Association between iron deficiency anemia and severe maternal morbidity: A retrospective cohort study

Samuel H. Nyarko, Lucy T. Greenberg, George R. Saade, Ciaran S. Phibbs, Jeffrey S. Buzas, Scott A. Lorch, Jeannette Rogowski, Molly Passarella, Nansi S. Boghossian

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We examined the association between iron deficiency anemia (IDA) and severe maternal morbidity (SMM) during delivery and up to 1-year postpartum. Methods: In a retrospective cohort study across 3 states, we computed adjusted relative risks (aRR) for SMM comparing individuals with IDA versus those without, using modified Poisson regression models. Results: Among 2459,106 individuals, 10.3 % (n = 252,240) had IDA. Individuals with IDA experienced higher rates of blood transfusion and non-transfusion SMM (329 and 122 per 10,000 deliveries, respectively) than those without IDA (33 and 46 per 10,000 deliveries, respectively). The risk of blood transfusion (aRR: 8.2; 95 % CI 7.9–8.5) and non-transfusion SMM (aRR: 1.9; 95 % CI: 1.8–2.0) were higher among individuals with IDA. The attributable risk per 10,000 deliveries due to IDA for blood transfusion and non-transfusion SMM during delivery were 29.5 (95 % CI: 28.9–30.0) and 5.7 (95 % CI: 5.3–6.2), respectively. Within 1-year postpartum, the relative risk of non-transfusion SMM (aRR:1.3; 95 % CI: 1.2–1.3) was 30 % higher among individuals with IDA. Conclusion: IDA is associated with increased SMM risk. Addressing IDA in pregnant individuals may reduce SMM rates.

Original languageEnglish (US)
Pages (from-to)10-15
Number of pages6
JournalAnnals of Epidemiology
Volume100
DOIs
StatePublished - Dec 2024

All Science Journal Classification (ASJC) codes

  • Epidemiology

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