Ronnenberg Alayne G, Wood Richard J, Wang Xiaobin, Xing Houxun, Chen Chanzhong, Chen Dafang, Guang Wenwei, Huang Aiqun, Wang Lihua, Xu Xiping
Department of Environmental Health, Harvard School of Public Health, Boston, USA.
J Nutr. 2004 Oct;134(10):2586-91. doi: 10.1093/jn/134.10.2586.
Prenatal anemia and iron deficiency are associated with adverse birth outcomes, but no previous studies have examined the relation between preconception anemia, iron deficiency, and pregnancy outcome in healthy women. We measured hemoglobin (Hb), ferritin, transferrin receptor (TfR), and vitamins B-6, B-12, and folate concentrations before pregnancy in 405 Chinese women (median time from sample collection to gestation end = 316 d). Both mild (95 </= Hb < 120 g/L) and moderate (Hb < 95 g/L) anemia were significantly associated with lower birthweight (139 and 192 g, respectively); iron-deficiency anemia alone (Hb < 120 g, ferritin < 12 microg/L, no B-vitamin deficiency) was associated with a 242-g decrease in birthweight. Both low (<12 microg/L) and high (>/=60 microg/L) ferritin were also significantly associated with lower birthweight (106 and 123 g, respectively). The risks of low birthweight (LBW) and fetal growth restriction (FGR) were significantly greater among women with moderate anemia compared with nonanemic controls [odds ratio (OR): 6.5; 95% CI: 1.6, 26.7; P = 0.009 and OR: 4.6; 95% CI: 1.5, 13.5; P = 0.006, respectively]. TfR and low ferritin were not associated with adverse birth outcome, but elevated ferritin, which could be a marker of inflammation, was associated with increased risk of LBW (OR: 2.2; 95% CI: 0.9, 5.7; P = 0.09) and FGR (OR: 2.7; 95% CI: 1.3, 5.6; P = 0.008). Preconception anemia, particularly iron-deficiency anemia, was associated with reduced infant growth and increased risk of adverse pregnancy outcome in Chinese women.
产前贫血和缺铁与不良分娩结局相关，但此前尚无研究探讨健康女性孕前贫血、缺铁与妊娠结局之间的关系。我们对405名中国女性（从样本采集到妊娠结束的中位时间 = 316天）孕前的血红蛋白（Hb）、铁蛋白、转铁蛋白受体（TfR）以及维生素B-6、B-12和叶酸浓度进行了测量。轻度贫血（95≤Hb＜120 g/L）和中度贫血（Hb＜95 g/L）均与较低出生体重显著相关（分别降低139克和192克）；单纯缺铁性贫血（Hb＜120 g，铁蛋白＜12 μg/L，无B族维生素缺乏）与出生体重降低242克相关。低铁蛋白（＜12 μg/L）和高铁蛋白（≥60 μg/L）也均与较低出生体重显著相关（分别降低106克和123克）。与非贫血对照组相比，中度贫血女性发生低出生体重（LBW）和胎儿生长受限（FGR）的风险显著更高[比值比（OR）：6.5；95%置信区间（CI）：1.6，26.7；P = 0.009和OR：4.6；95% CI：1.5，13.5；P = 0.006]。TfR和低铁蛋白与不良分娩结局无关，但高铁蛋白可能是炎症标志物，与LBW风险增加（OR：2.2；95% CI：0.9，5.7；P = 0.09）和FGR风险增加（OR：2.7；95% CI：1.3，5.6；P = 0.008）相关。中国女性孕前贫血，尤其是缺铁性贫血，与婴儿生长发育受限及不良妊娠结局风险增加相关。
