Maternal Hemoglobin Research Articles

Maternal iron nutrition during pregnancy and fetal intrauterine growth

BackgroundIron is critical for maternal and fetal health; however, the effect of iron nutrition on fetal intrauterine growth remains unclear. This study aimed to investigate the associations of maternal iron nutrition during pregnancy with fetal intrauterine growth parameters among the Chinese population.MethodsThis retrospective birth cohort study included 482 pregnant women. Maternal information was collected by standard questionnaires. Maternal concentrations of serum ferritin and hemoglobin were detected. Fetal ultrasound examinations in the second and third trimesters were conducted. Quantile regression or linear regression models were applied to assess the associations.ResultsParticipants took iron supplementation in early, mid, and late pregnancy accounted for 19.1%, 40.3%, and 37.8%, respectively. Iron supplementation in the first and second trimesters and total iron intake in pregnancy were positively associated with fetal intrauterine growth parameters at some percentiles. Compared with those without iron supplementation in the second trimester, women with iron supplementation in the second trimester had 0.37 (95%CI = 0.24–0.49), 0.37 (95%CI = 0.26–0.48), 0.15 (95%CI = 0.04–0.26), and 0.52 (95%CI = 0.42–0.61) higher z-scores in fetal biparietal diameter, femur length, abdominal circumference, and estimated fetal weight at the 50th percentile in the second trimester, respectively. Maternal serum ferritin and hemoglobin concentrations in the first and second trimesters were positively correlated with several fetal growth parameters.ConclusionsFetal intrauterine growth may benefit from maternal iron nutrition in the first and second trimesters.

The association between maternal anemia and neonatal anemia: a systematic review and meta-analysis

ImportanceNeonatal anemia has a long-term effect on children's growth and development. Anemia during pregnancy is also the most widespread nutritional deficiency among pregnant women in the world; If it leads to anemia in newborns, it will affect a wide range of people and be a public health problem worthy of attention.ObjectiveTo study the relationship between maternal anemia during pregnancy and neonatal hemoglobin levels.Data sourcesPubMed, Web of science, Scopus, MEDLINE, Embase, ProQuest, Dissertations & Theses Global, The Cochrane Library, China Biology Medicine Database, Chinese CNKI Database, and Chinese Wanfang Database were systematically searched from inception to August 31, 2022.Study selectionThe meta-analysis included all original studies which pertain to cohort studies, case-control studies or cross-sectional studies that investigated the relationship between maternal anemia during pregnancy and neonatal hemoglobin levels.Data extraction and synthesisHemoglobin level of both anemic and non-anemic pregnant mothers and their paired newborns were pooled from the selected studies. The random-effects model was used to assess the risk of getting a lower neonatal hemoglobin level between mothers with and without pregnant anemia. Data analyses were performed from September 5, 2022, to March 10, 2023.Main outcomes and measuresMaternal anemia during pregnancy is a risk factor of lower neonatal hemoglobin levels.ResultsThe initial search yielded 4267 records of which 116 articles underwent full-text evaluation, which identified 18 articles and a total of 1873 patients that were included. The findings of the meta-analysis showed a significant difference between the two groups(MD=-1.38; 95%CI:[-1.96,-0.80]. p<0.01), while the co-effect showed that the neonatal hemoglobin value of anemic mothers was 1.38g/dL lower than that of non-anemic mothers(-1.96,-0.80), suggesting a correlation between maternal anemia lower neonatal hemoglobin levels.Conclusions and relevanceThis systematic review and meta-analysis demonstrated that maternal anemia during pregnancy were associated with a lower level of newborn hemoglobin levels. This may enable a better understanding of neonatal anemia and provide guidance towards future development of nutritional supplementation during pregnancy and the prediction of postpartum outcomes.Trial registrationPROSPERO Identifier: CRD42022352759.

