[拉萨农村藏族孕妇血红蛋白水平的研究]

Kang Yijun, Li Fangzhen, Dang Shaonong, Yan Hong, Zeng Lingxia, Cheng Yue, Li Qiang, Bi Yuxue

School of Public Health, Xi'an Jiaotong University & Health Science Center/Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an 710061, China.

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Zhonghua Yu Fang Yi Xue Za Zhi. 2014 May;48(5):396-400.

OBJECTIVE

To understand the level of hemoglobin (Hb) and determine the risk factors of Hb concentration among the Tibetan pregnant women in rural Lhasa.

METHODS

Between August 2008 and May 2011, a hospital-based study was conducted among 1 530 Tibetan pregnant women after getting their informed consent in agricultural and pastoral areas in maternity clinic or hospital in city, county and township level of Lhasa. Their blood samples were tested and related socio-demographic information was collected. Blood was collected on tip of finger and the Hb concentration was measured using B-Hemoglobin photometer. American Centers for Disease Control and Prevention(CDC) method was used to adjust the Hb measurements based on altitude for estimating the prevalence of anemia. Anemia was assessed according to WHO criteria. A hemoglobin concentration of less than 110 g/L in a pregnant woman was considered an indication of anemia.

RESULTS

From August 2008 to May 2011, 1 530 Tibetan pregnant women living at (3 716.4 ± 69.1) m above sea level in rural Lhasa were examined. The findings indicated that average Hb concentration was (122.0 ± 17.5) g/L; the Hb concentration of 1(st), 2(nd) and 3(rd) trimester were (125.5 ± 18.0), (122.5 ± 16.9) and (120.6 ± 17.4) g/L, respectively. The Hb concentration of pregnant women decreased with the increase of gestational age(P < 0.05). Based onCDC method and the adjusted Hb level, the prevalence of anemia in pregnant women were 85.6% (1 310/1 530), the prevalence of anemia of 1(st), 2(nd), and 3(rd)rd trimester were 79.5% (206/259) , 86.1% (395/459)and 87.3% (698/800), respectively (P < 0.05) . The rate of moderate and severe anemia were 46.7% (612/1 310) among pregnant women. Multiple linear regression analysis showed that high Hb level was associated significantly with low family income status (β = 2.74, 95%CI:1.73-3.74), no bad habits (drinking or smoking) (β = 7.34, 95%CI:4.87-9.81) and fewer times of pregnancies(β = -1.62, 95%CI:-2.93--0.31) after adjusting for potential confounding factors.

CONCLUSION

Hb concentration level in pregnancy was rather low in rural Lhasa. The increase of family income, reduction the intervals of pregnancies and no bad habits might benefit for the improvement of Hb level of pregnant women in this region.

目的

了解拉萨市农村藏族孕妇血红蛋白（Hb）水平，确定影响藏族孕妇Hb浓度的危险因素。

方法

2008年8月至2011年5月，在拉萨市市、县、乡级妇幼保健院或医院，对1530名藏族孕妇进行了一项基于医院的研究，研究获得了她们的知情同意。采集她们的血样并收集相关的社会人口学信息。采用手指末梢采血，使用B型血红蛋白光度计测量Hb浓度。采用美国疾病控制与预防中心（CDC）的方法，根据海拔高度对Hb测量值进行校正，以估计贫血患病率。根据世界卫生组织标准评估贫血情况。孕妇血红蛋白浓度低于110g/L被视为贫血。

结果

2008年8月至2011年5月，对居住在拉萨市农村海拔（3716.4±69.1）米的1530名藏族孕妇进行了检查。结果显示，平均Hb浓度为（122.0±17.5）g/L；妊娠第1、2、3 trimester的Hb浓度分别为（125.5±18.0）、（122.5±16.9）和（120.6±17.4）g/L。孕妇的Hb浓度随着孕周的增加而降低（P<0.05）。根据CDC方法和校正后的Hb水平，孕妇贫血患病率为85.6%（1310/1530），妊娠第1、2、3 trimester的贫血患病率分别为79.5%（206/259）、86.1%（395/459）和87.3%（698/800）（P<0.05）。孕妇中重度贫血率为46.7%（612/1310）。多因素线性回归分析显示，在调整潜在混杂因素后，高Hb水平与低家庭收入状况（β=2.74，95%CI：1.73-3.74）、无不良习惯（饮酒或吸烟）（β=7.34，95%CI：4.87-9.81）和较少的妊娠次数（β=-1.62，95%CI：-2.93--0.31）显著相关。