ArticleNutrients2023
Variation Patterns of Hemoglobin Levels by Gestational Age during Pregnancy: A Cross-Sectional Analysis of a Multi-Center Retrospective Cohort Study in China.
Article in Nutrients, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Machine learning-based risk assessment of neonatal perinatal adverse outcomes of anemia during pregnancy: a modeling study.BMC medical informatics and decision making · 2026Article
- Longitudinal study on the relationship between DASH-style dietary pattern and allostatic load in Chinese pregnant women.Nutrition research and practice · 2026Article
- Observational
- Changes in Maternal Hemoglobin Concentration and Risk of Low Birth Weight and Small-for-Gestational-Age in the United Arab Emirates: The Mutaba'ah Study.International journal of women's health · 2026Article
- Maternal hemoglobin drop in multiple pregnancy is associated with higher gestational age at birth and birthweight.Acta obstetricia et gynecologica Scandinavica · 2024Article
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10 authors.
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Abstract
backgroundPregnancy anemia is a global health concern. However, to our knowledge, there still has little consensus on the reference value of hemoglobin levels. Particularly, little evidence from China was accessible in most existing guidelines.
objectiveTo evaluate hemoglobin levels and anemia prevalence of pregnant women in China and offer evidence for anemia and its reference values in China.
methodsA multi-center retrospective cohort study was conducted among 143,307 singleton pregnant women aged 15-49 at 139 hospitals in China, with hemoglobin concentrations routinely tested at each prenatal visit. Subsequently, a restricted cubic spline was performed to reveal a non-linear variation of hemoglobin concentrations during the gestational week. The Loess model was used to describe the changes in the prevalence of different degrees of anemia with gestational age. Multivariate linear regression model and Logistic regression model were applied to explore influencing factors of gestational changes in hemoglobin level and anemia prevalence, respectively.
resultsHemoglobin varied nonlinearly with gestational age, and the mean hemoglobin levels decreased from 125.75 g/L in the first trimester to 118.71 g/L in the third trimester. By analyzing hemoglobin levels with gestational age and pregnancy period, we proposed new criteria according to 5th percentile hemoglobin concentration in each trimester as a reference for anemia, with 108 g/L, 103 g/L, and 99 g/L, respectively. According to WHO's criteria, the prevalence of anemia sustainably increased with gestational age, with 6.2% (4083/65,691) in the first trimester, 11.5% (7974/69,184) in the second trimester and 21.9% (12,295/56,042) in the third trimester, respectively. In subsequent analysis, pregnant women in non-urban residents, multiparity, and pre-pregnancy underweight tended to have lower hemoglobin levels.
conclusionsThis research, the first large-sample study to present a set of gestational age-specific reference centiles for hemoglobin levels in China, could be used to obtain a better understanding of the overall levels of hemoglobin in Chinese healthy pregnant women and ultimately offer clues for a more precise hemoglobin reference value of anemia in China.
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