Iron deficiency anemia, cigarette smoking and risk of abruptio placentae
Abstract
AIM: A higher frequency of abruptio placentae among anemic patients has been documented in some, but not all previously published studies. Altered feto-placental angiogenesis during early pregnancy in anemic women may partially explain this increased risk. The present study assesses the iron deficiency anemia-abruptio placentae association in pregnant women from the Pacific Northwest. METHODS: A retrospective case-control study of 145 abruptio placentae cases and 1710 control subjects was conducted. The diagnosis of abruptio placentae was based on routine clinical examination performed by attending physicians. Iron deficiency anemia was assessed in early pregnancy and defined as hemoglobin level <10 g/dL or by physician diagnosis. Information on maternal sociodemographic characteristics, cigarette smoking status during pregnancy and reproductive history was abstracted from medical records. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. RESULTS: Eleven percent of abruptio placentae cases and 3.3% of controls were diagnosed with iron deficiency anemia. Maternal iron deficiency anemia in early pregnancy was associated with a 3.60-fold increased risk of abruptio placentae (95% CI 2.01-6.04). After adjusting for maternal age, gravidity, smoking during pregnancy, Medicaid payment status, and pre-gestational hypertension, the association was attenuated but remained statistically significant (adjusted OR = 2.40; 95% CI 1.22-4.73). Maternal smoking during pregnancy was associated with a 2.40-fold increased risk of abruptio placentae (95% CI 1.19-3.52). The iron deficiency anemia-abruptio placentae association was not modified by maternal smoking. CONCLUSION: Our results support the hypothesis that maternal iron deficiency anemia is associated with an increased risk of abruptio placentae.
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Pregestational and gestational diabetes are clinical risk factors for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [33]
Chorioamnionitis is a clinical risk factor for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [33]
Iron deficiency anemia, infection and other inflammatory states, folate deficiency, and hyperhomocysteinemia are associated with increased risk of abruption.
“Pregnant people with iron deficiency anemia, infection and other inflammatory states, as well as folate deficiency and hyperhomocysteinemia are also at increased risk (33–36).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [33]
Oligohydramnios is a clinical risk factor for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [33]
Preterm prelabor rupture of membranes is a clinical risk factor for abruption.
“Other clinical risk factors for abruption include pregestational and gestational diabetes, preterm prelabor rupture of membranes (PROM), chorioamnionitis, and oligohydramnios (31–33).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [33]
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Self-citation
- Authors
- Arnold, D. L., Williams, M. A., Miller, R. S., Qiu, C., & Sorensen, T. K.
- Affiliations
- University of Washington (US)
- Swedish Medical Center (US)
- Corresponding author
- Qiu, Chunfang
- Venue
- Journal of obstetrics and gynaecology research
- Publisher
- Wiley
- Published
- 2009-06
- Volume
- 35
- Issue
- 3
- Pages
- 446-452
- ISSN
- 1341-8076 (ISSN-L)
- 1447-0756
- OpenAlex
- W2019290712
- Cited by
- 57
- References
- 34
- Citations by year
- 2026: 2 · 2024: 9 · 2023: 3 · 2022: 7 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 4 · 2013: 4 · 2012: 1
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of obstetrics and gynaecology research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Fogarty International Center (T37TW000049)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD052462)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- iron deficiency anemia, placental abruption, cigarette smoking during pregnancy, pregnancy complications, anemia in pregnancy, risk factors
- MeSH terms
- Abruptio Placentae, Adult, Female, Humans, Pregnancy, Pregnancy Complications, Retrospective Studies, Risk Factors, Smoking, Case-Control Studies, Anemia, Iron-Deficiency
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