The role that carboxyhemoglobin plays as a biomarker for low birth weight and maternal hemoglobin concentrations

The role that carboxyhemoglobin plays as a biomarker for low birth weight and maternal hemoglobin concentrations

Study of placenta histopathology in low birth weight deliveries: A prospective cross-sectional study at Nobel Medical College Teaching Hospital

Background: Placenta is the most important organ that represents the status of the mother and fetus. Its examination on gross and microscopy can reveal varied pregnancy-related diseases, decreasing future adverse pregnancy outcomes. This study aims to examine the placenta histopathologically among low birth weight pregnancies. Materials and methods: A prospective case-control study was conducted in the Department of Pathology over one year. The placenta of low birth weight (weight &lt; 2.5 kg) term pregnancies were histopathologically examined. The maternal demographics, co-morbidity, gravida, and hemoglobin levels were recorded. Descriptive statistics, and student t-test or Chi-square test were used for two-group analysis. Results: Thirty-two consecutive patients enrolled in each group. A significant proportion of the patients in the study group were anemic (9.2 vs. 11.5 gm/dl; p=0.03). Pregnancy-induced hypertension rate was significantly higher in the study group (31% vs. 9%; p = 0.042). Gross observations in low birth weight pregnancies were sub-chorionic fibrin deposition (75%), calcification (37%) and infarction (31%). On microscopy, chorionic vessel thrombosis was significantly higher in the study group (56% vs. 6%; p= 0.003). Furthermore, chorioamnionitis (34%) and placental floor infarction (12%) were also observed in a significantly higher number of placentas in the study group. Conclusions: Anemia and pregnancy-induced hypertension are important associated factors for low birth weight pregnancies. Pathological examinations reveal higher fibrin deposition, infarction, calcification, sub-chronic vessel thrombosis, and chorioamnionitis in low birth weight placenta.

Assessment of fetal cardiac function in pregnant women with anemia: prospective case-control study.

To compare fetal cardiac function in pregnant women with iron deficiency anemia (IDA) vs healthy pregnant controls. This was a single-center, prospective, case-control study conducted in a tertiary hospital between November 2022 and September 2023. Women diagnosed with IDA who attended as outpatients at the pregnancy follow-up clinic at 30-34 weeks' gestation or who were hospitalized for intravenous iron treatment owing to profound anemia were included. The control group consisted of randomly selected gestational-age-matched pregnant women with no obstetric complications or comorbidities and who did not have anemia. Patients underwent two-dimensional imaging, followed by pulsed-wave Doppler and M-mode and tissue Doppler imaging (TDI) to evaluate fetal cardiac function. A fetal cardiac score was calculated using systolic, diastolic and global hemodynamic function parameters, and was compared between patients with IDA and those without. The fetal cardiac score was also assessed according to the severity of anemia in the IDA group. A total of 150 patients, comprising 50 patients with IDA and 100 healthy pregnant women at 30-34 weeks' gestation, were included in the study. Of the patients with IDA, 20 had mild, 18 had moderate and 12 had severe anemia. The fetal myocardial performance index and isovolumetric relaxation time were significantly higher in the IDA group compared with the control group (P < 0.0001 for both), while isovolumetric contraction time was similar. Among the fetal tricuspid and mitral valve diastolic parameters, the E, A and E/A values were significantly lower in the IDA group (P < 0.05 for all). Mitral (MAPSE) and tricuspid (TAPSE) annular plane systolic excursions were significantly lower in the IDA group (P < 0.05 for both). The IDA group also had significantly lower values for the TDI parameters mitral and tricuspid E', A', S' and E'/A' ratio and a significantly higher E/E' ratio (P < 0.05 for all). Among the IDA subgroups, a significant decrease was observed in the tricuspid and mitral A, E and E/A ratio in fetuses whose mothers had severe anemia (P = 0.001). M-mode Doppler analysis revealed significantly lower fetal TAPSE and MAPSE in the patient group with severe maternal anemia (P = 0.001 for both). According to the subgroup comparison of TDI findings, the fetuses of mothers with severe anemia had significantly lower tricuspid and mitral E', A', S' and E'/A' ratio values and a significantly higher E/E' ratio (P < 0.05 for all). The fetal cardiac score was significantly higher in the maternal IDA group compared with the control group (P < 0.001). A significant negative correlation was found between maternal hemoglobin level and fetal cardiac score (P < 0.001). We observed differences in fetal systolic and diastolic cardiac function in pregnancies with maternal IDA. Fetal cardiac function was affected more among patients with severe anemia. This study found an increased E/E' ratio in the fetuses of pregnant women with IDA, suggesting decreased fetal heart maturation. Prenatal fetal cardiac evaluation, especially in women with severe anemia, can facilitate a more seamless transition to the postnatal period for these newborns. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Variables Associated With Favorable Obstetrical Outcomes in Early Pregnancy Bleeding in the Emergency Department.

