산모빈혈이 조산 및 임신결과에 미치는 영향에 관한 환자 - 대조군 연구 = A Hospital Based Case-Control Study for the Effects of Maternal Anemia on the Preterm Birth and Adverse Pregnancy Outcomes

다국어 초록 (Multilingual Abstract)

Objective: Maternal anemia is one of the most common hematologic disorders of the child-bearing mothers. However the role of maternal anemia in the etiology of preterm delivery and adverse pregnancy outcomes remains a source of controversy. The aim of this study was to determine the effects of maternal anemia on the preterm birth and the adverse pregnancy outcomes. Study Design: A total of 1,010 women aged 19~44 years, who admitted to our hospital for the delivery between December 1994 and October 1995, were recruited into a hospital baed case-control study design. 259 women complicated by maternal anemia(cases) were compared with 751 women without maternal anemia(controls). Multiple logistic regression analyses were performed to control for the effects of other potentially confounding factors, including maternal age, body mass index, previous term delivery, previous preterm delivery and previous abortion. In all logistic regression analyses odds ratio and 95% confidence intervals were calculated. Results: The prevalence of maternal anemia(hemoglobin<10g/dl) was 25.6%. There was a positive linear relationship between the prepartum hemoglobin concentration and the postpartum concentration. There was no significant differences of the incidence of preterm birth and the neonatal morbidity, such as poor Apgar scores, fetal distress, congenital anomaly, birth trauma, admission to neonatal intensive care unit, resuscitation and sepsis between case and control groups. Small for gestational age and low birth weight were associated with an somewhat decreased risk of maternal anemia and large for gestational age, not macrosomia, was associated with an 70% increased risk of maternal anemia at the time of delivery. Maternal anemia was associated with 6.5 fold increases in the risks of postpartum bleeding, 8.5 fold increases in the postpartum transfusion and 80% increases in the puerperal fever respectively. Conclusions: Maternal anemia was not associated with increased risks of preterm birth and the neonatal morbidty. However there was a significant relationship between maternal anemia and postpartum maternal morbidity, such as postpartum bleeding, postpartum transfusion and puerperal fever.