221: Does antepartum additional iron supplementation to standard prenatal vitamins decrease anemia at delivery?

Abstract

standard prenatal vitamins decrease anemia at delivery? Samantha Boreland, Clones Lans, Chaur-Dong Hsu, Vinette Greenland, Elsi Santana-Fox, Maggie Tetrokalashvili, Scott Stanislawski, Joshua Fogel Nassau University Medical Center, OBGYN, East Meadow, NY OBJECTIVE: To investigate whether the addition of iron supplementation to the standard prenatal vitamins, improve hemoglobin/hematocrit levels, at delivery. STUDY DESIGN: This is a retrospective review of 300 medical charts of women delivered at our medical health system from January 2009 to December 2009. The patients were divided equally in 2 groups: group 1 consisted of patients who had prenatal care at Hospital Medical Center (HMC) obstetric clinic and received only standard prenatal vitamins, and group 2 consisted of patients followed at the outreach obstetric clinics of Federal Qualified Health Centers (FQHC) affiliated to HMC and received ferrous sulfate in addition to the standard prenatal vitamins. The hemoglobin and hematocrit levels at the first prenatal visit were compared to those at delivery for both groups. ANOVA, Chi-square test, McNemar test and ANCOVA were used for statistical analysis. Data were expressed as mean standard deviation. RESULTS: There were no significant differences for any of the baseline laboratory variables between the two groups. The mean comparisons for the laboratory variables at delivery showed both hemoglobin and hematocrit had significantly lower mean values for the HMC group as compared to FQHC group (Hemoglobin: 11.9 1.26 vs. 12.2 1.26 g/dL, p 0.0001; hematocrit: 34.9% vs. 35.8%, p 0.01). In analyses comparing within each of the two groups, hematocrit significantly decreased (p 0.001) from the first prenatal visit (35.9 3.02%) to delivery (34.9 3.53%) and hemoglobin significantly decreased (p 0.001) from the first prenatal visit (12.3 1.05g/dL) to delivery (11.9 1.26 g/dL). In categorical variable comparisons, there was significant increase of anemia percentage in HMC group from the first prenatal visit to delivery. In the FQHC group, both hematocrit and hemoglobin did not significantly differ from the first prenatal visit to delivery. CONCLUSION: Our data suggests that additional iron supplementation from antepartum at the first prenatal visit to delivery can benefit woman by keeping their hemoglobin/hematocrit levels stable prior to delivery. 222 Birth weight, breast cancer and the potential mediating hormonal environment Radek Bukowski, Rowan Chlebowski, Inger Thune, Anne-Sofie Furberg, Gary Hankins, Fergal Malone, Mary D’Alton University of Texas Medical Branch, Department of Obstetrics and Gynecology, Galveston, TX, Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, Oslo University Hospital, Department of Oncology, Oslo, Norway, University of Troms, Faculty of Health Sciences, Department of Community Medicine, Troms, Norway, The University of Texas Medical Branch, Obsterics & Gynecology, Galveston, TX, Royal College of Surgeons in Ireland, Obstetrics and Gynaecology, Dublin, Ireland, Columbia University, Department of Obstetrics and Gynecology, New York, NY OBJECTIVE: A womans breast cancer risk is proportional to her birth weight and the birth weight of her children. The relative contributions of these factors and their mediating mechanisms are not known. STUDY DESIGN: Risk of breast cancer in relation to a mothers birth weight and her first infants birth weight were evaluated in a prospective cohort of 410 women in the Framingham Study. Serum concentrations of estriol (E3), anti-estrogen alpha-fetoprotein (AFP), and pregnancy-associated plasma protein-A (PAPP-A) were measured in 23,824 pregnant women from a separate perspective cohort, the FASTER trial. RESULTS: During follow-up (median, 14 years) 31 women (7.6%) were diagnosed with breast cancer. Women with large birth weight infants (in the top quintile) had a higher breast cancer risk compared to other women (hazard ratio (HR), 2.5; 95% confidence interval (CI), 1.2-5.2; P 0.012). The finding was not affected by adjustment for birth weight of the mother and traditional breast cancer risk factors (adjusted HR, 2.6; 95% CI, 1.2-5.7; P 0.016). An infants birth weight had a strong positive relationship with the mothers serum E3/AFP ratio and PAPP-A concentration during pregnancy. Adjustment for breast cancer risk factors did not have a material effect on these relationships. CONCLUSION: Maternal risk of breast cancer was associated with giving birth to an infant with high birth weight, independent of a mothers own birth weight and traditional breast cancer risk factors. Having an infant with high birth weight was also associated with a hormonal environment during pregnancy favoring breast cancer development and progression.