Associations of anaemia and race with peripartum transfusion in three United States datasets
Associations of anaemia and race with peripartum transfusion in three United States datasets
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DOI：
10.2450/2021.0217-21
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发表时间：
2022-09-01
影响因子：
3.7
通讯作者：
Ahmadzia, Homa
中科院分区：
文献类型：
--
作者：
Davis, Elisabeth;Amdur, Richard;Ahmadzia, Homa
背景-在美国，输血使相当大比例的分娩复杂化，黑人妇女在分娩时输血的流行率高于白色妇女。产前贫血是围产期输血的一个危险因素，在黑人妇女中比白色妇女更常见。我们的目的是描述种族分布的产前贫血在三个国家的数据集，并评估围产期输血率和特点的输血受体，调查差异止血outcome.Material和方法-我们进行了回顾性分析尤尼斯肯尼迪施莱佛国家研究所儿童健康和人类发展（NICHD）的母胎医学单位网络剖腹产登记（CR），NICHD安全劳动登记联盟（CSL）和一组在全民健康服务医院（UHS）分娩的患者。计算种族、贫血和输血之间的单变量关联和多变量logistic回归。协变量包括年龄，产次，吸烟，体重指数，保险类型，和交付mode.Results -我们包括n=56,964交付CR（28%黑人），87,465从UHS（12%黑人），和140,324从CSL（24%黑人）。贫血患病率在CR中为8%，在UHS中为7%，在CSL中为13%。贫血在黑人患者中更常见（OR分别为2.52、2.61和1.48），在所有数据库中均与输血相关（OR分别为6.46 [95% CI 5.78-7.22]; 5.79 [4.74-7.27]; 1.27 [1.18-1.37]）。在调整协变量后，黑人患者在CR中的输血几率高于非黑人患者（aOR 1.32 [1.16-1.50]），但在UHS或CSL中不存在（aOR分别为1.19 [0.89-1.59]和0.40 [0.36-0.44]）。讨论-在我们使用三个美国登记中心的回顾性队列研究中，我们强调了贫血与输血之间的联系。虽然贫血在黑人患者中更普遍，但种族-输血关系在数据库之间存在差异，表明涉及其他未探索的因素。
Background - Transfusion complicates a significant proportion of births in the United States, and Black women have greater prevalence of transfusion at delivery than White women. Antepartum anaemia, a risk factor for peripartum transfusion, is more common among Black women than White women. We aimed to describe the racial distribution of antepartum anaemia in three national datasets and to evaluate the peripartum transfusion rate and characteristics of transfusion recipients, to investigate disparities in haemostatic outcomes.Material and methods - We performed a retrospective analysis of Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network Cesarean Registry (CR), NICHD Consortium on Safe Labor Registry (CSL), and a cohort of deliveries at Universal Health Services hospitals (UHS). Univariable associations and multivariable logistic regressions were calculated between race, anaemia and transfusion. Covariates included age, parity, smoking, body mass index, type of insurance, and delivery mode.Results - We included n=56,964 deliveries from CR (28% Black), 87,465 from UHS (12% Black), and 140,324 from CSL (24% Black). Anaemia prevalence was 8% in CR, 7% in UHS, and 13% in CSL. Anaemia was more common among Black patients (ORs 2.52, 2.61, and 1.48 respectively) and was associated with transfusion in all databases (ORs 6.46 [95% CI 5.78-7.22]; 5.79 [4.74-7.27]; 1.27 [1.18-1.37] respectively). After adjusting for covariates, Black patients had greater odds of transfusion than non-Black patients in CR (aOR 1.32 [1.16-1.50]), but not in UHS or CSL (aORs 1.19 [0.89-1.59] and 0.40 [0.36-0.44] respectively).Discussion - In our retrospective cohort study using three US registries, we emphasized the link between anaemia and transfusion. Although anaemia was more prevalent among Black patients, the race-transfusion relationship differed between databases, indicating other unexplored factors are involved.