刚果民主共和国金沙萨大学诊所孕产妇贫血与其他危险因素在严重产科综合征发生中的关联。
Association of maternal anemia with other risk factors in occurrence of Great obstetrical syndromes at university clinics, Kinshasa, DR Congo.
作者信息
Tandu-Umba Barthélémy, Mbangama Andy Muela
机构信息
Department of Obstetrics and Gynecology, University Clinics, University avenue Campus, PO Box 123, Kinshasa XI, DR Congo.
出版信息
BMC Pregnancy Childbirth. 2015 Aug 21;15:183. doi: 10.1186/s12884-015-0623-z.
BACKGROUND
Maternal anemia, a common situation in developing countries, provokes impairment of nutrients/oxygen supply to the placenta-fetus unit that leads to Great obstetrical syndromes (GOS). In our setting, however, occurrence of GOS has been found also depending on variables existing prior to pregnancy such as diabetes in family, hypertension in family, previous macrosomia, stillbirth, SGA and pre-eclampsia as well as overweight/obesity. Our study thus aimed to determine the magnitude of maternal anemia and its association with these pre-pregnancy high-risk variables in occurrence of GOS.
METHODS
This is a cross-sectional study including women delivered at the University Clinics of Kinshasa, DR Congo, 12. during 18 months. Anemia was stated at hemoglobin blood concentration < 10 g/dL. Sampled women were checked for pregnancy high-risk factors and pregnancy complications. Odds ratios (95% confidence intervals) were calculated to establish associations of anemia with various variables. Multivariate calculations aimed to isolate variables influencing these associations. The p <0.05 was considered significant.
RESULTS
The study sample included 412 women, among whom 220 (53.4%) were diagnosed anemic. Anemia was found significantly linked to malaria, urinary infection, cesarean section, prematurity, SGA and stillbirth whose risk was 1.6 - 6.1 times augmented. Anemia was also found linked to pre-pregnancy high-risk factors such as age < 18 and ≥ 35 years, previous miscarriage, grand multiparity, diabetes in family, previous prematurity, overweight/obesity, previous cesarean section and previous pre-eclampsia, all of them enhancing the link of maternal anemia with complications.
CONCLUSION
Maternal anemia is very prevalent among pregnant women of our setting. It strongly contributes to worsening of morbidities that act with pregnancy high-risk factors in raising the risk of cesarean section, prematurity, SGA and stillbirth.
背景
孕产妇贫血在发展中国家是一种常见情况，会导致胎盘 - 胎儿单位的营养物质/氧气供应受损，进而引发严重产科综合征（GOS）。然而，在我们的研究环境中，发现GOS的发生还取决于妊娠前就存在的变量，如家族糖尿病、家族高血压、既往巨大儿、死产、小于胎龄儿（SGA）和子痫前期以及超重/肥胖。因此，我们的研究旨在确定孕产妇贫血的严重程度及其与这些妊娠前高危变量在GOS发生中的关联。
方法
这是一项横断面研究，纳入了在刚果民主共和国金沙萨大学诊所分娩的女性，研究持续18个月。血红蛋白血浓度<10 g/dL被定义为贫血。对抽样的女性进行妊娠高危因素和妊娠并发症检查。计算优势比（95%置信区间）以确定贫血与各种变量之间的关联。多变量计算旨在分离影响这些关联的变量。p<0.05被认为具有统计学意义。
结果
研究样本包括412名女性，其中220名（53.4%）被诊断为贫血。发现贫血与疟疾、泌尿系统感染、剖宫产、早产、SGA和死产显著相关，其风险增加了1.6 - 6.1倍。还发现贫血与妊娠前高危因素有关，如年龄<18岁和≥35岁、既往流产、多产、家族糖尿病、既往早产、超重/肥胖、既往剖宫产和既往子痫前期，所有这些因素都增强了孕产妇贫血与并发症之间的联系。
结论
在我们研究环境中的孕妇中，孕产妇贫血非常普遍。它极大地导致了发病率的恶化，这些发病率与妊娠高危因素共同作用，增加了剖宫产、早产、SGA和死产的风险。
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