Letters

Maternal haemoglobin and birth weight in different ethnic groups

EDITOR,--We have three comments on the methods used by Philip Steer and colleagues in their study of the relation between maternal haemoglobin concentration and birth weight.¹

Firstly, Steer and colleagues repeatedly refer to the fall in haemoglobin concentration. This implies comparison of two values. They use only the lowest haemoglobin concentration and are therefore relating birth weight to minimum haemoglobin concentration and not to the fall in haemoglobin concentration.

Secondly, they base their analysis on the lowest haemoglobin concentration during the pregnancy without taking into account the gestation at which haemoglobin concentration was estimated. Surprisingly, they do this despite emphasising the importance of the relation between gestation, expansion of plasma volume, and haemoglobin concentration.

Thirdly, they take no account of multiple pregnancies, in which low birth weight and premature labour are often seen in conjunction with low haemoglobin concentrations. Multiple pregnancies should have been . . . [Full text of this article]

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Relevant Article

Relation between maternal haemoglobin concentration and birth weight in different ethnic groups

Philip Steer, M Ash Alam, Jane Wadsworth, and Anne Welch
BMJ 1995 310: 489-491. [Abstract] [Full Text]

This article has been cited by other articles:

• Godfrey, K, Robinson, S, Barker, D., Osmond, C, Cox, V (1996). Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. BMJ 312: 410-410 [Abstract] [Full text]