Andreas S Rigas1, Ole B Pedersen2, Erik Sørensen1, Lise W Thørner1, Margit H Larsen1, Louis M Katz3, Kaspar Nielsen4, Kjell Titlestad5, Gustaf Edgren6,7, Klaus Rostgaard8, Christian Erikstrup9, Henrik Hjalgrim8,10, Henrik Ullum1. 1. Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark. 2. Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark. 3. America's Blood Centers, Washington, DC, Washington, DC. 4. Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark. 5. Department of Clinical Immunology, Odense University Hospital, Odense, Denmark. 6. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 7. Department of Cardiology, Södersjukhuset, Stockholm, Sweden. 8. Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. 9. Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark. 10. Department of Haematology, Copenhagen University Hospital, Copenhagen, Denmark.
Abstract
BACKGROUND: The prevalence of iron depletion is high among premenopausal women who donate blood frequently. Studies in nondonor populations indicate that iron deficiency anemia is associated with an increased risk of low birth weight. This prompts concerns that iron deficiency induced by frequent blood donation might impair subsequent fetal development. STUDY DESIGN AND METHODS: The aim of this study was to assess whether prepregnancy donation intensity affects the birth weight of singletons born at term (gestational week 38 or later) to nulliparous female donors in Denmark. We identified 293,897 first live singleton births to Danish women between 1997 and 2012 with complete information on gestational age, birth weight, child sex, parental age, maternal smoking status during pregnancy, and parental education length and annual income. Linear regression analysis was applied, with birth weight as outcome, number of donations within the 3 years before pregnancy as the explanatory variable, and confounding variables as described. RESULTS: Birth weight among children of low-intensity donors (n = 22,120) was 12.6 g (95% confidence interval, 6.7-18.6) higher than nondonors (n = 268,253) after controlling for the above-mentioned factors. The higher birth weight among low-intensity donors can be explained by the healthy donor effect. In fully adjusted analyses, birth weight among children of high-intensity donors (n = 3,524) was 20.2 g (95% confidence interval, 5.1-35.3 g) lower compared with low-intensity donors. This reduced birth weight among high-intensity donors compared to low-intensity donors may reflect blood donation-induced iron deficiency. CONCLUSIONS: Our results show that high prepregnancy donation intensity is inversely associated with birth weight of singletons born at term to nulliparous women.
BACKGROUND: The prevalence of iron depletion is high among premenopausal women who donate blood frequently. Studies in nondonor populations indicate that iron deficiency anemia is associated with an increased risk of low birth weight. This prompts concerns that iron deficiency induced by frequent blood donation might impair subsequent fetal development. STUDY DESIGN AND METHODS: The aim of this study was to assess whether prepregnancy donation intensity affects the birth weight of singletons born at term (gestational week 38 or later) to nulliparous female donors in Denmark. We identified 293,897 first live singleton births to Danish women between 1997 and 2012 with complete information on gestational age, birth weight, child sex, parental age, maternal smoking status during pregnancy, and parental education length and annual income. Linear regression analysis was applied, with birth weight as outcome, number of donations within the 3 years before pregnancy as the explanatory variable, and confounding variables as described. RESULTS: Birth weight among children of low-intensity donors (n = 22,120) was 12.6 g (95% confidence interval, 6.7-18.6) higher than nondonors (n = 268,253) after controlling for the above-mentioned factors. The higher birth weight among low-intensity donors can be explained by the healthy donor effect. In fully adjusted analyses, birth weight among children of high-intensity donors (n = 3,524) was 20.2 g (95% confidence interval, 5.1-35.3 g) lower compared with low-intensity donors. This reduced birth weight among high-intensity donors compared to low-intensity donors may reflect blood donation-induced iron deficiency. CONCLUSIONS: Our results show that high prepregnancy donation intensity is inversely associated with birth weight of singletons born at term to nulliparous women.
Authors: Thomas Folkmann Hansen; Karina Banasik; Christian Erikstrup; Ole Birger Pedersen; David Westergaard; Piotr Jaroslaw Chmura; Kaspar Nielsen; Lise Thørner; Henrik Hjalgrim; Helene Paarup; Margit Anita Hørup Larsen; Mikkel Petersen; Poul Jennum; Steffen Andersen; Mette Nyegaard; Gregor Borut Ernst Jemec; Jes Olesen; Thomas Werge; Pär I Johansson; Erik Sørensen; Søren Brunak; Henrik Ullum; Kristoffer Sølvsten Burgdorf Journal: BMJ Open Date: 2019-06-09 Impact factor: 2.692