Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Perinatology Division, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Chin Med Assoc. 2019 Nov;82(11):840-844. doi: 10.1097/JCMA.0000000000000184.
The aim of the current study was to investigate the effects of prophylactic iron supplementation on the pregnancy outcome of nonanemic pregnant women in a sample of Iranian population.
This non-randomized clinical trial was conducted during a 2-year period in obstetrics clinics of Shiraz, southern Iran. We included a sample of singleton pregnancies registered in our clinics. Those with comorbidities were excluded. Serum ferritin was measured at baseline and participants were classified accordingly: those with normal serum ferritin levels (≥30 µg/dL) who received standard prophylactic iron supplementation during the pregnancy (Group 1); those who had minor thalassemia and elevated serum ferritin levels (≥30 µg/dL) who did not receive prophylactic iron supplementation or those with normal ferritin levels (≥30 µg/dL) who refused to receive iron supplementation due to gastrointestinal upset (Group 2); and those with iron deficiency anemia with low serum ferritin levels (<30 µg/dL) who received standard iron supplementation during pregnancy (Group 3). All the participants were followed to the delivery and maternal and neonatal outcomes were recorded and compared between three study groups.
Overall we included 30 pregnant women in each group with mean age of the participants was 28.66 ± 6.02 years. There was no significant difference between three study groups regarding gestational age at delivery (p = 0.250), birthweight (p = 0.893), Apgar at 1 (p = 0.532) and 5 (p = 0.590) minutes, and route of delivery (p = 0.590). The overall rate of maternal complication of the pregnancy was comparable between the three study groups (p = 0.188). However, those in group 1, had significantly higher rate of gestational diabetes mellitus (GDM) when compared to other two groups (p = 0.038).
Prophylactic iron supplementation in pregnant women with normal ferritin levels is associated with increased risk of GDM. Other pregnancy and neonatal outcomes are not affected by the prophylactic iron supplementation.
本研究旨在探讨在伊朗人群样本中,对非贫血孕妇进行预防性补铁对妊娠结局的影响。
这是一项为期 2 年的非随机临床试验,在伊朗南部设拉子的妇产科诊所进行。我们纳入了在我们诊所登记的单胎妊娠样本。排除有合并症的患者。在基线时测量血清铁蛋白,并据此进行分类:血清铁蛋白水平正常(≥30μg/dL)的患者在妊娠期间接受标准预防性补铁(第 1 组);铁蛋白水平升高(≥30μg/dL)且患有轻度地中海贫血的患者未接受预防性补铁,或铁蛋白水平正常(≥30μg/dL)但因胃肠道不适而拒绝补铁的患者(第 2 组);血清铁蛋白水平低(<30μg/dL)的缺铁性贫血患者在妊娠期间接受标准补铁(第 3 组)。所有参与者均随访至分娩,并记录母婴结局并进行比较。
我们在每组中总共纳入了 30 名孕妇,参与者的平均年龄为 28.66±6.02 岁。三组间在分娩时的孕周(p=0.250)、出生体重(p=0.893)、1 分钟(p=0.532)和 5 分钟(p=0.590)时的 Apgar 评分和分娩方式(p=0.590)方面无显著差异。三组间妊娠并发症的总体发生率相当(p=0.188)。然而,与其他两组相比,第 1 组的妊娠期糖尿病(GDM)发生率显著更高(p=0.038)。
在铁蛋白水平正常的孕妇中进行预防性补铁与 GDM 风险增加有关。预防性补铁对其他妊娠和新生儿结局无影响。