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贫血能否预测孕期不同阶段的围产期结局?

Can anemia predict perinatal outcomes in different stages of pregnancy?

作者信息

Vural Tayfun, Toz Emrah, Ozcan Aykut, Biler Alper, Ileri Alper, Inan Abdurrahman Hamdi

机构信息

Tayfun Vural, Department of Obstetrics and Gynecology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey.

Emrah Toz, Department of Obstetrics and Gynecology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey.

出版信息

Pak J Med Sci. 2016 Nov-Dec;32(6):1354-1359. doi: 10.12669/pjms.326.11199.

Abstract

OBJECTIVE

To investigate the effect of anemia on perinatal outcomes as preterm delivery (PTD) and low birth weight (LBW) in the different stages of pregnancy.

METHODS

Medical records of 39,587 Turkish pregnant women who delivered between January 2011 and September 2014 were reviewed. Anemia during pregnancy was defined as hemoglobin (Hb)< 11 g/dl, low birth weight was defined as birth weight <2500 gr and PTD was defined as <37 weeks. The pregnant women were divided into three groups (Hb<10 gr/dl, Hb 10-11 gr/dl, Hb>11 gr/dl). Perinatal outcomes were compared between these anemic and non-anemic groups.

RESULTS

The anemia prevalence in our study was 25.1%. In the first and second trimester of Hb<10g/dl group LBW ratio was significantly higher (respectively 13.5%, 9.8%, p=0.03; 22.7%, 14.7%, p=0.01). In the second and third trimesters of Hb<10 g/dl group PTD ratio was significantly higher (respectively 29.1%, 19%, p=0.00; 17.7%, 15.4% p=0.02). In the first trimester Hb<10 g/dl group cesarean section rate was significantly higher (respectively 65.2%, 57.6%, p = 0.01).

CONCLUSIONS

LBW infants and preterm birth rate was higher in Hb <10 gr/dl group than non-anemic in the first, second and third trimester. Hb <10 gr/dl group had higher cesarean rate in first trimester. The mean birth weight was significantly lower in anemic pregnant women in the second trimester. Preterm birth and cesarean section rate, in the group of anemic throughout pregnancy was higher than those of non-anemic in the whole pregnancy period.

摘要

目的

探讨孕期不同阶段贫血对围产期结局如早产(PTD)和低出生体重(LBW)的影响。

方法

回顾了2011年1月至2014年9月期间分娩的39587名土耳其孕妇的病历。孕期贫血定义为血红蛋白(Hb)<11 g/dl,低出生体重定义为出生体重<2500克,早产定义为<37周。将孕妇分为三组(Hb<10 g/dl、Hb 10 - 11 g/dl、Hb>11 g/dl)。比较这些贫血组和非贫血组的围产期结局。

结果

本研究中贫血患病率为25.1%。在Hb<10g/dl组的孕早期和孕中期,低出生体重比率显著更高(分别为13.5%、9.8%,p = 0.03;22.7%、14.7%,p = 0.01)。在Hb<10 g/dl组的孕中期和孕晚期,早产比率显著更高(分别为29.1%、19%,p = 0.00;17.7%、15.4%,p = 0.02)。在孕早期,Hb<10 g/dl组剖宫产率显著更高(分别为65.2%、57.6%,p = 0.01)。

结论

Hb<10 g/dl组在孕早期、孕中期和孕晚期的低出生体重婴儿和早产率高于非贫血组。Hb<10 g/dl组在孕早期剖宫产率更高。孕中期贫血孕妇的平均出生体重显著更低。整个孕期贫血组的早产和剖宫产率高于非贫血组。

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本文引用的文献

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Iron Deficiency Anemia in Pregnancy.妊娠期缺铁性贫血
Semin Hematol. 2015 Oct;52(4):339-47. doi: 10.1053/j.seminhematol.2015.07.003. Epub 2015 Jul 10.
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Can anemia in the first trimester predict obstetrical complications later in pregnancy?孕早期贫血能否预测后期妊娠的产科并发症?
J Matern Fetal Neonatal Med. 2012 Nov;25(11):2454-7. doi: 10.3109/14767058.2012.703723. Epub 2012 Jul 2.
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Anemia during pregnancy and treatment with intravenous iron: review of the literature.孕期贫血与静脉补铁治疗:文献综述
Eur J Obstet Gynecol Reprod Biol. 2003 Sep 10;110(1):2-7. doi: 10.1016/s0301-2115(03)00113-1.
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Iron and oxidative stress in pregnancy.孕期的铁与氧化应激
J Nutr. 2003 May;133(5 Suppl 2):1700S-1708S. doi: 10.1093/jn/133.5.1700S.
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Maternal and perinatal outcome in varying degrees of anemia.不同程度贫血的孕产妇及围产期结局
Int J Gynaecol Obstet. 2002 Nov;79(2):93-100. doi: 10.1016/s0020-7292(02)00225-4.
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Plasma volume expansion in early pregnancy.妊娠早期的血浆容量扩充
Obstet Gynecol. 2001 May;97(5 Pt 1):669-72. doi: 10.1016/s0029-7844(00)01222-9.

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