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Placental abruption and neonatal anemia

Journal of Perinatology (2023)Cite this article

Subjects

Abstract

Objective

Placental abruption can cause maternal blood loss and maternal anemia. It is less certain whether abruption can cause fetal blood loss and neonatal anemia.

Study design

Retrospective multi-hospital 24-month analysis of women with placental abruption and their neonates.

Results

Of 55,111 births, 678 (1.2%) had confirmed abruption; 83% of these neonates (564) had one or more hemoglobins recorded in the first day. Four-hundred-seventy (83.3%) had a normal hemoglobin (≥5th% reference interval) while 94 (16.7%) had anemia, relative risk 3.26 (95% CI, 2.66–4.01) vs. >360,000 neonates from previous reference interval reports. The relative risk of severe anemia (<1st% interval) was 4.96 (3.44–7.16). When the obstetrician identified the abruption as “small” or “marginal” the risk of anemia was insignificant.

Conclusions

Most abruptions do not cause neonatal anemia but approximately 16% do. If an abruption is not documented as small, it is important to surveille the neonate for anemia.

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Fig. 1
Fig. 2: Five-hundred-sixty four neonates born after confirmed placental abruption had one or more blood hemoglobin concentrations recorded during the first 24 h.
Fig. 3: Neonates with two or more blood hemoglobin concentrations reported during the first 10 h after birth are shown with a line connecting the hemoglobin values.

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Acknowledgements

We thank Jillyn Spencer, Office of Research, Intermountain Healthcare, for her expert interactions with the Intermountain Healthcare Institutional Review Board. We also thank Michael W. Varner, MD, Maternal-Fetal Medicine, University of Utah and Stephen D. Minton, MD, Neonatology, Intermountain Healthcare for very helpful discussions.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA

    Sarah M. Tweddell, Timothy M. Bahr, Robin K. Ohls & Robert D. Christensen

  2. Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT, USA

    Timothy M. Bahr, Erick Henry, Jessica M. Page & Robert D. Christensen

  3. Transfusion Medicine, Intermountain Medical Center, Murray, UT, USA

    Sarah J. Ilstrup

Authors
  1. Sarah M. Tweddell
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  2. Timothy M. Bahr
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  4. Jessica M. Page
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  5. Sarah J. Ilstrup
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  6. Robin K. Ohls
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  7. Robert D. Christensen
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Contributions

SMT: Conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript. TMB: Data analysis and interpretation, manuscript writing, final approval of manuscript. EH: Collection and assembly of data, manuscript writing, final approval of manuscript. JMP: Collection and assembly of data, manuscript writing, final approval of manuscript. SJI: Collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript. RKO: Data analysis and interpretation, manuscript writing, final approval of manuscript. RDC: Conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript.

Corresponding author

Correspondence to Sarah M. Tweddell.

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Tweddell, S.M., Bahr, T.M., Henry, E. et al. Placental abruption and neonatal anemia. J Perinatol (2023). https://doi.org/10.1038/s41372-023-01603-w

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