Free Hb can bind and inactive NO, thus leading to vasoconstriction with consequent hypertension [ 22 ] and placental ischemia. Furthermore, oxidized Hb could create methemoglobin-derived heme deposits on the vascular endothelium, which in turn directly damage the endothelium or promote atheroma formation via the effect of oxidized low-density lipoproteins [ 23 ].
In addition to GDM and PE, our study revealed a significant association between anemia and a high risk of preterm birth. Other studies have also confirmed that anemia is an independent risk factor for preterm birth, although studies on Hb levels and the risk of preterm birth are sparse. However, an international multicenter cross-sectional study of singleton and nulliparous pregnancies indicated that there was no statistically significant effect of anemia on the risk of preterm birth [ 26 ].
In our opinion, variations in population characteristics of the studied participants in the different studies may be the main reason explaining these inconsistent results. Additionally, several studies have confirmed that iron-deficiency anemia, rather than anemia from other causes, influences preterm birth [ 27 , 28 ]. Thus, they postulated that iron deficiency may be the cause of preterm birth.
However, to date, the exact mechanisms underlying iron deficiency or iron-deficiency anemia and preterm birth have not yet been established. The possible mechanism may involve inadequate transfer of oxygen to the uterus, placenta, and fetus due to a damaged Hb transport capacity caused by iron deficiency.
After we conducted subgroup analyses stratified by pre-pregnancy BMI, we found that the associations of increased Hb with the risk of developing GDM remained in each subgroup. These results seem to suggest that Hb levels in the first trimester play varied roles on the occurrence of PE and preterm birth in different pre-pregnancy BMI categories.
Thus, these findings imply that pre-pregnancy BMI should be considered when evaluating Hb levels in the first trimester. However, to date, there are no uniform standards defining a high Hb level. The sample size in our study is very large. Additionally, our study was conducted by trained staff, and most of the data were collected from medical records, which ensured the standardization of data collection.
Furthermore, the subgroup analyses stratified by pre-pregnancy BMI allowed us to show that pre-pregnancy BMI plays a role on influencing the associations between Hb levels and pregnancy outcomes. However, our study is retrospective, and the recruited pregnant women were from three cities in China. In addition, there are some differences between the original cohort and the final study cohort.
Thus, these limitations could introduce bias and limit the generalization of the study findings to all pregnant women in China. Additionally, the number of participants with PE and preterm birth may also be deficient in our study to evaluate a statistically significant difference due to our exclusion criteria. Recent studies have noted that elevated iron stores may play a role in the development of GDM during pregnancy [ 19 , 29 ].
However, we do not have data regarding either maternal iron levels or ferritin levels in this study, and we also do not have data regarding supplements taking such as folic acid or iron tablets in the first trimester.
Therefore, we could not determine whether the observed anemia was related to iron deficiency, nor make a detailed discussion on the impact of supplements on anemia, nor even perform a joint analysis of Hb levels and iron status in the present study.
Furthermore, depending on the results of our study and others, establishing a balance between iron status and Hb levels may be a future challenge and should be revealed through more rigorously designed studies. The data shown in our study confirmed that Hb levels during the first trimester play a role in predicting the risk of GDM, PE, and preterm birth. These findings are of clinical and public health importance, since they help clinicians be aware of these complications early in pregnancy other than these syndromes appear overt signs or symptoms later.
Thus improving pregnancy outcomes through early intervention to the greatest extent. Maternal complications and perinatal mortality: findings of the World Health Organization multicountry survey on maternal and newborn health. Article Google Scholar. The International Federation of Gynecology and Obstetrics FIGO initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. Umesawa M, Kobashi G. Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis.
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Early evidence of a reduced plasma volume. Acta Obstet Gynecol Scand. Phaloprakarn C, Tangjitgamol S. Impact of high maternal hemoglobin at first antenatal visit on pregnancy outcomes: a cohort study. J Perinat Med. High maternal hemoglobin and ferritin values as risk factors for gestational diabetes.
Haemoglobin and serum ferritin in pregnancy--correlation with smoking and body mass index. Zhou B. Coorperative meta-analysis group of China obesity task force. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy.
A World Health Organization guideline. Diabetes Res Clin Pract. WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Maternal hemoglobin and risk of gestational diabetes mellitus in Chinese women. Obstet Gynecol. CAS Google Scholar. Relation of haemoglobin levels in first and second trimesters to outcome of pregnancy.
Mehrabian F, Hosseini SM. Comparison of gestational diabetes mellitus and pre-eclampsia in women with high hemoglobin in the first trimester of pregnancy: a longitudinal study. Pak J Med Sci. A prospective study of prepregnancy dietary iron intake and risk for gestational diabetes mellitus. Role of iron deficiency and overload in the pathogenesis of diabetes and diabetic complications.
