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Tian J, Fan Y, Wei X, Li J, Yang Z, Na X, Zhang Y. Hospitalization of patients with nutritional anemia in the United States in 2020. Front Public Health 2024; 12:1333069. [PMID: 38803814 PMCID: PMC11128583 DOI: 10.3389/fpubh.2024.1333069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/04/2024] [Indexed: 05/29/2024] Open
Abstract
Background Nutritional anemia is highly prevalent and has triggered a globally recognized public health concern worldwide. Objective To better understand the prevalence of anemia and the state of nutritional health in developed countries to inform global nutritional health and better manage the disease. Method We employed the Healthcare Cost and Utilization Project (HCUP)-2020 National Inpatient Health Care Data (NIS), administered by The Agency for Healthcare Research and Quality. Nutritional anemia was diagnosed according to the International Classification of Diseases, 10th Revision (ICD-10). Matching analysis and multivariate regression were used to adjust for patient and hospital characteristics. Controls were obtained by stratifying and matching for age and sex. Results The 2020 HCUP-NIS database encompassed a survey over 6.4 million hospitalized patients, among which 1,745,350 patients diagnosed with anemia, representing approximately 26.97% of the hospitalized population, over 310,000 were diagnosed with nutritional anemia, and 13,150 patients were hospitalized for nutritional anemia as primary diagnosis. Hospitalization rate for nutritional anemia exhibited an increased age-dependent increase nationwide, especially among females, who displayed 1.87 times higher than males. Notably, in comparison to the control group, individuals of the Black race exhibit a higher prevalence of nutritional anemia (case group: 21.7%, control group: 13.0%, p < 0.001). In addition, hospitalization rates were higher among low-income populations, with lower rates of private insurance (case group: 18.7%, control group: 23.5%, p < 0.001) and higher rates of Medicaid insurance (case group: 15.4%, control group: 13.9%, p < 0.001). In areas characterized by larger urban centers and advanced economic conditions within the urban-rural distribution, there was an observed increase in the frequency of patient hospitalizations. Iron deficiency anemia emerged as the predominant subtype of nutritional anemia, accounting for 12,214 (92.88%). Secondary diagnosis among patients hospitalized for nutritional anemia revealed that a significant number faced concurrent major conditions like hypertension and renal failure. Conclusion In economically prosperous areas, greater attention should be given to the health of low-income individuals and the older adult. Our findings hold valuable insights for shaping targeted public health policies to effectively address the prevalence and consequences of nutritional anemia based on a overall population health.
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Affiliation(s)
| | | | | | | | | | | | - Yunbo Zhang
- Department of Environmental Hygiene, Public Health College, Harbin Medical University, Harbin, Heilongjiang, China
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Bruce KE, Busse CE, Tully KP, Patterson ES, Stuebe AM. Hemoglobin on Admission for Childbirth and Postpartum Acute Care Use in a Southeastern Health Care System. Am J Perinatol 2024; 41:e3313-e3318. [PMID: 38057086 DOI: 10.1055/a-2223-6292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Our objective was to evaluate whether hemoglobin on admission for childbirth is associated with postpartum acute care use (ACU). STUDY DESIGN We conducted a retrospective cohort study of patients giving birth at a southeastern quaternary care hospital from January 2018 through June 2021 using electronic health records. Predelivery hemoglobin was categorized as <9, 9- < 10, 10- < 11, 11- < 12, and ≥12 g/dL. Acute care was defined as a visit to obstetric triage, the emergency department, or inpatient admission within 90 days postpartum. Generalized estimating equations quantified the crude and multivariable-adjusted association between predelivery hemoglobin and ACU. RESULTS Among 8,677 pregnancies, 1,467 (17%) used acute care in the system within 90 days postpartum. In unadjusted models, those with predelivery hemoglobin <9 had twice the risk of postpartum ACU compared to those with hemoglobin ≥12 (95% confidence interval [CI]: 1.59-2.69), with a decrease in risk for each increase in hemoglobin category (9- < 10 g/dL: risk ratio [RR]: 1.47, CI: 1.21-1.79; 10- < 11 g/dL: RR: 1.44, CI: 1.26-1.64; 11- < 12 g/dL: RR: 1.20, CI: 1.07-1.34). The adjusted model showed a similar trend with smaller effect estimates (<9 g/dL: RR: 1.50, CI: 1.14-1.98; 9- < 10 g/dL: RR: 1.22, CI: 1.00-1.48; 10- < 11 g/dL: RR: 1.22, CI: 1.07-1.40; 11- < 12 g/dL: RR: 1.09, CI: 0.98-1.22). CONCLUSION Low hemoglobin at childbirth admission was associated with increased postpartum ACU. Low hemoglobin on admission could signal to providers that additional follow-up, resources, and ongoing support are warranted to identify and address underlying health needs. Because hemoglobin is routinely assessed during the childbirth hospitalization, this indicator may be especially valuable for risk assessment among patients with limited prior engagement in health care. KEY POINTS · Low hemoglobin on admission for birth is associated with postpartum acute care use.. · Hemoglobin on admission may aid in risk-stratification during childbirth hospitalization.. · Point-of-care metrics may help identify high-risk patients with limited preventive health care..
