title: Maternal anemia effects during pregnancy on male and female fetuses: are there any differences?
abstract: OBJECTIVE
  Sideropenic anemia is a common pregnancy disorder. The relationship between anemia and adverse pregnancy outcome are contradictory, and it is related to the severity of the hemoglobin deficit. The aim of the study was to evaluate the relationship between maternal mild anemia at third trimester of pregnancy, fetal birth weight and fetal gender.
  
  
  METHODS
  A retrospective study including 1131 single physiological term pregnancies was conducted. According to maternal Hb levels during the third trimester, pregnant women enrolled were divided in two groups: Group A (n = 156) with Hb ≤ 11 g/dl and Group B (n = 975) with Hb ≥ 11,1 g/dl.
  
  
  RESULTS
  Maternal characteristics, gestational age at delivery, Apgar score and post-partum hemorrhage were similar between groups. However, when neonatal sex was considerate, female newborns of anemic women had a higher birth weight (p = 0.01). Moreover, anemic women showed a significantly higher rate of emergency cesarean section (p = 0.006), in particular when the newborn was a male (p= 0.03).
  
  
  CONCLUSIONS
  Maternal mild anemia in third trimester of pregnancy correlates with fetal birth weight, influencing fetal growth and delivery outcome on the basis of fetal gender. Even though the reason of this phenomenon is still unknown, these new data may represent a novel parameter to add significant prognostic information in relation to maternal mild anemia and neonatal outcome.
authors.affiliation: a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Orlandini
authors.affiliation: a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Torricelli
authors.affiliation: b Department of Obstetric and Gynecology , Ospedale Apuane , Massa Carrara , Italy , and.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Spirito
authors.affiliation: a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Alaimo
authors.affiliation: c Department of Health Sciences, Division of Pediatrics, Obstetrics and Gynecology and Nursing Science , University of Florence , Florence , Italy.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Di Tommaso
authors.affiliation: a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy.
authors.forename: Filiberto Maria
authors.initials: FM
authors.lastname: Severi
authors.affiliation: b Department of Obstetric and Gynecology , Ospedale Apuane , Massa Carrara , Italy , and.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ragusa
authors.affiliation: a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D000740:Anemia / Q000503:physiopathology*; D001724:Birth Weight; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000503:physiopathology*; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D012737:Sex Factors
keywords: Maternal anemia; birth weight; cesarean section; fetal sex; neonatal outcome