Maternal Hematological Status in Third Trimester and Its Correlation With Neonatal Birth Weight

ABSTRACT Objective The interplaying relationship between anemia and adverse pregnancy outcomes is concerning to both short‐ and long‐term maternal and child health. Despite strong biological plausibility, a causal link has not been established for all outcomes. On the contrary, there are statements which state that higher maternal hemoglobin (Hb) concentration increases risk for adverse perinatal outcomes. Both low and high Hb concentrations should be identified as at‐risk groups and optimal level of Hb that would yield the best outcome should be included in guidelines for clinical practice. However, it is also not clear which trimester Hb should be taken as the standard for assessment. During pregnancy, fetal growth occurs in various phases and most of the micronutrient related issues occur in the third trimester. Hence, the aim of the study is to find the correlation of maternal Hb level during the third trimester on neonatal birth weight. Methods A hospital‐based cross‐sectional study was conducted at Gynecology and Obstetrics Department, Bharatpur Hospital, Chitwan, Nepal, after ethical approval. Pregnant ladies in their third trimester admitted to maternity ward of Bharatpur Hospital in the view of delivery from both Emergency Department (ED) and Out‐Patient Department (OPD), who met the inclusion criteria, were included in the study. Informed written consent was taken from all the participants. Routine panel of investigations as per hospital protocol were sent on admission which invariably included hemoglobin concentration. Estimated hematocrit (Hct) level was calculated from maternal Hb using a factor of 3. Birth weight of the newborn was measured using digital infant weighing scale and noted immediately after birth, if possible, otherwise within 24 h. Karl Pearson's correlation coefficient was calculated between estimated Hct and neonatal birth weight. Results A total of 97 patients were included in the study. Our study showed that maternal hematological status in pregnancy affects neonatal birth weight. There was lower mean Birth weight of the neonates were lower than the mean in both high and low Hct group participants. A weak positive correlation between maternal Hct in third trimester and neonatal birth weight with p ‐value of 0.974 was analyzed. Pregnant individuals having higher mean Hct had assisted vaginal delivery/instrumental delivery. The study showed that there was a higher proportion of neonates with low Apgar scores in participants with high Hct ( ≥ 40%). Conclusion While our study observed a weak positive trend between maternal hematocrit and neonatal birth weight, this correlation was not statistically significant ( r = 0.003, p = 0.974), and thus no definitive association can be concluded. Pregnant individuals with high hematocrit appeared to have a higher proportion of assisted vaginal deliveries and neonates with lower birthweight and Apgar scores; however, these observations were not statistically significant and should be considered exploratory. Thus, this study suggests that further research with larger or multicenter sample is needed to clarify potential relationships.