Casanova Bruno F, Sammel Mary D, Macones George A
Department of Obstetrics and Gynecology, Pennsylvania Hospital, University of Pennsylvania, Philadelphia 19107, USA.
Am J Obstet Gynecol. 2005 Aug;193(2):460-6. doi: 10.1016/j.ajog.2004.12.008.
The purpose of this study was to elucidate if anemia in pregnancy caused by iron deficiency could be predicted by simple measures obtained on a complete blood count (CBC) using ferritin as the gold standard.
One hundred forty-one pregnant patients with anemia were recruited during their first prenatal visit. CBC and ferritin level were obtained and candidate-predictors identified. Receiver operator characteristic (ROC) curves, stratified analysis, and logistic regression analysis were used to develop a prediction rule with maximum specificity.
A hemoglobin level < or = 9.7 and a red cell distribution width (RDW) > or = 15 (in gestational age <20 weeks) predicted iron deficiency with high specificity. Our final model correctly classified 79.43% of the patients (area under the ROC curve of 0.88 [95%CI 0.82-0.93], specificity of 95.74%).
Iron deficiency anemia can be predicted in pregnancy using lower cost tests, which could be an incredibly useful tool in areas with limited resources and a high prevalence of the disease. This study was limited to a mostly African American population in an urban setting, and the results may not be generalized to other populations.
本研究旨在阐明以铁蛋白作为金标准，通过全血细胞计数（CBC）获得的简单指标能否预测缺铁所致的妊娠期贫血。
招募了141名在首次产前检查时患有贫血的孕妇。获取了她们的CBC和铁蛋白水平，并确定了候选预测指标。采用受试者操作特征（ROC）曲线、分层分析和逻辑回归分析来制定具有最大特异性的预测规则。
血红蛋白水平≤9.7且红细胞分布宽度（RDW）≥15（孕周<20周）对缺铁具有较高的预测特异性。我们的最终模型正确分类了79.43%的患者（ROC曲线下面积为0.88[95%CI 0.82 - 0.93]，特异性为95.74%）。
使用成本较低的检测方法可在孕期预测缺铁性贫血，这对于资源有限且该病患病率高的地区可能是一项极其有用的工具。本研究局限于城市环境中以非裔美国人为主的人群，结果可能无法推广至其他人群。
