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Health Equity/Community Health

Poster Session 3

(788) Impact of anemia on perinatal outcomes by race and ethnicity

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Foundation Awardee
Objective: Anemia in pregnancy is common and associated with substantial morbidity. Racial and ethnic disparities in recognition and treatment of anemia exist, despite routine screening. The objective of this study was to evaluate perinatal outcomes associated with anemia in pregnancy, stratified by race and ethnicity in a large US-based cohort. 

Study Design: Secondary analysis of California linked hospital discharge-vital statistics data from 2016-2019 was performed. Deliveries 23-42 weeks’ gestation were included and anemia was identified using birth certificate and International Classification of Disease (ICD-10) codes. Race and ethnicity were categorized into Non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, Asian/Pacific Islander (API), and American-Indian and Alaskan Native (AIAN).  Multivariable logistic regressions were created to assess the association of anemia with adverse perinatal outcomes in the total cohort and by race and ethnicity. 

Results: A total of 1,719,596 births met inclusion criteria; 303,718 (18%) had maternal diagnosis of anemia. Anemia prevalence was highest among NHB (31%), followed by AIAN (20%), Hispanic (19%), and NHW (16%; p< 0.001). Anemia was significantly associated with hypertensive disease in NHW (aOR=1.44, 95% CI: 1.40, 1.48), NHB (aOR=1.47 (1.40, 1.53), Hispanic (aOR=1.53 (1.50, 1.56), API (aOR=1.62 (1.54, 1.69), and AIAN (aOR=1.31 (1.05, 1.64). Similarly, across all racial categories, individuals with anemia had higher rates of preterm delivery (< 37 weeks and < 32 weeks), NICU admission, small for gestational age, respiratory distress syndrome, hypoglycemia, and low birth weight compared to those without anemia (Table 1).  

Conclusion: Anemia in pregnancy is associated with increased odds of adverse perinatal outcomes, that were overall similar among diverse racial and ethnic backgrounds. Given higher rates of anemia in Hispanic, AIAN, and NHB pregnant individuals in this cohort, further investigation is warranted.