Haematological changes from conception to childbirth: An indicator of major pregnancy complications.
clinical haematology
complete blood count
longitudinal data
maternal health
mixed effects model
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
revised:
26
07
2022
received:
04
05
2022
accepted:
29
07
2022
pubmed:
6
9
2022
medline:
13
10
2022
entrez:
5
9
2022
Statut:
ppublish
Résumé
About 800 women die every day worldwide from pregnancy-related complications, including excessive blood loss, infections and high-blood pressure (World Health Organization, 2019). To improve screening for high-risk pregnancies, we set out to identify patterns of maternal hematological changes associated with future pregnancy complications. Using mixed effects models, we established changes in 14 complete blood count (CBC) parameters for 1710 healthy pregnancies and compared them to measurements from 98 pregnancy-induced hypertension, 106 gestational diabetes and 339 postpartum hemorrhage cases. Results show interindividual variations, but good individual repeatability in CBC values during physiological pregnancies, allowing the identification of specific alterations in women with obstetric complications. For example, in women with uncomplicated pregnancies, haemoglobin count decreases of 0.12 g/L (95% CI -0.16, -0.09) significantly per gestation week (p value <.001). Interestingly, this decrease is three times more pronounced in women who will develop pregnancy-induced hypertension, with an additional decrease of 0.39 g/L (95% CI -0.51, -0.26). We also confirm that obstetric complications and white CBC predict the likelihood of giving birth earlier during pregnancy. We provide a comprehensive description of the associations between haematological changes through pregnancy and three major obstetric complications to support strategies for prevention, early-diagnosis and maternal care.
Sections du résumé
BACKGROUND
BACKGROUND
About 800 women die every day worldwide from pregnancy-related complications, including excessive blood loss, infections and high-blood pressure (World Health Organization, 2019). To improve screening for high-risk pregnancies, we set out to identify patterns of maternal hematological changes associated with future pregnancy complications.
METHODS
METHODS
Using mixed effects models, we established changes in 14 complete blood count (CBC) parameters for 1710 healthy pregnancies and compared them to measurements from 98 pregnancy-induced hypertension, 106 gestational diabetes and 339 postpartum hemorrhage cases.
RESULTS
RESULTS
Results show interindividual variations, but good individual repeatability in CBC values during physiological pregnancies, allowing the identification of specific alterations in women with obstetric complications. For example, in women with uncomplicated pregnancies, haemoglobin count decreases of 0.12 g/L (95% CI -0.16, -0.09) significantly per gestation week (p value <.001). Interestingly, this decrease is three times more pronounced in women who will develop pregnancy-induced hypertension, with an additional decrease of 0.39 g/L (95% CI -0.51, -0.26). We also confirm that obstetric complications and white CBC predict the likelihood of giving birth earlier during pregnancy.
CONCLUSION
CONCLUSIONS
We provide a comprehensive description of the associations between haematological changes through pregnancy and three major obstetric complications to support strategies for prevention, early-diagnosis and maternal care.
Identifiants
pubmed: 36059200
doi: 10.1111/ejh.13844
pmc: PMC9825915
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
566-575Subventions
Organisme : IST/core funding
ID : PCEGP3-181181
Organisme : SNF / Eccellenza Grant (PCEGP3-181181)
Informations de copyright
© 2022 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.
Références
Cureus. 2022 Mar 16;14(3):e23204
pubmed: 35444886
BMC Pregnancy Childbirth. 2020 Apr 21;20(1):233
pubmed: 32316915
Indian J Hematol Blood Transfus. 2012 Sep;28(3):144-6
pubmed: 23997449
Sci Rep. 2021 Sep 28;11(1):19238
pubmed: 34584125
N Engl J Med. 2018 Jul 05;379(1):32-43
pubmed: 29972751
PLoS One. 2019 Nov 21;14(11):e0225536
pubmed: 31751422
Ochsner J. 2020 Spring;20(1):39-43
pubmed: 32284681
Iran J Nurs Midwifery Res. 2012 Feb;17(2 Suppl 1):S165-70
pubmed: 23833600
Am J Obstet Gynecol. 2019 Sep;221(3):179-182
pubmed: 31492377
J Clin Diagn Res. 2015 Nov;9(11):QC20-3
pubmed: 26674673
J Obstet Gynaecol Res. 2014 Apr;40(4):976-82
pubmed: 24612458
Cell Mol Immunol. 2014 Nov;11(6):571-81
pubmed: 24954221
Lancet. 2020 Sep 5;396(10252):e22
pubmed: 32861313
Vasc Health Risk Manag. 2016 Nov 21;12:477-480
pubmed: 27920548
J Matern Fetal Neonatal Med. 2015 May;28(7):790-2
pubmed: 24987875
Methods Mol Biol. 2007;412:3-11
pubmed: 18453101
Obstet Gynecol. 1991 Feb;77(2):190-4
pubmed: 1988879
Cardiovasc J Afr. 2016 Mar-Apr;27(2):89-94
pubmed: 27213856
Eur J Haematol. 2022 Nov;109(5):566-575
pubmed: 36059200
Mol Hum Reprod. 2009 Nov;15(11):713-24
pubmed: 19628509
Microvasc Res. 2021 Nov;138:104226
pubmed: 34252400
Blood. 2020 Nov 5;136(19):2103-2117
pubmed: 32808006
Obstet Gynecol Clin North Am. 2005 Sep;32(3):397-410
pubmed: 16125040
Best Pract Res Clin Obstet Gynaecol. 2007 Jun;21(3):467-78
pubmed: 17448730
Scand J Clin Lab Invest. 2001;61(8):583-92
pubmed: 11768317
Lancet. 2008 Jan 5;371(9606):75-84
pubmed: 18177778
Diagn Gynecol Obstet. 1981 Summer;3(2):123-6
pubmed: 7261863