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[妊娠早期铁状态及相关因素分析]

[Analysis on the iron status and associated factors during the first trimester of pregnancy].

作者信息

Lin Y W, Zhou Y L, Zhao R L, Xu Y J, Liu Y P

机构信息

Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.

Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Aug 18;55(4):600-605. doi: 10.19723/j.issn.1671-167X.2023.04.005.

Abstract

OBJECTIVE

To investigate the impact of dietary and underlying factors on the iron status of women in early pregnancy and to provide evidence for preventing iron deficiency and iron deficiency anemia, thereby reducing the incidence of associated adverse outcomes.

METHODS

From November to December 2018, women in the first trimester of pregnancy (< 12 weeks gestation) who established prenatal records at the Shunyi District Maternal and Child Health Hospital, Beijing, were enrolled in this study, in which 388 participants were accessed for data including demographic characteristics, anthropometric measurements, parity, biomarkers reflecting iron status, and food-frequency questionnaire. SPSS 26.0 were used for statistical analysis. Dietary patterns were extracted using principal component analysis, and factor scores of each dietary pattern were calculated. Two-sided Fisher exact probability test and one-way ANOVA were conducted to access differences in iron status among the groups, and the differences were significant if < 0.05. Iron deficiency was defined as serum ferritin(SF) < 30 μg/L. To analyze the potential role of dietary factors on iron deficiency during the first trimester, the collected data listed above were adopted as independent factors for the cross-sectional Logistic regression. We used Logistic regression to analyze the potential effects of baseline characteristics and dietary factors on iron status.

RESULTS

Among the 388 participants included in the analysis, 121 (32.2%) were iron deficient, in which 107 (27.6%) were iron depletion (ID), 8 (2.1%) were iron deficiency erythropoiesis (IDA), 6(1.5%) were iron deficiency anemia. The mean SF concentration was (50.4±35.3) μg/L. Multiparity(=3.9, 95%: 1.81-8.42, =0.001)was a risk factor for iron deficiency during early pregnancy. No significant iron status differences were found among the participants with different educational levels and anthropometric measurements. In contrast, age ( =0.96, 95%: 0.94-0.97, < 0.001) was a protective factor. For multiparas, taking iron-containing supplements might have a protective effect for iron deficiency (=0.27, 95%: 0.09-0.83, =0.022). The balance-diet pattern (=0.81, 95%: 0.66-1.00, =0.054) only showed a marginally significant effect.

CONCLUSION

Increasing attention should be paid to the iron status of pregnant multiparas and young pregnant women. For those women of reproductive age with the risk factors listed above, especially for multiparas, iron-containing supplements should be recommended to prevent gestational iron deficiency. The effect of the "balance" dietary pattern on iron status in the first trimester and following requires further research and discussion.

摘要

目的

探讨饮食及潜在因素对孕早期女性铁状态的影响,为预防缺铁及缺铁性贫血提供依据,从而降低相关不良结局的发生率。

方法

2018年11月至12月,选取在北京顺义区妇幼保健院建立产前检查记录的孕早期(妊娠<12周)女性纳入本研究,对388名参与者收集人口统计学特征、人体测量学指标、产次、反映铁状态的生物标志物及食物频率问卷等数据。采用SPSS 26.0进行统计分析。运用主成分分析法提取饮食模式,并计算各饮食模式的因子得分。采用双侧Fisher确切概率检验和单因素方差分析比较各组铁状态差异,P<0.05为差异有统计学意义。缺铁定义为血清铁蛋白(SF)<30μg/L。为分析孕早期饮食因素对缺铁的潜在作用,将上述收集的数据作为独立因素进行横断面Logistic回归分析。采用Logistic回归分析基线特征和饮食因素对铁状态的潜在影响。

结果

纳入分析的388名参与者中,121名(32.2%)缺铁,其中107名(27.6%)为铁耗竭(ID),8名(2.1%)为缺铁性红细胞生成(IDA),6名(1.5%)为缺铁性贫血。SF平均浓度为(50.4±35.3)μg/L。多产次(OR=3.9,95%CI:1.81-8.42,P=0.

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