RESUMO
Hemoglobin levels are commonly assessed to prevent causing or worsening of anemia in prospective blood donors. We compared head-to-head the accuracy of different technologies for measuring hemoglobin suitable for use in mobile donation units. We included 144 persons donating platelets at the Central Institute for Blood Transfusion and Immunology in Innsbruck, Austria. Hemoglobin levels were measured in venous blood using the portable hemoglobinometer HemoCue Hb-801 and noninvasively using OrSense NBM-200, and compared to values obtained with the Sysmex XN-430, an automated hematology analyzer employing the sodium lauryl sulphate method, which is broadly used as reference method in everyday clinical practice. Mean age of participants was 34.2 years (SD 13.0); 34.0% were female. Hemoglobin values measured with HemoCue were more strongly correlated with the Sysmex XN-430 (r = 0.90 [95% CI: 0.87-0.93]) than measured with OrSense (r = 0.49 [0.35-0.60]). On average, HemoCue overestimated hemoglobin by 0.40 g/dL (0.31-0.48) and OrSense by 0.75 g/dL (95% CI: 0.54-0.96). When using OrSense, we found evidence for higher overestimation at higher hemoglobin levels (proportional bias) specifically in females but not in males (Pdifference = .003). Sensitivity and specificity for classifying donors according to the hemoglobin donation thresholds were 99.2% (95% CI: 95.3%-100.0%) and 43.8% (23.1%-66.8%) for HemoCue vs 95.3% (89.9%-98.0%) and 12.5% (2.2%-37.3%) for OrSense. Areas under the receiver operating characteristic curves were higher using HemoCue vs OrSense both in females (0.933 vs 0.547; P = .044) and males (0.948 vs 0.628; P < .001). HemoCue Hb-801 measures hemoglobin more accurately than OrSense NBM-200 in the setting of mobile blood donation units. Our findings are particularly relevant for females, having in mind that anemia is more prevalent in females than in males.
Assuntos
Doadores de Sangue , Hemoglobinas , Humanos , Feminino , Doadores de Sangue/estatística & dados numéricos , Masculino , Hemoglobinas/análise , Adulto , Pessoa de Meia-Idade , Hemoglobinometria/métodos , Hemoglobinometria/instrumentação , Hemoglobinometria/normas , Anemia/sangue , Anemia/diagnóstico , Adulto Jovem , ÁustriaRESUMO
BACKGROUND: Although maternal hemoglobin levels during pregnancy are commonly associated with perinatal outcomes, their link to childhood neurodevelopment remains uncertain. OBJECTIVE: This study aimed to examine the associations between maternal hemoglobin in early and late pregnancy and the educational attainment of offspring mid-childhood in a high-resource obstetric setting. STUDY DESIGN: Pregnancy data from a prospective birth cohort (Pregnancy Outcome Prediction Study, Cambridge, United Kingdom, 2008-2012, N=3285) were linked to mid-childhood educational outcomes (Department for Education, United Kingdom). Regression models adjusted for maternal, child, and socioeconomic factors were used to determine associations between maternal hemoglobin, pregnancy complications, and offspring educational outcomes (aged 5-7 years). RESULTS: No association was observed between maternal hemoglobin at 12 weeks and the likelihood of either adverse pregnancy outcomes or children meeting expected educational standards between ages 5-7 years. Higher maternal hemoglobin at 28 weeks was associated with an increased risk of small-for-gestational-age infants (adjusted odds ratio, 1.26 [95% confidence interval, 1.11-1.59]; P=.002) and preterm birth (adjusted odds ratio, 1.38 [95% confidence interval, 1.11-1.81]; P=.005). There were no adverse birth outcomes associated with anemia. However, children of mothers who were anemic at 28 weeks had â¼40% increased risk of not attaining expected educational standards at age 5 (adjusted odds ratio, 1.42 [95% confidence interval, 1.03-1.95]; P=.03). There was no association between maternal anemia at 28 weeks and educational performance at ages 6-7. No associations were found between high maternal hemoglobin concentrations (top decile) or change in hemoglobin concentrations between 12 and 28 weeks and childhood educational attainment. CONCLUSION: Maternal anemia at 28 weeks of pregnancy is associated with reduced educational attainment at 5 years old but not at older ages (6-7 years old). A proactive approach to increasing maternal hemoglobin in high-resource settings is unlikely to impact long-term childhood educational attainment.
