Abstract
Background: Both high and low placental weights are associated with adverse pregnancy outcomes. Maternal hemoglobin levels can influence placental weight, but the evidence is conflicting. Since maternal hemoglobin does not invariably correlate with fetal/neonatal blood hemoglobin levels, we sought to determine whether cord blood hemoglobin or maternal hemoglobin status more closely associates with placental weight in women undergoing elective cesarean section at term. Methods: This was a cross-sectional study conducted at the Royal Alexandra Hospital, Edmonton, Canada, involving 202 women with term singleton pregnancies undergoing elective cesarean section. Maternal blood and mixed cord blood hemoglobin levels were analyzed using a HemoCue Hb201+ system. Birth weight, placental weight, one- and five-minute APGAR scores, American Society of Anesthesiologists physical state classification, maternal age, and maternal height were also recorded. Relationships between maternal and cord blood hemoglobin levels with placental weight, birth weight, and birth weight to placental weight ratio were the main outcome measures. Results: A total of 182 subjects were included in the analysis. Regression analysis showed that cord blood hemoglobin, but not maternal hemoglobin, was inversely related with placental weight (β = −2.4, p = 0.001) and positively related with the birth weight to placental weight ratio (β = 0.015, p = 0.001 and p = 0.63, respectively). Conclusions: Our findings suggest that measuring cord blood hemoglobin levels, rather than maternal hemoglobin levels, may provide important diagnostic information about in utero fetal adaptation to suboptimal placental function and neonatal health.
Highlights
Optimal fetal growth and development are dependent on an adequate supply of oxygen and nutrients, which is obtained from the mother via the placenta
When a mismatch occurs between placental supply and fetal demand, morphological and functional adaptations by the placenta can reduce the incidence of fetal growth restriction or macrosomia [1]
Two neonates met the criterion for low birth weight but had normal Hb levels
Summary
When a mismatch occurs between placental supply and fetal demand, morphological and functional adaptations by the placenta can reduce the incidence of fetal growth restriction or macrosomia [1]. Pregnancies characterized by inadequate placental adaptation can result in aberrant fetal growth with implications for long-term health. Anemia is characterized by reduced blood hemoglobin (Hb) levels and reduced oxygen-carrying capacity in the blood. Both high and low placental weights are associated with adverse pregnancy outcomes. Since maternal hemoglobin does not invariably correlate with fetal/neonatal blood hemoglobin levels, we sought to determine whether cord blood hemoglobin or maternal hemoglobin status more closely associates with placental weight in women undergoing elective cesarean section at term
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