Cohen J H, Haas J D
Cornell University, Division of Nutritional Sciences, Ithaca, New York, USA.
Rev Panam Salud Publica. 1999 Dec;6(6):392-9. doi: 10.1590/s1020-49891999001100004.
This study had two primary objectives: 1) to derive a method to determine hemoglobin cutoffs that could be used to better estimate the prevalence of iron deficiency anemia in pregnancy at high altitudes and 2) to estimate the prevalence of anemia in a sample of pregnant women residing in two cities in Bolivia, La Paz (3,600 meters) and El Alto (4,000 meters). We derived a hemoglobin-altitude curve from previously published data on the mean hemoglobin concentrations of nonanemic women of childbearing age at various altitudes. In addition, we abstracted data on hemoglobin concentration during pregnancy from medical records of women from La Paz and El Alto who had given birth at a maternity hospital in La Paz between January and June of 1996. Using our approach and two other previously published, currently used methods, we calculated and compared prevalences of iron deficiency anemia in this population using hemoglobin cutoffs determined from a hemoglobin-altitude curve corrected for pregnancy. The hemoglobin-altitude curve derived in this study provided a better fit to data for women of childbearing age than the two other models. Those models used cutoffs based on non-iron-replete populations of children or men, both of which were residing below 4,000 m, and then extrapolated to women and higher altitudes. The estimated prevalences of iron deficiency anemia in pregnancy using the hemoglobin cutoffs determined in this study were higher than those estimated by the two other approaches.
1）得出一种确定血红蛋白临界值的方法，该方法可用于更好地估计高海拔地区妊娠期缺铁性贫血的患病率；2）估计居住在玻利维亚两个城市（拉巴斯，海拔3600米；埃尔阿尔托，海拔4000米）的孕妇样本中的贫血患病率。我们根据先前发表的关于不同海拔地区非贫血育龄妇女平均血红蛋白浓度的数据得出了一条血红蛋白-海拔曲线。此外，我们从1996年1月至6月在拉巴斯一家妇产医院分娩的拉巴斯和埃尔阿尔托妇女的病历中提取了孕期血红蛋白浓度数据。使用我们的方法以及另外两种先前发表的、目前使用的方法，我们使用根据校正了孕期因素的血红蛋白-海拔曲线确定的血红蛋白临界值，计算并比较了该人群中缺铁性贫血的患病率。本研究得出的血红蛋白-海拔曲线比另外两种模型更符合育龄妇女的数据。那两种模型使用的临界值是基于居住在海拔4000米以下的非铁充足儿童或男性人群，然后外推到女性和更高海拔地区。使用本研究确定的血红蛋白临界值估计的妊娠期缺铁性贫血患病率高于另外两种方法估计的患病率。
