Department of Obstetrics and Gynecology, Emek Medical Center, Yitzhak Rabin Boulevard 21, 1834111, Afula, Israel.
Department of Obstetrics and Gynecology, Baruch Padeh Medical Center Poriya, Tiberias, Israel.
Sci Rep. 2021 Mar 18;11(1):6309. doi: 10.1038/s41598-021-85622-7.
We aimed to assess risk factors for anemia at delivery by conducting a secondary analysis of a prospective cohort study database including 1527 women who delivered vaginally ≥ 36 gestational weeks. Anemia (Hemoglobin (Hb) < 10.5 g/dL) was assessed at delivery. A complete blood count results during pregnancy as well as maternal and obstetrical characteristics were collected. The primary endpoint was to determine the Hb cutoff between 24 and 30 gestational weeks that is predictive of anemia at delivery by using the area under the curve (AUC) of the receiver operating characteristic curve. Independent risk factors for anemia at delivery were assessed using stepwise multivariable logistic regression. Hb and infrequent iron supplement treatment were independent risk factors for anemia at delivery (OR 0.3 95%CI [0.2-0.4] and OR 2.4 95%CI [1.2-4.8], respectively; C statistics 83%). Hb 10.6 g/dL was an accurate cutoff to predict anemia at delivery (AUC 80% 95%CI 75-84%; sensitivity 75% and specificity 74%). Iron supplement was beneficial to prevent anemia regardless of Hb value. Altogether, Hb should be routinely tested between 24 and 30 gestational weeks to screen for anemia. A flow chart for anemia screening and treatment during pregnancy is proposed in the manuscript.Trial registration: ClinicalTrials.gov Identifier: NCT02434653.
我们旨在通过对包括 1527 名阴道分娩≥36 孕周的妇女的前瞻性队列研究数据库进行二次分析，评估分娩时贫血的危险因素。在分娩时评估贫血（血红蛋白（Hb）<10.5 g/dL）。收集了妊娠期间的全血细胞计数结果以及产妇和产科特征。主要终点是使用受试者工作特征曲线（ROC）的曲线下面积（AUC）确定 24 至 30 孕周之间的 Hb 截止值，该截止值可预测分娩时的贫血。使用逐步多变量逻辑回归评估分娩时贫血的独立危险因素。Hb 和铁补充治疗不频繁是分娩时贫血的独立危险因素（OR 0.3 95%CI [0.2-0.4]和 OR 2.4 95%CI [1.2-4.8]；C 统计量 83%）。Hb 10.6 g/dL 是预测分娩时贫血的准确截止值（AUC 80% 95%CI 75-84%；敏感性 75%和特异性 74%）。无论 Hb 值如何，铁补充都有益于预防贫血。总之，应在 24 至 30 孕周之间常规检测 Hb，以筛查贫血。本文提出了妊娠期间贫血筛查和治疗的流程图。试验注册：ClinicalTrials.gov 标识符：NCT02434653。
