母亲贫血对围产儿死亡率的影响：中国一项基于人群的前瞻性队列研究。

The impact of maternal anemia on perinatal mortality: a population-based, prospective cohort study in China.

机构信息

Merck & Co., Inc., Whitehouse Station, NJ, USA.

出版信息

Ann Epidemiol. 2009 Nov;19(11):793-9. doi: 10.1016/j.annepidem.2009.06.002. Epub 2009 Aug 3.

DOI:10.1016/j.annepidem.2009.06.002

PMID:19648029

Abstract

PURPOSE

To evaluate whether anemia during pregnancy is associated with increased risk of stillbirth and neonatal death.

METHODS

A prospective cohort study, using data from a population-based pregnancy-monitoring system in 13 counties in East China (1993-1996) was conducted. Singleton live births (n=163,313) and stillbirths (n=1,354) delivered at 20 to 44 weeks to women with one or more hemoglobin measures during pregnancy were included. Stillbirth and neonatal mortality rates by anemia status in each trimester were estimated. Multivariable Cox proportional hazards regression models were used to evaluate the association between hemoglobin levels and mortality risk.

RESULTS

The stillbirth rates were 6.2 and 9.2 per 1,000 births in women with and without anemia (hemoglobin < 10 g/dL), respectively. The protective effect of anemia was mainly in the third trimester. Hemoglobin of 9 g/dL in the third trimester was associated with reduced risk (hazard ratio [HR], 0.8; 95% confidence interval [CI], 0.7-0.97). Maternal anemia was not associated with neonatal mortality.

CONCLUSIONS

Although maternal anemia was not associated with increased risk of mortality in the neonatal period, women with anemia during the third trimester had lower risk of stillbirth.

摘要

目的

评估妊娠期间贫血是否与死产和新生儿死亡风险增加相关。

方法

采用前瞻性队列研究，使用中国华东地区 13 个县基于人群的妊娠监测系统的数据（1993-1996 年）进行。纳入妊娠期间至少有一次血红蛋白测量值的单胎活产（n=163313）和死产（n=1354）。按各孕期贫血状况估计死产和新生儿死亡率。采用多变量 Cox 比例风险回归模型评估血红蛋白水平与死亡风险之间的关联。

结果

贫血（血红蛋白<10g/dL）和非贫血（血红蛋白≥10g/dL）孕妇的死产率分别为 6.2/1000 活产和 9.2/1000 活产。贫血的保护作用主要在孕晚期。孕晚期血红蛋白为 9g/dL 与降低的风险相关（风险比[HR]，0.8；95%置信区间[CI]，0.7-0.97）。母亲贫血与新生儿死亡率无关。