The relationship between the degree of maternal iron deficiency anemia and fetal neonatal hypoxemia: A cross-sectional study

Abstract

Abstract Aim. Chronic maternal iron deficiency anemia has been found to be related with preterm delivery, low birth weight and intrauterine growth retardation. The potential detrimental effects of maternal anemia on the transplacental fetal oxygen extraction during labor have not been investigated yet. Method. Upon the spontaneous initiation of delivery among 32 term pregnant women, half of them with hemoglobin values lower than 9.5gr/dL as anemic group, have been included to the study. Arterial cord blood samples have been collected immediately after delivery. Neonatal A pgar scores, birth weight and cord blood analysis of pH, PaO 2 , PaCO 2 , O 2 saturation and HCO 3 have been recorded. Results. The mean hemoglobin levels of the anemic and non-anemic patients were 7.69±1.14 gr/dL and 10.5 ±0.67gr/dL respectively. Neonatal cord blood PaO 2 and O 2 saturation of the non-anemic patients were significantly higher than anemic patients (84.3 vs . 41.3 mmHg for PaO 2 and 69.5% vs. 42.6% for O 2 saturation respectively). No significant difference in cord blood PaCO 2 , pH and HCO 3 levels were found between anemic and non anemic ones. Conclusion. Although third trimester maternal iron deficiency anemia decreases neonatal cord blood PaO 2 and O 2 saturation levels; apart from severe ones, it does not result in neonatal hypoxemia generally. The possible effects of maternal iron deficiency anemia that can deteriorate transplacental oxygen transport to the fetus and neonatal acid-base status of the newborn should be clarified by further studies based on the short and long term clinical results of neonatal hypoxemia in the newborn’s physiological state. Keywords: Maternal anemia , neonatal hypoxemia , cord blood Ozet Amac. Maternal kronik demir eksikligi anemisinin preterm eylem, dusuk dogum agirligi ve intrauterin gelisme geriligi ile iliskili oldugu bulunmustur. Maternal aneminin dogum sirasinda transplasental fetal oksijenizasyon u uzerine olumsuz etkileri henuz calisilmis degildir. Yontem. Spontan dogum eylemi baslayan, hemoglobin degeri 9,5gr/dL altinda olan 16’si anemik toplam 32 term gebe calismaya dahil edilmistir. Dogumdan hemen sonra arteri y el kord kani ornekleri toplanmistir. Neonatal A pgar skorlari, dogum agirliklari ve umbilikal kord pH, PaO 2 , PaCO 2 , O 2 saturasyonu ve HCO 3 degerleri kaydedilmistir. Bulgular. Anemik ve anemik olmayan hastalarin ortalama hemoglobin degerleri sirasiyla 7,69±1,14gr/dL ve 10,5±0,67gr/dL’dir. Anemik olmayan hastalarin neonatal kord kani PaO 2 ve O 2 saturasyonu degerleri anemik hastalardan anlamli derecede daha yuksek bulunmustur (PaO 2 icin 84,3 vs . 41,3mmHg ve O 2 saturasyonu icin %69,5 vs . %42,6 , sirasiyla). Anemik ve anemik olmayan hastalarin kord kani PaCO 2 , pH ve HCO 3 degerleri arasinda fark bulunamamistir. Sonuc. Her ne kadar, 9,5gr/dL’nin altindaki ucuncu trimester maternal hemoglobin seviyesi neonatal kord kani PaO 2 ve O 2 saturasyonunda azalmaya sebep olsa da, ciddi anemi disinda genel olarak neonatal hipoksemiye yol acmaz. Maternal demir eksikligi anemisinin fetusun transplasental oksijen transportu ve neonatal asit-baz dengesi uzerine muhtemel etkileri, neonatal hipokseminin yenidoganin fizyolojik durumuna uzun ve kisa donemli klinik etkilerinin arastirildigi calismalarla acikliga kavusturulmalidir. Anahtar sozcukler: Gebelik anemisi, yenidogan hipoksemisi, kordon kani