{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:32:42Z","timestamp":1792099962975,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"am","delay-in-days":366,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T00:00:00Z","timestamp":1566864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["120100069"],"award-info":[{"award-number":["120100069"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>This study aimed to describe how haemoglobin trajectories in pregnant Australian women were associated with subsequent postpartum haemorrhage, blood transfusion and other outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>The study was conducted in two tertiary public hospitals in Australia, using routinely collected maternity and hospital data on singleton pregnancies (2011\u20132015). Latent class growth modelling defined trajectories among those with at least one haemoglobin in each of three antenatal time periods (0\u201315, 16\u201330 and 31+\u00a0weeks; <jats:italic>n<\/jats:italic>\u00a0=\u00a07104). Observed over expected ratios were calculated after predicting expected outcomes with adjusted logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean minimum haemoglobin levels across the three periods were 127\u00b79, 116\u00b75 and 119\u00b73\u00a0g\/l. We identified seven groups of women with similar haemoglobin trajectories: five with parallel U\u2010shaped trajectories, one with increasing and one with decreasing trajectory. Thirty\u2010eight women (0.5%) had very low haemoglobin across the pregnancy and the highest adverse outcomes, including higher than expected blood transfusion risk. One hundred thirteen women (1.6%) with a progressively decreasing trajectory also had higher risk of transfusion. Women with high haemoglobin across the antenatal period had higher than expected risk of preterm birth, small for gestational age and infants transferred to higher care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Haemoglobin trajectories across pregnancy can predict women at higher risk of requiring transfusion around birth. Women who maintain high haemoglobins across the pregnancy are worthy of increased surveillance as they carry increased risks of newborn morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.12839","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T08:53:55Z","timestamp":1566896035000},"page":"842-852","source":"Crossref","is-referenced-by-count":13,"title":["Haemoglobin trajectories during pregnancy and associated outcomes using pooled maternity and hospitalization data from two tertiary hospitals"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-0227","authenticated-orcid":false,"given":"Deborah A.","family":"Randall","sequence":"first","affiliation":[{"name":"The University of Sydney Northern Clinical School Clinical and Population Perinatal Health Research St Leonards NSW Australia"},{"name":"Northern Sydney Local Health District Kolling Institute St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9888-9818","authenticated-orcid":false,"given":"Jillian A.","family":"Patterson","sequence":"additional","affiliation":[{"name":"The University of Sydney Northern Clinical School Clinical and Population Perinatal Health Research St Leonards NSW Australia"},{"name":"Northern Sydney Local Health District Kolling Institute St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Gallimore","sequence":"additional","affiliation":[{"name":"Health Informatics, Kolling Institute, Northern Clinical School Sydney Medical School St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Morris","sequence":"additional","affiliation":[{"name":"The University of Sydney Northern Clinical School Clinical and Population Perinatal Health Research St Leonards NSW Australia"},{"name":"Northern Sydney Local Health District Kolling Institute St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy M.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health The University of Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese M.","family":"McGee","sequence":"additional","affiliation":[{"name":"Women's and Newborn Health Westmead Hospital Westmead NSW Australia"},{"name":"The University of Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane B.","family":"Ford","sequence":"additional","affiliation":[{"name":"The University of Sydney Northern Clinical School Clinical and Population Perinatal Health Research St Leonards NSW Australia"},{"name":"Northern Sydney Local Health District Kolling Institute St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Obstetric Transfusion Steering Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/72.1.257S"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-006-0108-2"},{"key":"e_1_2_8_4_1","volume-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity","author":"World Health Organization","year":"2011"},{"key":"e_1_2_8_5_1","volume-title":"Patient Blood Management Guidelines: Module 5 \u2010 Obstetrics and Maternity","author":"National Blood Authority","year":"2015"},{"key":"e_1_2_8_6_1","unstructured":"Centers for Disease Control and Prevention.Recommendations to prevent and control iron deficiency in the United States Atlanta GA: CDC;1998[updated 3 April 1998; accessed 15 January]. 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