The impact of maternal anemia and vitamin D deficiency on neonatal outcomes: A retrospective study from a medical center in northern taiwan

OBJECTIVE: To investigate the impact of maternal anemia and vitamin D deficiency on neonatal outcomes, and to analyze the association between anemia subtypes and response to iron supplementation. MATERIALS AND METHODS: We enrolled women who delivered between 2018 and 2022 at Mackay Memorial Hospital, Taipei, Taiwan. Anemia was defined as hemoglobin <11.0 g/dL in the first and third trimesters, and <10.5 g/dL in the second trimester. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D < 20 ng/mL. Neonatal outcomes included preterm birth, low birth weight, Apgar scores <7, and neonatal hospitalization. RESULTS: Third-trimester anemia was significantly associated with lower 5-min Apgar score (p = 0.04) and higher risk of neonatal hospitalization (p = 0.03). Hb ≤ 10.0 g/dL in second trimester had significantly lower 5-min Apgar score. Combined second-trimester anemia and vitamin D deficiency significantly increased preterm birth risk (p = 0.003). Normocytic and microcytic anemia occurred frequently, with about 80% of iron-deficiency anemia cases responding to supplementation. CONCLUSION: Third-trimester anemia is significantly associated with adverse neonatal outcomes. Routine mid-trimester anemia screening incorporating MCV-based evaluation for furthermore survey and close monitoring of treatment efficacy is warranted to improve maternal and neonatal health. Routine vitamin D screening and close follow-up of supplementation may provide additional benefits in reducing the risk of preterm birth.