Background Vaginal bleeding in early pregnancy is a frequent emergency department presentation and is associated with various obstetrical outcomes. Despite this, there has been limited research on the variables that predict less-than-preferred obstetrical outcomes in these cases. This study aims to identify predictors of preferred obstetrical outcomes for women presenting to the emergency department with early pregnancy bleeding. Methods We conducted a retrospective review of health records from an emergency department at a Canadian tertiary care center. Pregnant females presenting with vaginal bleeding before 20 weeks gestation were included. Variables analyzed included maternal age, gravidity, parity, hemoglobin levels, Rh status, cramping, socioeconomic status, and ultrasound findings. The primary outcome was a preferred outcome, defined as a full-term live birth (≥37 weeks). Less-preferred outcomes included miscarriage, preterm birth, and stillbirth. Point-of-care ultrasound and radiology ultrasound findings were also evaluated. Results A total of 422 patients were screened, and 180 were included in the analysis. Overall, 75 (41.7%) patients had a preferred outcome, while 105 (58.3%) had a less-preferred outcome. The strongest predictor of a preferred outcome was the presence of a live intrauterine pregnancy with fetal heartbeat onultrasound, with a preferred outcome rate of 74.5% (56/76) (95% CI 59.8-88.7; p < 0.01) on point-of-care ultrasound (POCUS), and 100% (65/65); p = 0.04 for radiology-performed ultrasound. In contrast, 80.8% (21/26) of patients with findings other than a live intrauterine pregnancy onPOCUS, and 100% (88/88) on radiology-performed ultrasound had a less-preferred outcome. Cramping with bleeding was associated with a higher rate of less-than-preferred outcomes (62.1%, 77/124; 95% CI 54.2-71.1; p = 0.07). Socioeconomic status was not a significant predictor, with similar outcomes above and below the poverty line. Anemia was associated with a 100% non-live birth rate, although only 5 patients were anemic. Conclusion Identification of a live intrauterine pregnancy onultrasound is a strong predictor of a preferred outcome in early pregnancy bleeding. POCUS has the advantage of being immediately available, whereas radiology-performed ultrasound may be more definitive as a predictor. Cramping and anemia may also be associated with less-preferred outcomes, though further research is needed to confirm these findings. These predictors may help guide clinical decision-making and improve counseling for patients presenting to the emergency department with early pregnancy bleeding.

Safety and Efficacy of Praziquantel in Pregnant Women Infected with Schistosoma haematobium in Lambaréné, Gabon – Clinical Results from the Randomized, Single-Blinded, Controlled freeBILy-Gabon Trial

ObjectiveDespite evidence of praziquantel's safety for treating schistosomiasis in pregnancy, many countries withhold treatment. Only two randomized controlled trials have investigated praziquantel in pregnancy, none involving Schistosoma haematobium. MethodsPregnant women during second trimester in Lambaréné (Gabon) were screened for S. haematobium infection using urine microscopy and circulating anodic antigen detection. Participants positive for either test were randomized (3:1) to single-dose praziquantel 40mg/kg during pregnancy versus no treatment during pregnancy. Investigators were blinded for allocation. Primary outcomes were reduction of egg- (ERR) and antigen production (IRR) while explorative outcomes included assessment of cure rate, adverse events, maternal hemoglobin levels maternal anemia prevalence at delivery, pregnancy outcomes, and newborn anthropometric parameters. ResultsOf 761 women screened 165 were eligible and randomized (intervention n=124, control n=41). 124 completed the study (n=90 and n=34, respectively). Tretament led to a significant higher ERR (95.0%[91%-97%] vs. 27.0%[-42%-63%]) and IRR (95%[91%-97%] vs. 56%[14%-78%]). Common adverse events were dizziness, nausea, and vomiting. Maternal anemia at delivery was significantly lower in the intervention group (OR:0.40[0.16;0.96],p=0.04). No increased risk for adverse pregnancy outcomes was observed. ConclusionsThis first randomized controlled trial investigating praziquantel in pregnant women with S. haematobium found praziquantel to be safe, effective and reducing maternal anemia. We recommend treating confirmed infections to prevent morbidity in pregnant women.

