Maternal Anemia is Associated with Increased Fetal Erythropoietin Level

Seo, Y S; Roh, J R; Oh, J M; Yang, S H; Jeong, J H; Kim, S W; Lee, J H

Abstract

Maternal anemia during pregnancy is associated with low birth weight, preterm delivery and increased perinatal mortality. The level of fetal erythropoietin has been regarded as an index of prolonged fetal hypoxia. This study was undertaken to evaluate whether maternal anemia influences fetal hematologic index and fetal erythropoietin levels. We measured paired maternal and umbilical cord plasma immunoreactive erythropoietin levels and complete blood counts (CBC) at spontaneous vaginal and cesarean delivery at term. All singletone pregnant women were in 37~42 weeks` gestation and without medical complications. They were classified into two groups according to maternal hemoglobin (Hb) concentration; those with maternal Hb concentration <10 mg/dl to group 1 (n=23), and those with maternal Hb > or =10 mg/dl to group 2 (n=59). There was no statistical difference in maternal erythropoietin levels between group 1 (23.00+/-2.95 mU/mL) and group 2 (31.1+/-1.95 mU/mL). Maternal hemoglobin concentrations did not show any significant relationship with maternal erythropoietin levels. Also there was no significant relationship between fetal hemoglobin concentration and fetal erythropoietin level. But fetal erythropoietin level (93.0+/-15.10 mU/mL) of group 1 with maternal anemia was significantly higher than that of group 2. Moreover, there was a significant relationship between maternal hemoglobin concentration and fetal erythropoietin level (y=-20.396x+ 273.67, gamma2=0.3751, p<0.05). The result of present study suggests that maternal anemia, causing relative fetal hypoxia, might have induced an increase in fetal plasma erythropoietin level.