Obstetrics and Gynecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Pregnancy and Birth, Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
Acta Obstet Gynecol Scand. 2022 Aug;101(8):917-922. doi: 10.1111/aogs.14376. Epub 2022 May 18.
Placental abruption can result in serious perinatal morbidity and mortality. However, it is not clear whether placental abruption could lead to neonatal anemia, as a direct relation has not been described yet. The objective of this study is to investigate whether there is a relation between occurrence of placental abruption and neonatal anemia.
All women with a clinical diagnoses of placental abruption between January 2016 and April 2021 in Amsterdam UMC, from both the VU University Medical Center and Amsterdam Medical Center, were included. Demographic data and delivery outcomes were collected retrospectively using the medical files. The primary outcome was neonatal anemia, defined as hemoglobin levels less than the fifth percentile for gestational age.
A total of 65 mothers and 65 neonates were included in our study. Average gestational age was 30 + 5 weeks. Mean hemoglobin level of the neonates at birth was 16.5 g/dl (10.2 mmol/L) with hemoglobin levels comparable to the reference curve. Two neonates (3.6%) were diagnosed with anemia based on their hemoglobin level at birth, and six (9.2%) neonates received a blood transfusion within 24 h after birth.
With this study, we found that the hemoglobin levels of the neonates born after placental abruption are comparable to the reference curve and do not show more neonates than expected below the fifth percentile for gestational age. It remains unclear whether there is fetal blood loss during a placental abruption but our results suggest that at least a big amount of fetal blood is not lost, since we did not found a large number of anemic neonates. Severe neonatal anemia in the case of placental abruption does not need to be expected.
胎盘早剥可导致严重的围产期发病率和死亡率。然而，目前尚不清楚胎盘早剥是否会导致新生儿贫血，因为尚未描述两者之间的直接关系。本研究的目的是探讨胎盘早剥与新生儿贫血之间是否存在关系。
本研究纳入了 2016 年 1 月至 2021 年 4 月期间阿姆斯特丹 UMC 医院（由阿姆斯特丹大学医学中心和阿姆斯特丹医学中心共同运营）所有临床诊断为胎盘早剥的女性。使用病历回顾性收集人口统计学数据和分娩结局。主要结局是新生儿贫血，定义为血红蛋白水平低于胎龄第 5 百分位。
本研究共纳入 65 名母亲和 65 名新生儿。平均胎龄为 30+5 周。新生儿出生时平均血红蛋白水平为 16.5 g/dl（10.2 mmol/L），与参考曲线相当。根据出生时的血红蛋白水平，有 2 名新生儿（3.6%）被诊断为贫血，有 6 名新生儿（9.2%）在出生后 24 小时内接受了输血。
通过本研究，我们发现胎盘早剥后出生的新生儿的血红蛋白水平与参考曲线相当，并未发现比预期胎龄第 5 百分位以下的新生儿数量更多。目前尚不清楚胎盘早剥时是否存在胎儿失血，但我们的结果表明，至少没有大量胎儿血液流失，因为我们没有发现大量贫血的新生儿。胎盘早剥时不应预期出现严重的新生儿贫血。