The impact of different doses of oral iron supplementation during pregnancy: a pilot randomized trial

AbstractOral iron is first-line medication for iron deficiency anemia in pregnancy. We conducted a pilot randomized trial to investigate the impact of different doses of oral iron supplementation started early in pregnancy on women without anemia for 4 main outcomes: recruitment and protocol compliance, adherence, maintenance of maternal hemoglobin, and side effects. At antenatal clinic visits, participants were allocated to 1 of 3 trial arms in a 1:1:1 ratio: 200 mg ferrous sulfate daily, alternate days, or 3 times per week. The participants were followed to delivery. Baseline characteristics of 300 recruited participants were well matched between trial arms. The mean proportion of tablets taken as expected per participant was 82.5% overall (72.3%, 89.6%, and 84.5% for the daily, alternate days, and 3 times a week arm, respectively). There was a lower overall adherence rate in the daily arm (47%) than in the alternate days (62%) and the 3 times per week (61%) arms. A reduction in hemoglobin between randomization and 28 weeks’ gestation seemed smaller for the daily arm. A range of side effects were commonly reported at baseline before starting interventions and at later antenatal visits. Many side effects of iron overlapped with normal pregnancy symptoms. A daily iron dosing schedule might give the best opportunity for delivering an adequate iron load during pregnancy in women without anemia. Further randomized trials powered on clinical outcomes are needed to establish the clinical effectiveness of oral iron supplementation to prevent iron deficiency anemia. This study was registered (#ISRCTN12911644).

Association between maternal haemoglobin status during pregnancy and children’s mental and psychomotor development at 18 months of age: Evidence from rural Bangladesh

ABSTRACT Background Anaemia is commonly caused by iron deficiency and screened by haemoglobin (Hb) concentration in blood. There is a scarcity of longitudinal data on the relationship between maternal Hb levels during pregnancy and neurodevelopment in children. Objective To measure the relationship of maternal Hb concentrations during pregnancy on early child development. Methods This prospective cohort study included 1,720 mother-child dyads in rural Bangladesh. Maternal Hb concentrations were measured at 14 and 30 weeks of gestation. The child’s Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) at 18 months of age were measured using Bayley Scales of Infant and Toddler Development (BSID-II). Data on socio-demographic characteristics, anthropometrics, mothers’ IQ and children’s home stimulation were also collected. Bivariate and multivariable-adjusted linear regression analyses were used to explore associations of maternal Hb with child development. Results Mean Hb concentrations at 14 and 30 weeks of gestation were 116.6 g/L (±12.7) and 114.7 g/L (±12.7), respectively. Mean MDI and PDI scores among 18-month-old children were 78.9 (±12.4) and 93.8 (±13.7), respectively. Maternal 14-week Hb concentration was correlated with PDI (r = 0.06; p < 0.05) and 30-week Hb concentrations was correlated with MDI (r = 0.05; p < 0.05). Multivariable adjusted linear regression analysis showed that an increase in 14-week Hb concentrations increased the PDI scores among boys (β = 0.09; 95% CI: 0.02, 0.16). Hb concentrations at 30 weeks of gestation were not associated with MDI or PDI scores. Conclusion Higher maternal Hb concentrations at 14 weeks of gestation were associated with higher PDI among 18-month-old boys in Bangladesh.

The epidemiology and risk factors for postnatal complications among postpartum women and newborns in southwestern Uganda: A prospective cohort study.

