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Postpartum hemoglobin levels are not associated with maternal health-related quality of life measures
Abstract Number: SA-01
Abstract Type: Original Research
Background: Delivery has a major impact on health-related quality of life (QoL),(1) however it is unclear whether other modifiable factors, such as maternal hemoglobin (Hb), influence postpartum QoL. The primary aim of this prospective observational study was to examine the relations between postpartum Hb levels and QoL. For our secondary analyses, we examined the relations between postpartum Hb with maternal fatigue and depression.
Methods: After obtaining IRB approval and patient consent, we enrolled 60 patients admitted to a large obstetric center intending vaginal delivery. We assessed QoL, maternal fatigue, and depression on postpartum day 2, using the following validated survey instruments: the RAND 36-Item Short-Form Health Survey (SF-36), the Multidimensional Fatigue Inventory (MFI), and the Edinburgh Postnatal Depression Scale (EPDS). Maternal Hb levels were measured on postpartum day 2. We abstracted maternal obstetric/peripartum data from the medical records. Data are presented as mean (SD), median [IQR], and n (%). We performed unadjusted and multivariate linear regression (adjusting for age, parity, mode of delivery, and race) to assess the associations between post-delivery Hb and each subscale of the SF-36 and MFI. Using EPDS, Hb levels were determined for women with vs. without depression. P<0.01 as statistically significant.
Results: Within our cohort, 53 women (88.3%) had vaginal delivery and 7 (11.7%) had cesarean delivery. The race distribution was: 39.4% Hispanic, 26.2% Asian, 24.6% Caucasian, and 9.8% Other. The mean postpartum Hb level was 10.8 (1.4) g/dl. We observed no statistically significant associations between postpartum Hb level with each SF-36 QoL subscale (Table). Additionally, postpartum Hb was not independently associated with any of the five MFI subscales. Using the EPDS, Hb levels were similar among women with vs. without postpartum depression (11 [9.7-11.5] g/dl vs. 11.5 [11.2-13.7 g.dl; P=0.05).
Conclusion: Our findings suggest that postpartum Hb levels may not influence health-related QoL, fatigue or the likelihood of postpartum depression. This may be explained by the fact that the degree of postpartum anemia in our cohort was not severe. Future studies are needed to determine whether postpartum Hb influences QoL among women with moderate-severe anemia (Hb less than 8 g/dl).
Reference: (1) Womens Health Issues 2008; 18: 267-80.