[孕晚期血红蛋白浓度与低出生体重及早产风险的研究]

Wang Juan, Ren Ai-guo, Ye Rong-wei, Zheng Jun-chi, Li Song, Liu Jian-meng, Yang Rui-lan, Zhang Fei-ran, Zhang Tan, Zhang Jing-bo, Li Zhu

Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100083, China.

Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Jan;28(1):15-8.

OBJECTIVE

To investigate the association between third trimester hemoglobin (Hb) concentrations and the risk of low birth weight and preterm delivery in a Chinese population.

METHODS

Subjects were women who delivered in four cities/counties in Jiangsu and Zhejiang provinces, China, during the period of 1995 - 2000. Incidence of low birth weight and preterm delivery was calculated and compared among groups of women with different levels of Hb during the third trimester. Multiple logistic regression was used to address relationships between Hb levels and the risk of preterm delivery and low birth weight while controlling for potential confounding factors.

RESULTS

The overall prevalence of anemia during third trimester of pregnancy was 48.2% , mainly consisting of mild and moderate anemia. Mild and moderate anemia did not increase the risk of preterm delivery and low birth weight statistically. The lowest incidence of preterm delivery and low birth weight was found among pregnant women with Hb levels at 90-99 g/L. The risk for preterm delivery and low birth weight increased with either increasing or decreasing hemoglobin concentrations. However,there was no remarkable elevation of the risk when Hb was in the range of 70-119 g/L. Women with severe anemia (Hb< 70 g/L) had 80% higher risk (95% CI:1.0-3.3) of preterm delivery and a 4.0-fold higher risk (95 % CI :2. 1-7.5) of low birth weight compared with women with an Hb value of 90-99 g/L. In addition, women with a high Hb concentration (Hb> 130 g/L) had 20% higher risk (95 % CI: 1..0-1.4) of preterm delivery and 50 % higher risk (95 % CI: 1.2-1.9) of low birth weight.

CONCLUSION

A U-shape relationship was found between Hb concentration and the risk of preterm delivery and low birth weight. Severe anemia and high hemoglobin concentration were both associated with increased risk of preterm deliveries and low birth weight.

目的

探讨中国人群孕晚期血红蛋白（Hb）浓度与低出生体重及早产风险之间的关联。

方法

研究对象为1995年至2000年期间在中国江苏省和浙江省四个市/县分娩的女性。计算并比较孕晚期不同Hb水平女性群体的低出生体重和早产发生率。采用多因素logistic回归分析，在控制潜在混杂因素的同时，分析Hb水平与早产及低出生体重风险之间的关系。

结果

孕期第三个月贫血的总体患病率为48.2%，主要为轻度和中度贫血。轻度和中度贫血在统计学上并未增加早产和低出生体重的风险。Hb水平在90 - 99 g/L的孕妇中早产和低出生体重的发生率最低。早产和低出生体重的风险随血红蛋白浓度的升高或降低而增加。然而，当Hb在70 - 119 g/L范围内时，风险没有显著升高。与Hb值为90 - 99 g/L的女性相比，重度贫血（Hb < 70 g/L）的女性早产风险高80%（95% CI：1.0 - 3.3），低出生体重风险高4.0倍（95% CI：2.1 - 7.5）。此外，高Hb浓度（Hb > 130 g/L）的女性早产风险高20%（95% CI：1.0 - 1.4），低出生体重风险高50%（95% CI：1.2 - 1.9）。