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Haemoglobin during pregnancy: relationship to erythropoietin and haematinic status

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McMullin MF, White R, Lappin T, Reeves J, MacKenzie G. Haemoglobin during pregnancy: relationship to erythropoietin and haematinic status.

Eur J Haematol 2003: 71: 44–50. © Blackwell Munksgaard 2003. Abstract: Objective:

To investigate the effect of haematinic status on erythropoietin throughout pregnancy in order to assess whether haematinic supplementation is appropriate for all pregnant women or should be reserved for individuals in whom deficiency has been identified. Methods:

A prospective, repeated-measures, longitudinal study of 263 women enrolled at an antenatal clinic in a district general hospital who received standard obstetric management including haematinic supplements. Haematological indices, iron status, folate and B12 status, and erythropoietin levels were measured by standard methods at scheduled intervals throughout pregnancy. The relationships between the measurements were analysed using statistical models which took into account the serial correlation between repeated measurements on the same individuals. Results:

Erythropoietin levels rose throughout pregnancy from a mean of 22.8 mU/mL at booking to 43.7 mU/mL at 38 wk. There was a significant relationship between erythropoietin levels and haemoglobin, ferritin, TIBC and folate. The relationship was strongest between erythropoietin and haemoglobin. Erythropoietin levels were influenced by parity but not maternal age. Conclusion:

Haematinic levels, particularly iron are related to the rise in serum EPO which occurs during pregnancy. Therefore, haematinic deficiency in pregnancy will result in increased stimulation of erythroid progenitor cells by erythropoietin. While haematinic supplementation is not always prescribed throughout pregnancy, haematinic status must be assessed on an individual basis and supplementation provided as required.
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Keywords: erythropoietin; haematinic status; haemoglobin; pregnancy

Document Type: Research Article

Affiliations: 1: Department of Haematology, The Queen's University of Belfast, Belfast 2: Department of Obstetrics and Gynaecology, Mater Hospital Trust, Belfast, and 3: The Centre for Medical Statistics, Keele University, Keele, UK

Publication date: July 1, 2003

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