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Affiliation(s)
- Katharine E Bruce
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Clara E Busse
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristin P Tully
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Emily S Patterson
- Division of Health Information Management and Systems, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
| | - Alison M Stuebe
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Habe S, Haruna M, Yonezawa K, Usui Y, Sasaki S, Nagamatsu T, Fujita M, Suetsugu Y, Ohori R, Tanaka M, Aoyama S. Factors Associated with Anemia and Iron Deficiency during Pregnancy: A Prospective Observational Study in Japan. Nutrients 2024; 16:418. [PMID: 38337702 PMCID: PMC10857081 DOI: 10.3390/nu16030418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Gestational anemia (GA) is a global health concern with a remarkably high prevalence in Japan, which is associated with various maternal and neonatal outcomes. This study aimed to explore whether GA and non-anemic iron deficiency (NAID) during the third trimester is associated with maternal characteristics, nutrient intake, low birth weight (LBW), and preterm birth. Participants were categorized into GA, NAID, and normal groups, based on serum ferritin and hemoglobin levels. Nutrient intake was assessed using the Brief Diet History Questionnaire. Data from 317 pregnant women were analyzed, including 110 (34.7%), 151 (47.6%), and 56 (17.6%) women in the GA, NAID, and normal groups, respectively. Factors associated with GA included being multipara (p < 0.001) and not taking any type of iron supplements in the third trimester (p = 0.043). The normal group had a significantly higher proportion of preterm birth and LBW than the GA and NAID groups. The GA group had a significantly higher energy intake than the normal group (p = 0.044). Overall, energy and micronutrient intake were significantly below the estimated average requirement in the dietary reference intakes for Japanese. Health care professionals need to consider nutritional advice that can prevent GA by focusing on overall micronutrients, not just energy intake.
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Affiliation(s)
- Sarasa Habe
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
| | - Megumi Haruna
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Kaori Yonezawa
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Yuriko Usui
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Takeshi Nagamatsu
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Health and Welfare, Chiba 286-8520, Japan;
| | - Megumi Fujita
- Department of Clinical Nursing, Graduate School of Medical Science, Yamagata University, Yamagata 990-9585, Japan;
| | - Yoshiko Suetsugu
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Riko Ohori
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Moeko Tanaka
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
| | - Satoko Aoyama
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (S.H.); (K.Y.); (Y.U.); (R.O.); (M.T.); (S.A.)
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Febriza A, Idrus HH. The Effects of Fresh Moringa Leaf Consumption During Pregnancy on Maternal Hemoglobin Level in Southern Ethiopia: Multilevel Analysis of a Comparative Cross-Sectional Study [LETTER]. Int J Womens Health 2023; 15:1959-1960. [PMID: 38115891 PMCID: PMC10729830 DOI: 10.2147/ijwh.s437623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- Ami Febriza
- Department of Physiology, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Makassar, Makassar, Indonesia
- Centre for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Centre, Cibinong – Bogor, West Java, Indonesia
| | - Hasta Handayani Idrus
- Centre for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Centre, Cibinong – Bogor, West Java, Indonesia
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Xie G, Wang R, Zhang B, Sun L, Xiang W, Xu M, Zhu S, Guo L, Xu X, Yang W. Non-linear connections between maternal hemoglobin during the third trimester of pregnancy and birth weight outcomes in full-term newborns: Estimating the breakpoints. Front Nutr 2022; 9:1031781. [PMID: 36618680 PMCID: PMC9815559 DOI: 10.3389/fnut.2022.1031781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Anemia is still an unfinished global health problem, and adverse birth weight outcomes have everlasting influences on the health of later life. However, the non-linear connections and breakpoints of maternal hemoglobin with birth weight outcomes are still needed to be further elucidated. We aimed to reveal the non-linear connections between maternal hemoglobin during the third trimester of pregnancy and birth weight, low birth weight (LBW), macrosomia, small for gestational age (SGA), and large for gestational age (LGA) in full-term newborns and elucidate the breakpoints of the connections. Methods A total of 11,411 singletons, full-term, and live newborns, whose mothers conducted the examination of hemoglobin concentration before delivery, were included in this study. A generalized additive model was used to identify and visualize the non-linear connections between maternal hemoglobin and birth weight outcomes. Piecewise linear regression model was adopted to estimate the breakpoints of the connections and report the non-linear connections in detail. Results There were inverted "U"-shaped exposure-response connections between maternal hemoglobin concentration and birth weight and the risk of macrosomia. There was an increasing trend of the risk of LBW and a decreased trend of LGA with the increase in maternal hemoglobin concentration. The breakpoints of maternal hemoglobin for birth weight were 100 and 138 g/L, and those for SGA were 97 and 138 g/L. The breakpoints of maternal hemoglobin were 119 g/L for LBW, 105 g/L for macrosomia, and 106 g/L for LGA. When maternal hemoglobin concentration ranged from 100 to 138 g/L, maternal hemoglobin concentration increased per 1 g/L, and birth weight significantly decreased by 2.58 g (95% CI: -3.33, -1.83). When maternal hemoglobin concentration ranged from 97 to 138 g/L, maternal hemoglobin concentration increased per 1 g/L, and the risk of SGA significantly increased by 2% (95% CI: 1%, 3%). When maternal hemoglobin concentration was equal to or lower than 119 g/L, maternal hemoglobin concentration increased per 1 g/L, and the risk of LBW significantly increased by 3% (95% CI: 0%, 5%). When maternal hemoglobin concentration was higher than the breakpoints, the risks of macrosomia (OR = 0.99, 95% CI: 0.98, 0.99) and LGA (OR = 0.99, 95% CI: 0.98, 1.00) declined as the increase of maternal hemoglobin concentration. Conclusions There were non-linear connections between maternal hemoglobin and birth weight outcomes, and there are breakpoints in the connections. Cost-effective interventions targeting pregnant women in the prevention of abnormal maternal hemoglobin concentration should be taken to reduce the incidence of adverse birth weight outcomes.
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Affiliation(s)
- Guilan Xie
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Ruiqi Wang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Landi Sun
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Wanwan Xiang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Mengmeng Xu
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Sijing Zhu
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Leqian Guo
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xu Xu
- National Medical Center Office, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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