Ribot Blanca, Ruiz-Díez Francisco, Abajo Susana, March Gemma, Fargas Francesc, Arija Victoria
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Nutr Hosp. 2018 Jan 10;35(1):123-130. doi: 10.20960/nh.1045.
To evaluate the prevalence of anaemia and the risk of haemoconcentration and its risk factors during all 3 trimesters of pregnancy in women in a Mediterranean area in the south of Europe.
Longitudinal study of 11,259 women whose pregnancies were monitored at primary care centres between 2007 and 2012. The computerised clinical histories of all the pregnancies were used to collect haemoglobin (Hb) data for each trimester. The histories also provided information on the age of the mother, her socioeconomic status, the presence of obesity, tobacco use, type of pregnancy, and number of previous pregnancies and births. Anaemia was defined as Hb < 110 g/L in the 1st and 3rd trimesters of pregnancy and Hb < 105 g/L in the second. The risk of haemoconcentration was defined as Hb > 130 g/L in the 2nd and 3rd trimesters of pregnancy.
The prevalence of anaemia increased from 3.8% in the first trimester to 21.5% in the 3rd trimester. Around 10% of the women had Hb > 130 g/L during the 3rd trimester. Having children previously and/or being younger than 20 increased the chances of anaemia (Adj. OR: 1.4; 95% CI: 1.1-1.9), but being older than 34 increased the chances of Hb > 130 g/L (Adj. OR: 1.3; 95% CI: 1.1-1.5).
The increased prevalence of anaemia is a moderate public health problem. Understanding the factors that influence these problems may help improve the guidelines regarding the use of iron supplements.
评估欧洲南部地中海地区女性孕期三个阶段贫血的患病率、血液浓缩风险及其危险因素。
对2007年至2012年在基层医疗中心接受孕期监测的11259名女性进行纵向研究。利用所有孕期的计算机化临床病史收集每个孕期的血红蛋白（Hb）数据。病史还提供了母亲的年龄、社会经济地位、肥胖情况、吸烟情况、妊娠类型以及既往妊娠和分娩次数等信息。贫血定义为妊娠第一和第三阶段Hb<110g/L，妊娠第二阶段Hb<105g/L。血液浓缩风险定义为妊娠第二和第三阶段Hb>130g/L。
贫血患病率从妊娠第一阶段的3.8%升至第三阶段的21.5%。约10%的女性在妊娠第三阶段Hb>130g/L。既往有子女和/或年龄小于20岁会增加贫血几率（调整后比值比：1.4；95%置信区间：1.1 - 1.9），但年龄大于34岁会增加Hb>130g/L的几率（调整后比值比：1.3；95%置信区间：1.1 - 1.5）。
贫血患病率上升是一个中度的公共卫生问题。了解影响这些问题的因素可能有助于改进铁补充剂使用指南。
