Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT, USA.
J Perinatol. 2023 Jun;43(6):782-786. doi: 10.1038/s41372-023-01603-w. Epub 2023 Jan 17.
Placental abruption can cause maternal blood loss and maternal anemia. It is less certain whether abruption can cause fetal blood loss and neonatal anemia.
Retrospective multi-hospital 24-month analysis of women with placental abruption and their neonates.
Of 55,111 births, 678 (1.2%) had confirmed abruption; 83% of these neonates (564) had one or more hemoglobins recorded in the first day. Four-hundred-seventy (83.3%) had a normal hemoglobin (≥5th% reference interval) while 94 (16.7%) had anemia, relative risk 3.26 (95% CI, 2.66-4.01) vs. >360,000 neonates from previous reference interval reports. The relative risk of severe anemia (<1st% interval) was 4.96 (3.44-7.16). When the obstetrician identified the abruption as "small" or "marginal" the risk of anemia was insignificant.
Most abruptions do not cause neonatal anemia but approximately 16% do. If an abruption is not documented as small, it is important to surveille the neonate for anemia.
胎盘早剥可导致产妇失血和产妇贫血。胎盘早剥是否会导致胎儿失血和新生儿贫血则不太确定。
回顾性多医院 24 个月的胎盘早剥妇女及其新生儿分析。
在 55111 例分娩中，有 678 例（1.2%）确诊为胎盘早剥；其中 83%（564 例）的新生儿在第一天有一个或多个血红蛋白记录。470 例（83.3%）血红蛋白正常（≥第 5%参考区间），94 例（16.7%）贫血，相对风险 3.26（95%CI，2.66-4.01）vs. 来自之前参考区间报告的 >360000 例新生儿。严重贫血（<第 1%间隔）的相对风险为 4.96（3.44-7.16）。如果产科医生将胎盘早剥诊断为“小”或“边缘”，则贫血的风险并不显著。
大多数胎盘早剥不会导致新生儿贫血，但约有 16%会导致贫血。如果没有记录胎盘早剥为小，则需要监测新生儿是否贫血。
