Jirakittidul Preeyaporn, Sirichotiyakul Supatra, Ruengorn Chidchanok, Techatraisak Kitirat, Wiriyasirivaj Busaba
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Arch Gynecol Obstet. 2018 Sep;298(3):545-550. doi: 10.1007/s00404-018-4821-6. Epub 2018 Jun 27.
To investigate the association between iron supplementation during early pregnancy and the presence of de novo hypertension after 20 weeks' gestation (either gestational hypertension or pre-eclampsia).
Retrospective cohort study.
This study retrospectively reviewed the medical records of non-anemic pregnant women who received first antenatal care at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, during the June 2009-December 2010 study period. All included women had blood pressure and urine albumin level data that were recorded at each antenatal visit. The study population was divided into one of the two following groups: iron supplementation starting at gestational age (GA) < 16 weeks (study group) or GA ≥ 16 weeks (control group). A comparison of the proportion of de novo hypertension arising after 20 weeks' gestation was then performed between groups.
Four hundred non-anemic pregnant women were included, with 200 patients allocated to each groups. The overall incidence of de novo hypertension after 20 weeks' gestation was 10% (40/400), with significantly higher prevalence in the study group than that in the control group [13.5% (27/200) vs. 6.5% (13/200); relative risk: 2.14, 95%, CI 1.22-3.73; p = 0.008]. None of the women in this study developed anemia at time of delivery. There was no significant difference between groups for GA at delivery, birth weight, or birth asphyxia.
In our study population, iron supplementation before 16 weeks' GA was significantly associated with increased risk of developing de novo hypertension after 20 weeks' gestation.
探讨孕早期补铁与妊娠20周后新发高血压（妊娠高血压或子痫前期）之间的关联。
回顾性队列研究。
本研究回顾性分析了2009年6月至2010年12月期间在泰国曼谷瓦吉拉医院医学院妇产科接受首次产前检查的非贫血孕妇的病历。所有纳入的女性在每次产前检查时均记录了血压和尿白蛋白水平数据。研究人群分为以下两组之一：妊娠年龄（GA）<16周开始补铁（研究组）或GA≥16周（对照组）。然后比较两组妊娠20周后新发高血压的比例。
纳入400名非贫血孕妇，每组200例。妊娠20周后新发高血压的总体发生率为10%（40/400），研究组的患病率显著高于对照组[13.5%（27/200）对6.5%（13/200）；相对风险：2.14，95%CI 1.22 - 3.73；p = 0.008]。本研究中没有女性在分娩时发生贫血。两组在分娩时的GA、出生体重或出生窒息方面没有显著差异。
在我们的研究人群中，妊娠16周前补铁与妊娠20周后新发高血压风险增加显著相关。