Sub-Saharan Africa accounts for two-thirds of the global burden of maternal and newborn deaths. Adverse outcomes among postpartum women and newborns occurring in the first six weeks of life are often related, though data co-examining patients are limited. This study is an exploratory analysis describing the epidemiology of postnatal complications among postpartum women and newborns following facility birth and discharge in Mbarara, Uganda. This single-site prospective cohort observational study enrolled postpartum women following facility-based delivery. To capture health information about both the postpartum women and newborns, data was collected and categorized according to domains within the continuum of care including (1) social and demographic, (2) pregnancy history and antenatal care, (3) delivery, (4) maternal discharge, and (5) newborn discharge. The primary outcomes were readmission and mortality within the six-week postnatal period as defined by the WHO. Multivariable logistic regression was used to identify risk factors. Among 2930 discharged dyads, 2.8% and 9.0% of women and newborns received three or more postnatal visits respectively. Readmission and deaths occurred among 108(3.6%) and 25(0.8%) newborns and in 80(2.7%) and 0(0%) women, respectively. Readmissions were related to sepsis/infection in 70(88%) women and 68(63%) newborns. Adjusted analysis found that caesarean delivery (OR:2.91; 95%CI:1.5-6.04), longer travel time to the facility (OR:1.54; 95%CI:1.24-1.91) and higher maternal heart rate at discharge (OR:1.02; 95%CI:1.00-1.01) were significantly associated with maternal readmission. Discharge taken on all patients including maternal haemoglobin (per g/dL) (OR:0.90; 95%CI:0.82-0.99), maternal symptoms (OR:1.76; 95%CI:1.02-2.91), newborn temperature (OR:1.66; 95%CI:1.28-2.13) and newborn heart rate at (OR:1.94; 95%CI:1.19-3.09) were risk factors among newborns. Readmission and death following delivery and discharge from healthcare facilities is still a problem in settings with low rates of postnatal care visits for both women and newborns. Strategies to identify vulnerable dyads and provide better access to follow-up care, are urgently required.

Maternal hemoglobin drop in multiple pregnancy is associated with higher gestational age at birth and birthweight.

This retrospective study investigated the hypothesis that maternal hemoglobin (Hb) levels in twin pregnancy fall between the first and second trimesters and that higher falls are associated with higher gestational age at birth and higher birthweight (BW). The study population was defined as pregnant women with twin pregnancies delivering two live, phenotypically normal neonates, after 24+0 weeks of gestation, between October 2009 and September 2021 at an inner London maternity unit. Maternal Hb and mean corpuscular volume (MCV), at ≤14+0 weeks of gestation (Hb1) and again at 20+0-30+0 weeks gestation (Hb2) were recorded from the Hospital's perinatal database. MCV was used as a possible indicator of iron deficiency anemia. The association of Hb drop, defined as [Hb1(adjusted for gestational age) - Hb2], and MCV values with gestational age at birth, BW of both twins and delivery of small for gestational age (SGA) neonates, defined as BW <10th percentile for gestation, was evaluated. 923 pregnant women with twin pregnancies were included. Maternal Hb1 did not correlate with any outcomes measured. However, a lower Hb2 and a larger Hb drop was associated with a higher gestational age at birth (p < 0.001), a larger BW of twin 1 and 2 (p < 0.001 for both) and a reduction in the incidence of delivering one or two SGA neonates (p < 0.001 for both). MCV values did not correlate significantly with these outcomes. This study showed that in twin pregnancy, a larger maternal Hb drop from the first to the second trimester is associated with a higher gestational age at birth and a larger BW. This change may represent a larger plasma volume expansion.

Maternal hemoglobin and iron status in early pregnancy and childhood cardiac outcomes

