Original article

Vol. 22 No. 1 (2024): Blood Transfusion 1-2024 (January-February)

Anemia, red blood cell transfusion and administration of blood products in obstetrics: a nationwide analysis of more than 6 million cases from 2011-2020

Authors

Key words: blood transfusion, anemia, blood products, obstetrics, red blood cell
Publication Date: 2023-09-15

Abstract

Background -The prevalence of anemia is high, especially in obstetrics. There is large evidence, that anemia during pregnancy is associated with increased maternal morbidity and mortality. Anemia and peripartum hemorrhage remain the main causes for transfusion of red blood cells (RBC). Patient Blood Management (PBM) reduces the need for RBC transfusion significantly. The present study retrospectively analyzed the impact and prevalence of anemia and RBC transfusion on pregnant women.

Materials and methods - Data were retrieved from the German Statistical Office on pregnant women who delivered in hospital between January 1st 2011 and December 31st 2020. The prevalence of anemia, peripartum hemorrhage, comorbidities, administration of blood products and complications were analyzed.

Results - A total of 6,356,046 pregnant women were analyzed of whom 78,257 (1.23%) received RBC transfusion (RBC transfusion group) and 6,277,789 (98.77%) did not receive RBC transfusion (non-RBC transfusion group). In all women analyzed anemia rate was 23.74%. The rates of anemia during pregnancy (70.39 vs 23.15%; p<0.0001), postpartum hemorrhage (41.42 vs 4.35%; p<0.0001), hospital length of stay (127.5 vs 87.08 hours; p<0.0001) and single complications were higher in women with RBC transfusion compared to women without RBC transfusion.

Discussion - The prevalence of anemia and the increased risk for RBC transfusion show that there is great potential for effective implementation of PBM in obstetrics. The treatment of anemia during pregnancy and reduction of RBC transfusions will decrease maternal morbidity and mortality.

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Authors

Jan Andreas Kloka - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0001-6890-3239

Benjamin Friedrichson - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0003-3790-281X

Thomas Jasny - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0009-0008-5845-6015

Oliver Old - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-3993-480X

Florian Piekarski - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-4095-3573

Kai Zacharowski - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-0212-9110

Vanessa Neef - Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany https://orcid.org/0000-0002-1793-2918

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