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缺铁性贫血对胎盘及出生体重的影响

[Effects of iron-deficiency anemia on placenta and birth weight].

作者信息

Levario-Carrillo Margarita, Hernández Margarito, Vásquez María Eugenia, Chávez Dora, Sánchez Celina, Corral Martha

机构信息

Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Ginecología y Obstetricia No. 15, Instituto Mexicano del Seguro Social, Chihuahua, Chihuahua, México.

出版信息

Ginecol Obstet Mex. 2003 Feb;71:75-81.

Abstract

OBJECTIVE

To determine placenta alterations in iron deficiency anemia cases and the effect of this condition on birthweight.

PATIENTS, MATERIAL AND METHODS: One hundred and fifty three women with term-pregnancy and their newborns were included. Patients with iron deficiency anemia were those with an hemoglobin of less than 11.0 g/dL and serum ferritin below 12 micrograms/L. Outcome variables were: placenta weight, placenta weight/newborn weight ratio, macroscopic and microscopic alterations on placenta, weight and height of the newborn.

RESULTS

The frequency of iron deficiency anemia was determined in 26 patients, 17%. The placenta weight in the group of women with a diagnosis of iron deficiency anemia was 558 +/- 105 g and in the group of women without this diagnosis 527 +/- 107 g (p = 0.18). Placenta weight/newborn weight ratio was higher in the anemia group patients (p = 0.04). The most frequent microscopic lesions observed were intervillous thrombosis, infarcts and fibrosis. The birthweight and length of newborn was similar in both groups.

CONCLUSION

A trend towards an increase in placenta weight and in the placenta weight/newborn weight ratio in patients fulfilling the anemia criteria was observed, but a significant effect on the weight and height of the newborn was not determined, suggesting that the changes present in the placenta would be enough to ensure a fetal growth.

摘要

目的

确定缺铁性贫血病例中的胎盘改变以及这种情况对出生体重的影响。

患者、材料与方法:纳入153例足月妊娠妇女及其新生儿。缺铁性贫血患者为血红蛋白低于11.0 g/dL且血清铁蛋白低于12微克/升的患者。观察指标包括:胎盘重量、胎盘重量/新生儿体重比、胎盘的宏观和微观改变、新生儿的体重和身高。

结果

26例患者被确定为缺铁性贫血,占17%。诊断为缺铁性贫血的女性组胎盘重量为558±105克,未诊断为此病的女性组胎盘重量为527±107克(p = 0.18)。贫血组患者的胎盘重量/新生儿体重比更高(p = 0.04)。观察到的最常见微观病变为绒毛间隙血栓形成、梗死和纤维化。两组新生儿的出生体重和身长相似。

结论

观察到符合贫血标准的患者胎盘重量及胎盘重量/新生儿体重比有增加趋势,但未确定对新生儿体重和身高有显著影响,这表明胎盘中存在的变化足以确保胎儿生长。

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