Demographics, clinical characteristics and outcomes of neonates diagnosed with fetomaternal haemorrhage
- 1Division of Newborn Medicine, Departments of Pediatrics and Preventive Medicine, Mount Sinai School of Medicine, New York, USA
- 2Department of Pediatrics, Environmental Medicine and Health Policy, New York University, New York, USA
- Correspondence to Annemarie Stroustrup, Division of Newborn Medicine, Department of Pediatrics, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1508, New York, NY 10029, USA;
Contributors Both authors have made substantive intellectual contributions to the study conception and design, acquisition of data, and analysis and interpretation of data. Each contributed to the drafting of the article and revising it critically for important intellectual content and has given final approval of the version to be published. Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content.
- Received 17 August 2011
- Accepted 2 January 2012
- Published Online First 28 February 2012
Objective To determine clinical characteristics, demographics and short-term outcomes of neonates diagnosed with fetomaternal haemorrhage (FMH).
Design The authors analysed the Nationwide Inpatient Sample, 1993 to 2008. Singleton births diagnosed with FMH were identified by International Classification of Diseases (ICD-9) code 762.3. Descriptive, univariate and multivariable regression analyses were performed to determine the national annual incidence of FMH over time as well as demographics and clinical characteristics of neonates with FMH.
Results FMH was identified in 12 116 singleton births. Newborns with FMH required high intensity of care: 26.3% received mechanical ventilation, 22.4% received blood product transfusion and 27.8% underwent central line placement. Preterm birth (OR 3.7), placental abruption (OR 9.8) and umbilical cord anomaly (OR 11.4) were risk factors for FMH. Higher patient income was associated with increased likelihood of FMH diagnosis (OR 1.2), and Whites were more likely to be diagnosed than ethnic minorities (OR 1.9). There was reduced frequency of diagnosis in the Southern USA (OR 0.8 vs the Northeastern USA).
Conclusions Diagnosis of FMH is associated with significant morbidity as well as regional, socioeconomic and racial disparity. Further study is needed to distinguish between diagnostic coding bias and true epidemiology of the disease. This is the first report of socioeconomic and racial/ethnic disparities in FMH, which may represent disparities in detection that require national attention.
Funding National Institutes of Health.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.