zhan, Yun-Li Chen, Ying-Jie Shi, Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Jiang Y and Ma LK conceived, coordinated and supervised the study; Sun Y, Shen ZZ and Huang FL designed and drafted the manuscript; Wang YW, Zhang SH, Ma S and Liu JT carried out the data collection and conducted data analysis; Zhan YL, Lin H, Chen YL, Shi YJ revised the manuscript; All authors reviewed the results and approved the final version of the manuscript.
Supported by Beijing Municipal Science and Technology Commission Capital Clinical Characteristic Application Research, No. Z161100000516117.
Institutional review board statement: The study was approved by the Ethics Committee of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (No. JS-1060).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at maliangkun2019@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Kun Ma, MD, Doctor, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. maliangkun2019@163.com
Received: April 29, 2021
Peer-review started: April 29, 2021
First decision: May 23, 2021
Revised: June 1, 2021
Accepted: August 6, 2021
Article in press: August 6, 2021
Published online: September 26, 2021
Processing time: 140 Days and 4.5 Hours
ARTICLE HIGHLIGHTS
Research background

Gestational anemia is a common complication of pregnancy and a serious public health problem worldwide. Several socio-demographic and economic characteristics of women influence the distribution of gestational anemia and should be taken into consideration in prenatal care. We hypothesized that pregnancy conditions and outcomes might be associated with gestational anemia.

Research motivation

The study aim was to investigate the association of pregnancy characteristics with anemia during pregnancy, exploring potential etiological factors of the disease. The results could be of significance for the prevention and management of gestational anemia, which might in turn help reduce adverse pregnancy outcomes and improve birth outcomes.

Research objectives

To assess the association of pregnancy parameters with gestational anemia.

Research methods

A nested case-control study was conducted based on the Chinese Pregnant Women Cohort Study-Peking Union Medical College Project (CPWCS-PUMC). A total of 3172 women were included. Patient characteristics and gestational anemia occurrence were extracted, and univariable and multivariable logistic regression models were used to analyze the association of pregnancy parameters with gestational anemia.

Research results

Of the 3172 women, 14.0% were anemic; 46.4% were 25-30 years of age, and 21.9%resided in eastern, 15.7% in middle, 12.4% in western, 18.0% in southern, and 32.0% in northern regions of China. Most women (65.0%) had normal prepregnancy BMIs. Multivariable analysis showed that gestational anemia occurrence was lower in the middle and western regions than in the eastern region (OR = 0.406, 95%CI: 0.309-0.533, P < 0.001), higher in the northern region than that in the southern region (OR = 7.169, 95%CI: 5.139-10.003, P < 0.001), lower in full-term births than in premature birth (OR = 0.491, 95%CI: 0.316-0.763, P = 0.002), and higher in cases with premature rupture of membranes (OR = 1.404, 95%CI: 1.051-1.876, P = 0.02).

Research conclusions

Gestational anemia continues to be a health problem in China, and geographical factors may contribute to the situation. Premature birth, and premature rupture of membranes may be associated with gestational anemia. Therefore, we should vigorously promote local policy reformation to adapt to the demographic characteristics for at-risk pregnant women, which would potentially reduce the occurrence of gestational anemia.

Research perspectives

Local policy reformation of different regions should be made to adapt to the demographic characteristics.