Placental abruption and neonatal anemia

Abstract OBJECTIVE Placental abruption can cause maternal blood loss and maternal anemia. It is less certain whether abruption can cause fetal blood loss and neonatal anemia. STUDY DESIGN: Retrospective multi-hospital 24-month analysis of women with placental abruption and their neonates. RESULTS Of 55 111 births, 678 (1.2%) had confirmed abruption; 83% of these neonates (564) had one or more hemoglobins recorded in the first 24 hours. Four-hundred-seventy-two (83.7%) had a normal hemoglobin (≥ 5th % reference interval) while 92 (16.3%) had anemia, relative risk 3.26 (95% CI, 2.66–4.01) vs. >360 000 neonates from previous reference interval reports. The relative risk of severe anemia (< 1st % interval) was 4.96 (3.44–7.16). When the obstetrician identified the abruption as “small” or “marginal” the risk of anemia was insignificant. CONCLUSIONS Most abruptions do not cause neonatal anemia but approximately 16% do. If an abruption is not documented as small, it is important to surveille the neonate for anemia.