title: Association between maternal haemoglobin at 27-29weeks gestation and intrauterine growth restriction.
abstract: OBJECTIVE
  To examine the relationship between maternal haemoglobin concentration (Hb) at 27-29weeks' gestation and fetal growth restriction (FGR).
  
  
  METHODS
  This was a retrospective, case control study.
  
  
  METHODS
  A University hospital in London, UK.
  
  
  METHODS
  Pregnant women attending for routine antenatal care at 27-29weeks of pregnancy.
  
  
  METHODS
  Maternal Hb, measured routinely at 27-29weeks in pregnancies complicated by FGR (n=491) was compared to normal controls (n=491). Multiple regression analysis was used to examine the association between Hb and maternal characteristics.
  
  
  METHODS
  Birthweight z-score, admission to the Neonatal Unit (NNU) and adverse perinatal outcome.
  
  
  RESULTS
  Increased Hb at 27-29weeks gestation is associated with reduced birthweight, with an inverse relationship between maternal Hb and fetal birthweight z-score (R(2)=0.10, p<0.0001). In addition, for the prediction of admission to the NNU (R(2)=0.24, p<0.0001) and serious adverse neonatal outcome (R(2)=0.10, p<0.0001), maternal Hb is an independent predictor with a linear and quadratic relationship, respectively. Therefore, both increased and decreased maternal Hb levels increase the risk of serious neonatal complications.
  
  
  CONCLUSIONS
  Raised Hb at 27-29weeks gestation is associated with FGR and with an increased risk of admission to the NNU and adverse fetal outcome.
authors.affiliation: Maternal Hypertension Unit, King's College Hospital, London, UK. Electronic address: mark.cordina@yahoo.com.
authors.forename: Mark
authors.initials: M
authors.lastname: Cordina
authors.affiliation: Maternal Hypertension Unit, King's College Hospital, London, UK.
authors.forename: Sadia
authors.initials: S
authors.lastname: Bhatti
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Marianna
authors.initials: M
authors.lastname: Fernandez
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Argyro
authors.initials: A
authors.lastname: Syngelaki
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK; Fetal Medicine Unit, University College Hospital, London, UK.
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
authors.affiliation: Maternal Hypertension Unit, King's College Hospital, London, UK; Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Nikos A
authors.initials: NA
authors.lastname: Kametas
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D006454:Hemoglobins; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006454:Hemoglobins
keywords: Fetal growth restriction; Haemoconcentration; Haemoglobin; Neonatal unit admission; Pregnancy