Obstetric conditions and erythropoietin levels

OBJECTIVE: Our purpose was to evaluate and compare erythropoietin levels as related to obstetric conditions, including acute and chronic bleeding, preeclampsia and multiple gestations. STUDY DESIGN: During April 1999 all women in the labor and delivery unit with delivery expected to occur within 24 to 72 hours of admission had erythropoietin and hematocrit values obtained. First-trimester hematocrit values, obstetric problems, medications, and history of vaginal bleeding were obtained from patient interview, examination, and the prenatal record. Statistics were analyzed by the student t test and χ². RESULTS: During a 1-month period, 302 consecutive women were divided into 5 groups on the basis of obstetric events. Group 1 consisted of women with normal, uncomplicated term singleton gestations (n = 230); group 2, women with acute vaginal bleeding (n = 10); group 3, women with chronic vaginal bleeding (n = 29); group 4, women with multiple gestations (n = 13); and group 5, women with preeclampsia (n = 16). The mean erythropoietin level in group 1 (20.2 ± 10.3 mU/mL) was significantly different from values in the other 4 groups (group 2, 74.2 ± 29.2 mU/mL; group 3, 65.0 ± 33.0 mU/mL; group 4, 34.8 ± 16.8 mU/mL; group 5, 43.4 ± 11.4 mU/mL; P < .001). The admission hematocrit for group 1 (0.369 ± 0.029) was significantly greater than for groups 2 and 3 (group 2, 0.323 ± 0.024 group 3, 0.321 ± 0.023; P < .001) and significantly lower than for group 5 (0.384 ± 0.022; P < .05). CONCLUSION: The maternal serum erythropoietin level varies depending on the events occurring during gestation. Acute and chronic bleeding, multiple gestations, and preeclampsia are all associated with various serum erythropoietin levels.