Curr Med Chem. Hemorheology and microvascular disorders. There is no prescribed home remedy for high levels of haemoglobin during pregnancy. This must be treated by an expert as and when they deem fit. You will be monitored closely by a specialist who will decide the treatment pattern based on your symptoms.
To enjoy your pregnancy to the fullest, keep a watch on what you eat, listen to your body and especially to your doctor. In case of the slightest doubt, consult your doctor immediately. Resources and References: WebMD. Sign in. Forgot your password? Get help. Create an account. Password recovery. FirstCry Parenting. Pregnancy Prenatal Care. Rima Sonpal Gynaecologist.
In This Article. What Is Haemoglobin? September 29, Ruchelle Fernandes - November 10, Milo is primarily a male name that has been derived from multiple sources. This test helps to determine if those observed count are different enough for the test to be significant association to be significant. The results of this test are shown in the table below: Table 9. The minimum expected count is 9. Computed only for a 2x2 table. The p-value 0. To test how strong this significance is, the phi test is done since the sample size is small: Table The null hypothesis: There is a positive correlation between disease status and hemoglobin level.
The alternative hypothesis: There is no positive correlation between disease status and hemoglobin level Table We accept H0 and reject HA since there is a very weak positive correlation 0. The null hypothesis: There is a negative correlation between coffee or tea consumption and hemoglobin level. The alternative hypothesis: There is no negative correlation between coffee or tea consumption and hemoglobin level Table According to the correlation table above, the hemoglobin levels decrease with the increase of coffee and tea consumption.
The null hypothesis: There is a negative correlation between calcium supplementation and hemoglobin level. The alternative hypothesis: There is no negative correlation between calcium supplementation and hemoglobin level Table In the pie chart in the descriptive statistics section, calcium supplementation intake among the participants recorded the lowest percentage This low value is justified by the correlation coefficient We accept H0 and reject HA. The null hypothesis: There is a positive correlation between weight of the baby and hemoglobin level.
The alternative hypothesis: There is no positive correlation between weight of the baby and hemoglobin level Table A moderate positive correlation exists between hemoglobin levels and weight of the unborn baby.
This result justifies the rapprochement in percentages of normal hemoglobin levels So we accept H0 that there is a correlation between hemoglobin level and weight of the baby.
The null hypothesis: There is no significant association between number of meals per day and hemoglobin level. The alternative hypothesis: There is significant association between number of meals per day and hemoglobin level Table The chi square test helps to determine if those observed count are different enough for the test to be significant association to be significant.
The results of this test are shown in the table below: Table Hemoglobin level is dependent on the number of meals consumed per day. Not assuming the null hypothesis. Using the asymptotic standard error assuming the null hypothesis. Number of meals consumed per day by the pregnant woman and the quality of food is what make the association with the hemoglobin level. Which variable affects positively or negatively hemoglobin levels in pregnant women? Table 18 a. As we see in the tables above, R is 0.
According to the last table, number of pregnancy affects positively 0. Table 19 a. Dependent Variable, Hemoglobin Level b. This test helps us how the type of food consumed with meat affect the hemoglobin levels. Knowing that some of these foods are inhibitors tomato and broccoli and enhancers vegetables, lemon, spinach of iron absorption, according to the table tomato and broccoli affect negatively hemoglobin levels justifying the finding in many previous studies.
While vegetables, lemon and spinach affect it positively with a higher positive association with lemon consumption. The results of this study were consistent with the recent findings of other studies concerning the effect of dietary habits on hemoglobin levels and its effects on the fetus. Some results contradict previous findings like the relation between age vs hemoglobin, sports vs hemoglobin and meat consumption vs hemoglobin. The highest correlation coefficient between hemoglobin and the variables is the 0.
The hemoglobin levels in the pregnant woman are affected by not the quantity of heme and non-heme iron only but the enhancers of absorption. Good enhancers must be consumed by every woman, non-pregnant, preparing for pregnancy and pregnant one. During this period, not only the weight of the baby is affected by low hemoglobin levels of the mother; many outcomes are scientifically proved that are caused by such deficiency affecting the whole life of the baby mentally and physically.
Pregnancy requires additional maternal absorption of iron. Maternal iron status cannot be assessed simply from hemoglobin concentration because pregnancy produces increases in plasma volume and the hemoglobin concentration decreases accordingly. So many other factors must be considered in future research. In previous studies, sport shows no relation with hemoglobin levels but since a correlation coefficient of 0.
Some of the limitations of our study are:. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.
Withdrawal Guidlines. Publication Ethics. Withdrawal Policies Publication Ethics. Review Article Volume 7 Issue 4. Descriptive statistics Before testing all the variables that may affect the hemoglobin levels in pregnant women, detecting their daily food intake frequency is so important for the direction of the study Figure 1 , Table 1. Figure 1 Meals per day. Frequency Percent Valid percent Cumulative percent Valid 12 Figure 2 Disease status.
Figure 3 Supplementation intakes. Figure 4 Number of pregnancy.
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