Räisänen Sari, Kancherla Vijaya, Gissler Mika, Kramer Michael R, Heinonen Seppo
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland.
Paediatr Perinat Epidemiol. 2014 Sep;28(5):372-80. doi: 10.1111/ppe.12134. Epub 2014 Jun 17.
Anaemia during pregnancy is an important public health problem. We investigated whether the association between maternal anaemia during pregnancy and adverse perinatal outcomes differed between nulliparous and multiparous women.
A retrospective population-based cohort study was conducted using data on all singleton births (n = 290 662) recorded in the Finnish Medical Birth Register during 2006-10. Maternal anaemia was defined as a maternal haemoglobin level of <100 g/L). Adverse perinatal outcomes that were examined included preterm delivery (<37 weeks), small-for-gestational age (SGA, <2 standard deviation), admission to neonatal intensive care, stillbirth, early neonatal death, and major congenital anomalies. An association between anaemia and adverse outcomes was assessed by logistic regression analysis.
The prevalence of anaemia during pregnancy was 2.5% among nulliparous women and 2.3% among multiparous women. Among nulliparous women, anaemia was not associated with adverse perinatal outcomes. Among multiparous women, anaemia was associated with preterm delivery (adjusted odds ratio [aOR] 1.32, [95% CI 1.14, 1.53]), SGA (aOR 1.27, [95% CI 1.04, 1.55]), and admission to neonatal intensive care (aOR 1.23, [95% CI 1.10, 1.38]); there was a trend towards increased odds of major congenital anomalies (aOR 1.15, [95% CI 0.99, 1.34]).
These data underscore that maternal anaemia is associated with several adverse perinatal outcomes. This association was, however, confined to multiparous women. Future research should explore in detail the timing of anaemia in these associations.
孕期贫血是一个重要的公共卫生问题。我们调查了初产妇和经产妇孕期母体贫血与不良围产期结局之间的关联是否存在差异。
采用2006 - 2010年芬兰医学出生登记处记录的所有单胎分娩数据（n = 290662）进行一项基于人群的回顾性队列研究。母体贫血定义为母体血红蛋白水平<100 g/L）。所检查的不良围产期结局包括早产（<37周）、小于胎龄儿（SGA，<2个标准差）、入住新生儿重症监护病房、死产、早期新生儿死亡和重大先天性畸形。通过逻辑回归分析评估贫血与不良结局之间的关联。
初产妇孕期贫血患病率为2.5%，经产妇为2.3%。在初产妇中，贫血与不良围产期结局无关。在经产妇中，贫血与早产（调整优势比[aOR] 1.32，[95%置信区间1.14, 1.53]）、小于胎龄儿（aOR 1.27，[95%置信区间1.04, 1.55]）和入住新生儿重症监护病房（aOR 1.23，[95%置信区间1.10, 1.38]）相关；重大先天性畸形的优势比有增加趋势（aOR 1.15，[95%置信区间0.99, 1.34]）。
这些数据强调母体贫血与多种不良围产期结局相关。然而，这种关联仅限于经产妇。未来的研究应详细探讨这些关联中贫血发生的时间。