Background & aimsDysregulation of iron homeostasis is associated with cardiac alterations in a sex-dependent manner in adults. It is unknown whether iron status during pregnancy has long-term impact on cardiovascular health, and if this association is influenced by sex. Therefore, the study aimed to evaluate sex-specific association between maternal iron status during early pregnancy and cardiac outcomes in children aged 10 years. MethodsIn a population-based cohort study among 1972 mother-child pairs, hemoglobin and ferritin were measured in early pregnancy (<18 weeks) and categorized into anemia (hemoglobin<11g/dL), elevated hemoglobin (hemoglobin≥13.2g/dL), iron deficiency (ferritin<15 μg/L), and iron overload (ferritin>150 μg/L). At 10 years of age, cardiac MRI was performed to measure right and left cardiac outcomes of function (ventricular end-diastolic volume (RVEDV and LVEDV) and ejection fraction (RVEF and LVEF)), and structure (left ventricular mass (LVM), and left ventricular mass-to-volume ratio (LMVR)). Results are presented for boys and girls separately and models were adjusted for confounders and multiple testing. ResultsIn boys, one standard deviation score (SDS) increase in maternal hemoglobin was associated with lower RVEDV and LVEDV (difference (95%CI) -0.10 (-0.17, -0.03) SDS and -0.09 (-0.16, -0.03) SDS, respectively). In boys, maternal anemia, as compared to normal hemoglobin levels, was associated with higher LVEDV (difference 0.34 (0.10, 0.59) SDS).No associations were observed for other cardiac outcomes and for ferritin in boys. No associations were observed in girls. ConclusionIn boys, dysregulated iron status during early pregnancy might permanently alter cardiovascular RVEDV and LVEDV function. Underlying mechanisms need further study.

Effects of Physical Activity on Blood Lipids and Hemoglobin A1c in Healthy Pregnant Women: The FitMum Randomized Controlled Trial

ObjectiveMaternal blood lipid and glucose concentrations during pregnancy affect fetal growth and the risk of pregnancy and delivery complications.We aimed to investigate the effects of physical activity (PA) during pregnancy on maternal blood lipid and hemoglobin A1c (HbA1c) concentrations. We hypothesized that higher PA was associated with improved lipid profile and glycemic control. MethodsIn a secondary analysis of a randomized controlled trial, we included 216 pregnant women before week 15 + 0 and tested the effects of two different PA interventions throughout pregnancy compared to standard care on maternal blood lipid and HbA1c concentrations. Additionally, we investigated the effect of PA per se measured by an activity tracker. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, and HbA1c concentrations were measured at week ≤15 + 0, 28+0-6, 34+0-6, and at delivery (week 32 + 1 to 42 + 0). Effects of the interventions and PA per se were tested using linear mixed effects models and linear regression analyses, respectively. ResultsNo effects of the PA interventions were detected on maternal lipids or HbA1c during pregnancy. In PA per se analyses, more minutes per week of moderate-to-vigorous intensity PA were associated with less increase in TC (−1.3E-04, P = .020) and LDL-C (−8.5E-05, P = .035) as pregnancy progresses. More active kilocalories were associated with less increase in TC (−5.5E-05, P < .001), HDL-C (−9.5E-06, P = .024), and LDL-C (−3.2E-05, P = .005). ConclusionWhilst there were no effects of offering PA interventions, higher PA was associated with reduced increases in TC, HDL-C, and LDL-C as pregnancy progressed.

Relationship between ferritin and maternal hemoglobin levels with those of newborns in a public hospital in Lima, Peru

Relationship between ferritin and maternal hemoglobin levels with those of newborns in a public hospital in Lima, Peru

Association of Maternal Lifestyle Factors and Hemoglobin with Low Birth Weight

Background: Low birth weight (LBW) is a major global public health problem and a leading cause of neonatal mortality, as well as a significant risk factor for infant and under-five morbidity and mortality. Objective: The study aimed to determine the association between maternal lifestyle factors and low birth weight, and to investigate the relationship between maternal hemoglobin levels and LBW infants. Methods: A total of 518 samples were included in the study, comprising 259 cases and 259 controls. Data were collected using a standard questionnaire administered through interviews and medical record reviews. The questionnaire covered maternal lifestyle factors and hemoglobin levels. Logistic regression was employed to analyze the associations between maternal lifestyle risk factors, hemoglobin levels, and low birth weight. Descriptive statistics were calculated for each variable, and statistical relationships were assessed using IBM SPSS version 25, with a significance level set at 0.05. Results: The study found that maternal hemoglobin levels (OR=0.742, 95% CI: 0.644-0.855, p&lt;0.001) and gestational age (OR=0.776, 95% CI: 0.696-0.866, p&lt;0.001) were inversely associated with low birth weight. Conversely, previous pregnancies (OR=5.043, 95% CI: 2.004-12.689, p=0.001 for one previous pregnancy), low maternal income (OR=7.156, 95% CI: 2.369-21.617, p&lt;0.001), specific occupations (OR=2.354, 95% CI: 1.416-3.914, p=0.001), and being underweight (OR=26.829, p&lt;0.001) were positively associated with low birth weight. Conclusion: These findings emphasize the importance of considering various socio-economic and health factors in the prevention and management of low birth weight, with a particular focus on maternal occupational status, income, previous pregnancies, gestational age, pregnancy complications, and maternal hemoglobin levels.

