Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Department of Public Health, School of Medicine, Shihezi University, Shihezi 832003, China.
Nutrients. 2022 Mar 28;14(7):1403. doi: 10.3390/nu14071403.
Background: Few studies have investigated the association of maternal longitudinal hemoglobin (Hb) with small for gestational age during pregnancy. The current study examined the associations of maternal Hb concentrations and Hb changes throughout the middle and late stages of pregnancy with small for gestational age (SGA) in a large prospective cohort study. Methods: This was a prospective cohort study, which enrolled pregnant women at 8−16 weeks of gestation and followed up regularly. Maternal Hb concentrations were measured at the middle (14−27 weeks) and late (28−42 weeks) stages of pregnancy, and the Hb change from the middle to late stage of pregnancy was assessed. The Log-Poisson regression model was used to identify the association of maternal Hb with SGA, including the implications of Hb during specific pregnancy periods and Hb change across the middle to late stages of pregnancy. Of the total 3233 singleton live births, 208 (6.4%) were SGA. After adjusting for potential confounders, compared with Hb 110−119 g/L, Hb ≥ 130 g/L at late pregnancy was significantly associated with a higher risk of SGA (adjusted RR: 2.16; 95% CI: 1.49, 3.13). When Hb changes from the middle to late stages of pregnancy were classified by tertiles, the greatest change in the Hb group (<−6.0 g/L) was significantly associated with a lower risk of SGA (adjusted RR: 0.56; 95% CI: 0.37, 0.85) compared with the intermediate group (−6.0~1.9 g/L). In conclusion, for women at low risk of iron deficiency, both higher Hb concentrations in late pregnancy and less Hb reduction during pregnancy were associated with an increased risk of SGA.
鲜有研究调查母亲纵向血红蛋白（Hb）与孕期胎儿生长受限之间的关联。本研究在一项大型前瞻性队列研究中，检验了孕妇妊娠中晚期 Hb 浓度及其变化与胎儿生长受限（SGA）的相关性。
这是一项前瞻性队列研究，纳入妊娠 8-16 周的孕妇，并进行定期随访。在妊娠中期（14-27 周）和晚期（28-42 周）测量母亲的 Hb 浓度，并评估妊娠中晚期 Hb 的变化。使用对数泊松回归模型来确定母亲 Hb 与 SGA 的关联，包括特定妊娠期间的 Hb 影响以及妊娠中晚期 Hb 的变化。在 3233 例单胎活产儿中，208 例（6.4%）为 SGA。在调整潜在混杂因素后，与妊娠晚期 Hb 110-119 g/L 相比，Hb≥130 g/L 与 SGA 的风险增加显著相关（调整 RR：2.16；95%CI：1.49，3.13）。当根据三分位数将妊娠中晚期的 Hb 变化分类时，Hb 变化最大的组（＜-6.0 g/L）与 SGA 的风险降低显著相关（调整 RR：0.56；95%CI：0.37，0.85），与中值组（-6.0-1.9 g/L）相比。总之，对于缺铁风险较低的女性，妊娠晚期 Hb 浓度较高和妊娠期间 Hb 减少较少与 SGA 风险增加相关。
