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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Medical/Surgical/Diseases/Complications

Poster Session 2

(654) Anemia and maternal-newborn dyadic birth outcomes: A Desirability of Outcome Ranking (DOOR) Analysis

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  
Objective:
To evaluate the association between maternal anemia and maternal-newborn dyadic outcomes using the desirability of outcome ranking (DOOR) methodology, which orders outcomes by clinical desirability.  

Study Design:
This retrospective cross-sectional study included all deliveries eligible for the Joint Commission’s PC-06 metric (term newborns without preexisting conditions) across seven hospitals in a New York health system (2019–2024). Only each patient’s first delivery was included. Anemia was categorized as none (Hb ≥11.0 g/dL), mild (10.0–10.9), or moderate-to-severe (< 10.0). Outcomes were classified into four DOOR categories: (1) uncomplicated vaginal delivery, (2) uncomplicated cesarean, (3) vaginal delivery with complications, and (4) cesarean with complications. Maternal and neonatal complications were defined by CDC severe maternal morbidity and PC-06 criteria. Multinomial logistic regression assessed associations between anemia and DOOR, adjusting for obstetric comorbidity index (OB-CMI) score, race and ethnicity, multiparity, insurance, and language.

Results:
A total of 105,156 deliveries were included. Birth outcomes by anemia severity are shown in the Figure; regression results are presented in the Table. Worsening anemia severity was strongly associated with less desirable outcomes. Compared to no anemia, mild anemia was associated with higher odds of vaginal delivery with complications (aOR 1.49; 95% CI, 1.34–1.65) and cesarean with complications (aOR 2.13; 95% CI, 1.93–2.34). Risks were greater for moderate-to-severe anemia: 3.49 times higher odds of vaginal delivery with complications (95% CI, 3.10–3.92) and 5.86 times higher odds of cesarean with complications (95% CI, 5.30–6.49). A dose-response pattern was observed across all categories.

Conclusion:
Maternal anemia is a strong, independent predictor of adverse maternal-newborn outcomes. Increasing severity is linked to significantly worse DOOR outcomes, underscoring the need for early detection and intervention.