Nyarko Samuel H, Greenberg Lucy T, Saade George R, Phibbs Ciaran S, Buzas Jeffrey S, Lorch Scott A, Rogowski Jeannette, Passarella Molly, Boghossian Nansi S
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
Vermont Oxford Network, Burlington, VT, United States.
Ann Epidemiol. 2024 Dec;100:10-15. doi: 10.1016/j.annepidem.2024.10.006. Epub 2024 Oct 21.
We examined the association between iron deficiency anemia (IDA) and severe maternal morbidity (SMM) during delivery and up to 1-year postpartum.
In a retrospective cohort study across 3 states, we computed adjusted relative risks (aRR) for SMM comparing individuals with IDA versus those without, using modified Poisson regression models.
Among 2459,106 individuals, 10.3 % (n = 252,240) had IDA. Individuals with IDA experienced higher rates of blood transfusion and non-transfusion SMM (329 and 122 per 10,000 deliveries, respectively) than those without IDA (33 and 46 per 10,000 deliveries, respectively). The risk of blood transfusion (aRR: 8.2; 95 % CI 7.9-8.5) and non-transfusion SMM (aRR: 1.9; 95 % CI: 1.8-2.0) were higher among individuals with IDA. The attributable risk per 10,000 deliveries due to IDA for blood transfusion and non-transfusion SMM during delivery were 29.5 (95 % CI: 28.9-30.0) and 5.7 (95 % CI: 5.3-6.2), respectively. Within 1-year postpartum, the relative risk of non-transfusion SMM (aRR:1.3; 95 % CI: 1.2-1.3) was 30 % higher among individuals with IDA.
IDA is associated with increased SMM risk. Addressing IDA in pregnant individuals may reduce SMM rates.
我们研究了分娩期间及产后1年内缺铁性贫血（IDA）与严重孕产妇发病（SMM）之间的关联。
在一项横跨3个州的回顾性队列研究中，我们使用改良泊松回归模型计算了患有IDA与未患IDA个体的SMM调整相对风险（aRR）。
在2459106名个体中，10.3%（n = 252240）患有IDA。患有IDA的个体输血性和非输血性SMM发生率（分别为每10000例分娩329例和122例）高于未患IDA的个体（分别为每10000例分娩33例和46例）。患有IDA的个体输血风险（aRR：8.2；95%CI 7.9 - 8.5）和非输血性SMM风险（aRR：1.9；95%CI：1.8 - 2.0）更高。分娩期间因IDA导致的每10000例分娩输血性和非输血性SMM的归因风险分别为29.5（95%CI：28.9 - 30.0）和5.7（95%CI：5.3 - 6.2）。产后1年内，患有IDA的个体非输血性SMM的相对风险（aRR：1.3；95%CI：1.2 - 1.3）高出30%。
IDA与SMM风险增加相关。解决孕妇的IDA问题可能会降低SMM发生率。
