The impact of maternal anemia and vitamin D deficiency on neonatal outcomes: A retrospective study from a medical center in northern taiwan

Objective To investigate the impact of maternal anemia and vitamin D deficiency on neonatal outcomes, and to analyze the association between anemia subtypes and response to iron supplementation. Materials and methods We enrolled women who delivered between 2018 and 2022 at Mackay Memorial Hospital, Taipei, Taiwan. Anemia was defined as hemoglobin <11.0 g/dL in the first and third trimesters, and <10.5 g/dL in the second trimester. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D < 20 ng/mL. Neonatal outcomes included preterm birth, low birth weight, Apgar scores <7, and neonatal hospitalization. Results Third-trimester anemia was significantly associated with lower 5-min Apgar score (p = 0.04) and higher risk of neonatal hospitalization (p = 0.03). Hb ≤ 10.0 g/dL in second trimester had significantly lower 5-min Apgar score. Combined second-trimester anemia and vitamin D deficiency significantly increased preterm birth risk (p = 0.003). Normocytic and microcytic anemia occurred frequently, with about 80% of iron-deficiency anemia cases responding to supplementation. Conclusion Third-trimester anemia is significantly associated with adverse neonatal outcomes. Routine mid-trimester anemia screening incorporating MCV-based evaluation for furthermore survey and close monitoring of treatment efficacy is warranted to improve maternal and neonatal health. Routine vitamin D screening and close follow-up of supplementation may provide additional benefits in reducing the risk of preterm birth.