title: [Maternal hemoglobin in Peru: regional differences and its association with adverse perinatal outcomes].
abstract: OBJECTIVE
  To evaluate hemoglobin (Hb) levels in pregnant women from different geographical regions from Peru; to establish anemia and erythrocytocis rates and to establish the role of Hb on adverse perinatal outcomes using the Perinatal Information System (PIS) database of Peruvian Ministry of Health.
  
  
  METHODS
  Data were obtained from 379,816 births of 43 maternity care units between 2000 and 2010. Anemia and erythrocytocis rates were determined in each geographical region as well as rates of adverse perinatal outcomes. To analyze data the STATA program (versión 10.0,Texas, USA) was used. The results were considered significant at p<0.01.
  
  
  RESULTS
  Mild anemia rate was higher in the coast (25.8%) and low forest (26.2%). Moderate/severe anemia rate in low forest was 2.6% and at the coast was 1.0%. In the highland, the highest rate of moderate/severe anemia was in the southern highlands (0.6%). The highest rate of erythrocytocis was found in the central highland (23.7%), 11.9% in the southern highland and 9.5% in the north highland. Severe anemia and erythrocytocis were associated with adverse perinatal outcomes.
  
  
  CONCLUSIONS
  There are differences by Peruvian geographical region in anemia rates. In the central highlands were found the highest rates of erythrocytocis due to hypoxia effect in the high altitudes; however in the southern highlands, erythrocytocis was lower. Severe anemia and erythrocytosis were associated with increased adverse perinatal outcomes.
authors.affiliation: Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú. Gustavo.gonzales@upch.pe
authors.forename: Gustavo F
authors.initials: GF
authors.lastname: Gonzales
authors.forename: Vilma
authors.initials: V
authors.lastname: Tapia
authors.forename: Manuel
authors.initials: M
authors.lastname: Gasco
authors.forename: Carlos
authors.initials: C
authors.lastname: Carrillo
mesh_terms: D000740:Anemia / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D010568:Peru / Q000453:epidemiology; D011086:Polycythemia / Q000097:blood* / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D011256:Pregnancy Outcome
chemical_list: D006454:Hemoglobins