Maternal haemoglobin concentrations before and during pregnancy and stillbirth risk: a population-based case-control study

摘要

Background Results of previous studies on the association between maternal haemoglobin concentration during pregnancy and stillbirth risk are inconclusive. It is not clear if haemoglobin concentration before pregnancy has a role. Using prospectively collected information from pre-pregnancy and antenatal visits, we investigated associations of maternal haemoglobin concentrations before and during pregnancy and haemoglobin dilution with stillbirth risk. Methods In a population-based case–control study from rural Golestan, a province in northern Iran, we identified 495 stillbirths (cases) and randomly selected 2,888 control live births among antenatal health-care visits between 2007 and 2009. Using logistic regression, we estimated associations of maternal haemoglobin concentrations, haemoglobin dilution at different stages of pregnancy, with stillbirth risk. Results Compared with normal maternal haemoglobin concentration (110–120?g/l) at the end of the second trimester, high maternal haemoglobin concentration (≥140?g/l) was associated with a more than two-fold increased stillbirth risk (OR?=?2.31, 95?% CI [1.30–4.10]), while low maternal haemoglobin concentration (Conclusions Haemoglobin concentration before pregnancy is not associated with stillbirth risk. High haemoglobin level and absence of haemoglobin dilution during pregnancy could be considered as indicators of a high-risk pregnancy.