Chen J H, Guo X F, Liu S, Long J H, Zhang G Q, Huang M C, Qiu X Q
Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China.
Department of maternity, Pingguo County Child Health, Baise 531400, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Feb 10;38(2):154-157. doi: 10.3760/cma.j.issn.0254-6450.2017.02.004.
To investigate the hemoglobin (Hb) levels during pregnancy and Hb changes from early pregnancy and association with birth weight on infants. Mothers of Zhuang Nationality who participated in the pregnancy care program and delivered at the Pingguo County Hospital from May 2013 to May 2015 were included in this study. Retrospective analysis was applied to collect data of health care and pregnancy outcomes. Multiple regression analysis and unconditional logistic regression model were used for data analysis. The mean birth weight appeared as (313 5.92±435.84) grams. The Hb levels at early pregnancy showed significantly positive association with birth weight. Results from our study demonstrated that when Hb levels increased + 1 g/dl at early pregnancy, birth weight would increase 17.61(95: 0.60-34.67) grams, in the adjusted model. The Hb levels at late pregnancy were significantly inversely associated with birth weight. Our findings suggested that when Hb levels increased + 1 g/dl at late pregnancy, birth weight would reduce 19.61(95: -37.53 --1.70) grams in the adjusted model. Changes in Hb from early pregnancy stages were significantly inversely associated with birth weight after adjusting for confounders and Hb levels in the early pregnancy stages. The results also indicated that when Hb levels increased a + 1 g/dl from early to late pregnancy, the birth weight would decrease 32.63 g(95: -48.93--16.32). Compared to the non-anemia group, the anemia group showed significantly increase of small-for-gestational-age (SGA)(=1.58, 95: 1.08-2.32) in early pregnancy. Compared to women under the most reduction status, women with the least reduction had a significantly increase of SGA (= 1.87, 95:1.24-2.81) among their infants. With the magnitude of reduction on Hb concentration during pregnancy, the risk of delivering babies with SGA showed a gradual trends of increase. Hb levels at early pregnancy were positively associated with birth weight, but the changes of Hb were inversely associated with birth weight at late pregnancy, in women of Zhuang Nationality. Anemia in early pregnancy and the low amplitude of decreased Hb concentration during pregnancy were both risk factors for newborns under less gestational ages.
探讨孕期血红蛋白（Hb）水平、孕早期至孕晚期Hb的变化及其与婴儿出生体重的关系。本研究纳入了2013年5月至2015年5月期间参与孕期保健项目并在平果县医院分娩的壮族母亲。采用回顾性分析收集保健和妊娠结局数据。数据分析采用多元回归分析和无条件逻辑回归模型。平均出生体重为（3135.92±435.84）克。孕早期Hb水平与出生体重呈显著正相关。本研究结果表明，在调整模型中，孕早期Hb水平每增加1g/dl，出生体重将增加17.61（95%CI：0.60 - 34.67）克。孕晚期Hb水平与出生体重呈显著负相关。我们的研究结果表明，在调整模型中，孕晚期Hb水平每增加1g/dl，出生体重将减少19.61（95%CI：-37.53至-1.70）克。在调整混杂因素和孕早期Hb水平后，孕早期至孕晚期Hb的变化与出生体重呈显著负相关。结果还表明，从孕早期至孕晚期Hb水平每增加1g/dl，出生体重将减少32.63克（95%CI：-48.93至-16.32）。与非贫血组相比，贫血组孕早期小于胎龄儿（SGA）显著增加（OR = 1.58，95%CI：1.08 - 2.32）。与Hb下降最多的女性相比，Hb下降最少的女性所生婴儿的SGA显著增加（OR = 1.87，95%CI：1.24 - 2.81）。随着孕期Hb浓度下降幅度的增加，分娩SGA婴儿的风险呈逐渐增加趋势。壮族女性中，孕早期Hb水平与出生体重呈正相关，但孕晚期Hb变化与出生体重呈负相关。孕早期贫血和孕期Hb浓度下降幅度小均是新生儿孕周较小的危险因素。
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