Assuntos
Escolaridade , Hemoglobinas , Humanos , Feminino , Gravidez , Hemoglobinas/análise , Hemoglobinas/metabolismo , Estudos Prospectivos , Criança , Pré-Escolar , Adulto , Reino Unido/epidemiologia , Masculino , Resultado da Gravidez/epidemiologia , Estudos de Coortes , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/sangue , Complicações na Gravidez/diagnóstico , Anemia/epidemiologia , Anemia/sangue , Anemia/diagnóstico , Nascimento Prematuro/epidemiologiaRESUMO
O objetivo deste estudo foi descrever a prevalência de anemia e avaliar a associação de nível de hemoglobina (Hb) com indicadores do estado nutricional e uso de serviços de saúde em uma população idosa (≥ 60 anos). Dos 1.742 idosos participantes da linha de base da coorte de Bambuí, Minas Gerais, Brasil, foram incluídos 1.441 (82,7%). A variável dependente foi o nível de Hb e as independentes foram número de hospitalizações e visitas ao médico nos 12 meses precedentes à entrevista, índice de massa corporal (IMC) e albumina sérica. Foi realizada regressão linear multivariada estratificada por sexo e ajustada por fatores de confusão. A prevalência de anemia foi baixa na população (4,5%), sem diferenças entre sexos e significativamente maior em idosos mais velhos (10,2%). Baixos níveis de Hb foram associados ao maior número de consultas médicas e a menores valores de albumina sérica e IMC em ambos os sexos. O estudo sugere um ciclo complexo entre baixos níveis de Hb, desnutrição e atendimento médico, o que deve ser considerado na estruturação de programas de saúde para idosos.
This study aimed to describe the prevalence of anemia and to evaluate the association between hemoglobin (Hb) level and indicators of nutritional status and health services utilization in an elderly population (≥ 60 years). Of the 1,742 older adults in the baseline of the Bambuí cohort, 1,441 (82.7%) were included. The dependent variable was Hb level, and the independent variables were number of hospitalizations and physician visits in the previous 12 months, body mass index (BMI), and serum albumin. Multivariate linear regression was performed, stratified by gender and adjusted for confounding factors. Prevalence of anemia was low (4.5%), with no difference by gender, and higher in the oldest old (10.2%). Low Hb level was associated with more physician visits and lower serum albumin and BMI in both men and women, suggesting a complex cycle between low Hb level, malnutrition, and medical care that should be considered when structuring health programs for the elderly.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anemia/epidemiologia , Saúde do Idoso , Serviços de Saúde para Idosos , Hemoglobina A/análise , Estado Nutricional , Albumina Sérica/análise , Fatores Etários , Anemia/sangue , Anemia/diagnóstico , Índice de Massa Corporal , Biomarcadores/sangue , Brasil/epidemiologia , Estudos de Coortes , Acessibilidade aos Serviços de Saúde , Prevalência , Fatores SocioeconômicosRESUMO
Objetivo. Explorar las correlaciones de niveles de hemoglobina (HB) y variables poblacionales en 940 embarazadas. Sitio. En dos hospitales y cuatro laboratorios de práctica privada de la ciudad de León (1800 m sobre el nivel del mar). Material y métodos. Se obtuvo información demográfica, obstétrica, nutricional y socioeconómica junto como muestras de sangre para citología y suero para parámetros de hierro. Las embarazadas tenían una gestación promedio de 25 semanas (rango 4 a 40) y 65 por ciento eran multíparas con paridad media de 2.1. Tenían indicadores sociales, nutricionales y de lapso intergenésico relativamente altos. Las asociaciones de HB con las variables se exploraron con un MANOVA por pasos sucesivos. Resultados. El 37 por ciento de las mujeres fue considerada anémica por tener HB<12 g/dL (más o menos equivalente a 11 a nivel de mar). El MANOVA (excluyendo deficiencia de hierro) mostró asociaciones de HB con gestación (p<0.001) y paridad (p=0.024). La deficiencia de hierro estuvo presente en 76 por ciento de las anémicas (136/180) y 31 por ciento de las no-anémicas (97/310). Las mediciones de folato y vitamina B12 en las mujeres con anemia sin deficiencia de hierro mostró deficiencia de folato o B12 en 14/43 dejando 29 mujeres con anemia de etiología desconocida. Conclusiones. 1. La edad gestacional fue el factor más fuertemente asociado a anemia y deficiencia de hierro en nuestra población. 2. Se observaron anemia y deficiencia de hierro, en 37 por ciento (N=180) y 48 por ciento (N=233) de las mujeres respectivamente. 3. De las 180 anémicas, 76 por ciento (N=136) eran deficientes en hierro pero soló 14/43 (33 por ciento) de las anémicas sin deficiencia de hierro eran deficientes en folatos o B12 dejando así 6 por ciento (29/490) con anemia de etiología desconocida. 4. Las prvalencia de anemia y deficiencia de hierro eran deficientes de folatos o B12 dejando así 6 por ciento (29/490) con anemia de etiología desconocida. 4. Las prevalencia de anemia y deficiencia de hierro fueron altas en nuestra población pese a poseer una sociodemografía y nutrición relativamente buenas