title: OS029. Severe anemia, sickle cell disease, and thalassemia as riskfactors for preeclampsia in developing countries.
abstract: BACKGROUND
  Hypertensive disorders during pregnancy contribute greatly to maternal and perinatal morbidity and mortality in developing countries. The pathogenesis of such conditions may be illuminated by exploring their relationship to anemia.
  
  
  OBJECTIVE
  To determine whether several types of anemia are risk factors for hypertensive disorders during pregnancy in developing countries.
  
  
  METHODS
  Using data from the World Health Organization Global Survey for Maternal and Perinatal Health, collected in hospitals in six African and six Latin American countries from 2007 to 2008 and in four Asian countries from 2004 to 2005, we examined the associations between severe anemia, sickle cell disease and thalassemia and gestational hypertension or preeclampsia/eclampsia. After exclusions for comorbidities (chronic hypertension, diabetes, HIV infection) and missing data, the severe anemia, sickle cell disease, and thalassemia groups consisted of 219,627,117,383, and 9376 women, respectively.
  
  
  RESULTS
  Multiparous women with severe anemia were at an increased risk of gestational hypertension (adjusted odds ratio (OR): 1.58; 95% confidence interval (CI): 1.15-2.19). Severe anemia had a significant association with preeclampsia/eclampsia for nulliparous (OR: 3.55; 95% CI: 2.87-4.41) and multiparous (OR: 3.94; 95% CI: 3.05-5.09) women. Sickle cell disease exhibited a significant association with gestational hypertension among nulliparous (OR: 2.49; 95% CI: 1.46-4.25) and multiparous (OR: 3.27; 95% CI: 2.33-4.58) women. No significant associations were found between sickle cell disease and preeclampsia/eclampsia, or between thalassemia and either gestational hypertension or preeclampsia/eclampsia.
  
  
  CONCLUSIONS
  Severe anemia appears to be a risk factor for preeclampsia/eclampsia, while sickle cell disease appears to be a risk factor for gestational hypertension among women seeking hospital care in developing countries.
authors.affiliation: Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: J J
authors.initials: JJ
authors.lastname: Zhang
authors.affiliation: NICHD, NIH, Bethesda, United States.
authors.forename: J
authors.initials: J
authors.lastname: Grewal
authors.affiliation: NICHD, NIH, Bethesda, United States.
authors.forename: M
authors.initials: M
authors.lastname: Roosen-Runge
authors.affiliation: Reproductive Health and Research, WHO, Geneva, Switzerland.
authors.forename: A P Betran
authors.initials: AP
authors.lastname: Lazaga
authors.affiliation: Reproductive Health and Research, WHO, Geneva, Switzerland.
authors.forename: J P
authors.initials: JP
authors.lastname: Souza
authors.affiliation: Reproductive Health and Research, WHO, Geneva, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Widmer
authors.affiliation: Reproductive Health and Research, WHO, Geneva, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Merialdi