Women’s Health
Preexisting Anemia Prevalence and Association with Severe Maternal Morbidity Indicators During Inpatient Hospitalization Deliveries from 2016-2022 Ashley Finke* Ashley Finke Alley Masocco
Maternal anemia has been reportedly associated with an increased risk of maternal morbidity. Anemia disproportionately affects American Indian, Black, and other minoritized patients, significantly amplifying severe maternal morbidity (SMM) disparities.
This study aims to determine the prevalence of in-hospital anemia among delivering patients with specific SMM indicators, assess the prevalence of hospital-acquired (HA), preexisting-acquired (PA), and inherited (IA) anemia among demographics, and examine the association of non-HA among delivering mothers with specific SMM outcomes.
This retrospective cohort study was conducted using data from the PINC AI™ Healthcare Database, 2016-2022. All measures were defined using ICD-10-CM diagnosis or procedure codes. Descriptive analysis was performed to assess the prevalence of anemia, SMM and patient demographics. Multivariable logistic regression models were utilized to examine the associations between PA with each SMM indicator. Models were adjusted to account for potential confounding patient, hospital, and COVID-19 effects. Exposure variable p-values were adjusted using the false discover rate to account for the multiplicity impact of multiple comparisons.
Among the 6,306,303 unique hospital deliveries, the highest rates of any anemia occurred among patients aged 10-19 (26%), Medicare/Medicaid payors (24%,23%), and American Indian and Black patients (25%,30%) in comparison to White reference patients (16%). The prevalence of anemia per 1,000 discharges: PA 127, IA 11, and HA 63. PA is associated with 11 SMMs and IA is associated with 3 SMMs. PA and IA both had statistically significant increased odds (p<0.05) of air and thrombotic embolism (OR:1.8,1.7). PA had a statistically significant increased odds of eclampsia and sepsis (OR:1.2,2.1).
This study contributes to critical insights into the impact of maternal anemia (including among preexisting anemia subtypes) among individual SMMs and demographic attributes.
