胎盘早剥与新生儿贫血。
Placental abruption and neonatal anemia.
机构信息
Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT, USA.
出版信息
J Perinatol. 2023 Jun;43(6):782-786. doi: 10.1038/s41372-023-01603-w. Epub 2023 Jan 17.
OBJECTIVE
Placental abruption can cause maternal blood loss and maternal anemia. It is less certain whether abruption can cause fetal blood loss and neonatal anemia.
STUDY DESIGN
Retrospective multi-hospital 24-month analysis of women with placental abruption and their neonates.
RESULTS
Of 55,111 births, 678 (1.2%) had confirmed abruption; 83% of these neonates (564) had one or more hemoglobins recorded in the first day. Four-hundred-seventy (83.3%) had a normal hemoglobin (≥5th% reference interval) while 94 (16.7%) had anemia, relative risk 3.26 (95% CI, 2.66-4.01) vs. >360,000 neonates from previous reference interval reports. The relative risk of severe anemia (<1st% interval) was 4.96 (3.44-7.16). When the obstetrician identified the abruption as "small" or "marginal" the risk of anemia was insignificant.
CONCLUSIONS
Most abruptions do not cause neonatal anemia but approximately 16% do. If an abruption is not documented as small, it is important to surveille the neonate for anemia.
目的
胎盘早剥可导致产妇失血和产妇贫血。胎盘早剥是否会导致胎儿失血和新生儿贫血则不太确定。
研究设计
回顾性多医院 24 个月的胎盘早剥妇女及其新生儿分析。
结果
在 55111 例分娩中，有 678 例（1.2%）确诊为胎盘早剥；其中 83%（564 例）的新生儿在第一天有一个或多个血红蛋白记录。470 例（83.3%）血红蛋白正常（≥第 5%参考区间），94 例（16.7%）贫血，相对风险 3.26（95%CI，2.66-4.01）vs. 来自之前参考区间报告的 >360000 例新生儿。严重贫血（<第 1%间隔）的相对风险为 4.96（3.44-7.16）。如果产科医生将胎盘早剥诊断为“小”或“边缘”，则贫血的风险并不显著。
结论
大多数胎盘早剥不会导致新生儿贫血，但约有 16%会导致贫血。如果没有记录胎盘早剥为小，则需要监测新生儿是否贫血。
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