Phenotypic changes of γδ T cells in Plasmodium falciparum placental malaria and pregnancy outcomes in women at delivery in Cameroon.

Depending on the microenvironment, γδ T cells may assume characteristics similar to those of Th1, Th2, Th17, regulatory T cells or antigen presenting cells. Despite the wide documentation of the effect of Th1/Th2 balance on pregnancy associated malaria and outcomes, there are no reports on the relationship between γδ T cell phenotype change and Placental Malaria (PM) with pregnancy outcomes. This study sought to investigate the involvement of γδ T cells and its subsets in placental Plasmodium falciparum malaria. In a case-control study conducted in Yaoundé, Cameroon from March 2022 to May 2023, peripheral, placental and cord blood samples were collected from 50 women at delivery (29 PM negative: PM- and 21 PM positive: PM+; as diagnosed by light microscopy). Hemoglobin levels were measured using hemoglobinometer. PBMCs, IVBMCs and CBMCs were isolated using histopaque-1077 and used to characterize total γδ T cell populations and subsets (Vδ1+, Vδ2+, Vδ1-Vδ2-) by flow cytometry. Placental Plasmodium falciparum infection was associated with significant increase in the frequency of total γδ T cells in IVBMC and of the Vδ1+ subset in PBMC and IVBMC, but decreased frequency of the Vδ2+ subset in PBMC and IVBMC. The expression of the activation marker: HLA-DR, and the exhaustion markers (PD1 and TIM3) within total γδ T cells and subsets were significantly up-regulated in PM+ compared to PM- group. The frequency of total γδ T cells in IVBMC, TIM-3 expression within total γδ T cells and subsets in IVBMC, as well as HLA-DR expression within total γδ T cells and Vδ2+ subset in IVBMC were negatively associated with maternal hemoglobin levels. Furthermore, the frequency of total γδ T cells in PBMC and PD1 expression within the Vδ2+ subset in CBMC were negatively associated with birth weight contrary to the frequency of Vδ1-Vδ2- subset in PBMC and HLA-DR expression within the Vδ2+ subset in IVBMC which positively associated with maternal hemoglobin level and birth weight, respectively. The data indicate up-regulation of activated and exhausted γδ T cells in Plasmodium falciparum placental malaria, with effects on pregnancy outcomes including maternal hemoglobin level and birth weight.

Dietary micronutrients intake and its effect on haemoglobin levels of pregnant women for clinic visit in the Mount Cameroon health area: a cross-sectional study.

Nutritional deficiencies and its consequences such as anaemia are frequent among pregnant women residing in under resource settings. Hence, this study sought to investigate specific dietary micronutrient inadequacy and its effect on maternal haemoglobin levels. This institution based cross-sectional survey enrolled 1,014 consenting pregnant women consecutively. Data on socio-demographic, economic and antenatal characteristics were recorded using a structured questionnaire. Minimum dietary diversity for women (MDD-W) was assessed using the 24-h recall method and haemoglobin (Hb) concentration (g/dL) determined using a portable Hb metre. Significant levels between associations was set at p < 0.05. Among those enrolled, 40.9% were anaemic while 89.6% had inadequate dietary nutrient intake. In addition, uptake of blood supplements, haem iron, plant and animal-based foods rich in vitamin A were 71.5, 86.2, 35.5 and 12.6%, respectively. Moreover, anaemia prevalence was significantly (p < 0.05) lower in women who took iron-folic acid along with food groups rich in haem iron (38.5%) or both plant and animal vitamin A (29.0%). Besides, mean maternal Hb levels was significantly (p < 0.001) higher in women who consumed haem iron (11.08 ± 1.35) and vitamin A food groups (11.34 ± 1.30) when compared with their counterparts who did not consume haem iron (10.54 ± 1.19) and vitamin A food groups (10.74 ± 1.31). Dietary uptake of foods rich in haem-iron and vitamin A significantly improves Hb levels in Cameroonian pregnant women. Our findings underscore the importance of improving maternal nutritional awareness and counselling during antenatal period to reduce the anaemia burden.

