Figure for lower end of range of maximal haemoglobin is too low

BMJ 1995;310:1601-1602 (17 June)

Letters

Figure for lower end of range of maximal haemoglobin is too low

EDITOR,--The U shaped curves of low birth weight and pretermdelivery by maternal haemoglobin concentration described byPhilip Steer and colleagues¹ were established by Garn et al.²The two groups agree about the decline in reproductive efficiencywhen maternal haemoglobin concentration is above about 140 g/l(or packed cell volume 0.41), observations which need to beknown by all obstetricians.

The two groups differ importantly, however, over what is thelower end of the range of maximal haemoglobin concentrationduring pregnancy. The curve of Garn et al showed reducing percentagesof favourable pregnancies when lowest maternal packed cell volumewas below 0.32 (haemoglobin concentration about 110 g/l) inwhite Americans or below 0.29 (haemoglobin concentration about100 g/l) in black Americans. In contrast, Steer and colleaguesreported a maximum mean birth weight and the lowest incidencesof low birth weight and preterm delivery in white women withthe lowest haemoglobin . . . [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]