Intravenous Iron Supplementation in Pregnancy: Comparisons of Dosage and Latency of Infusion Based on a Quality Improvement Project on Maternal Transfusion Reduction [ID 2683380

INTRODUCTION: Optimal dosing of intravenous iron supplementation (IVFe) and latency of the infusion for pregnant patients with iron deficiency anemia has been minimally evaluated. We analyzed the effects of specific IVFe dosage parameters as part of an institution-based protocol on maternal peripartum hemoglobin (Hb) levels stratifying by time of infusion to delivery. METHODS: We reviewed average changes in maternal Hb pre-infusion and pre-delivery over a 3-year period (2020–2023) after the implementation of a maternal transfusion reduction bundle was incorporated at our Level IV maternal care center in 2020. Pregnant patients who received IVFe and delivered at our institution were included and compared by IVFe dosage forms (800 mg) and infusion latency (by 2-week increments). We excluded patients with known antepartum blood transfusion. Maternal demographics and all comparison groups were analyzed among each other using GraphPad Prism software. RESULTS: Two hundred ninety-five patients met inclusion criteria. Demographics of maternal age, body mass index (BMI), nulliparity, and ferritin levels were similar in all groups. We found a statistically significant difference in improved pre-delivery Hb with larger IVFe doses (P=.002) and longer infusion-delivery periods (P=.049). A Tukey post-hoc test revealed that the highest yield on mean delta Hb was after 6–8 weeks or longer of latency with doses greater than 800 mg versus less than 2 weeks at doses of 800 mg or lower (2.6–3.1 g/dL; P&lt;.0001). CONCLUSION: Latency periods of at least 6 weeks with IVFe dosages of 800 mg or greater, regardless of maternal BMI or starting ferritin, may markedly improve pre-delivery Hb levels and ultimately reduce maternal morbidity hemorrhage complications.

Effect of HIV and substance use disorder comorbidity on the placenta, fetal and maternal health outcomes: systematic review and meta-analysis protocol

BackgroundSubstance use disorders and HIV infection have a bidirectional relationship. People who use illicit drugs are at increased risk of contracting HIV/AIDS, and people living with HIV/AIDS are at increased...

Study on the Effect of Maternal Haemoglobin on Birth Weight of Newborn Babies

Background: Anemia is a very common condition found in pregnant women, which has a deleterious effect on foetal wellbeing including weight gain of fetus. Studies indicate that anemia in pregnancy is a risk factor low birth weight and possibly for inferior neonatal health. The present study is done to determine the effect of the maternal hemoglobin on birth weight. Methods: An observational cross-sectional study was carried out at a tertiary care hospital in Mumbai. All pregnant females with single live pregnancy were included in this study. After the selection criteria was satisfied, all term babies born to pregnant females with single live pregnancy were examined and birth weight was recovered on a digital weighing scale. Results: Among the anemic mothers, 39 (27.3%) had mild anemia (Hb: 10 – 10.9), 32 (22.4%) had moderate anemia (Hb: 7 – 9.9) and 9 (6.3%) had severe anemia (Hb: &lt;7). Of the 143 newborns born to those mothers, 74 (51.7%) weighed between 2500 – 3500 grams, 56 (39.2%) were low birth weight (&lt;2500g) babies and only 13 (9.1%) were above 3500 grams. Conclusions: According to our study, anemic mothers delivered babies with low birth weight than nonanemic mothers. Present study showed prevalence of low-birth-weight babies to be 39.2%. Interventions to reduce low birth weight should be specific for specific populations. Approaches to improve the health of the women are needed to reduce the low-birth-weight problem in India. Keywords: Maternal haemoglobin, Anemia, Low birth weight.