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拉贾斯坦邦西部一家三级护理医院中孕期、孕中期和孕晚期孕妇造血生化参数的比较

Comparison of Hemopoietic Biochemical Parameters in the First, Second, and Third Trimester of Pregnant Females Attending a Tertiary Care Hospital of Western Rajasthan.

作者信息

Bissa Madhu Shekhar, Rawtani Jairam, Sihag Sapna, Bissa Richa

机构信息

Department of Biochemistry, Dr. Bhimrao Ramji Ambedkar Government Medical College, Sirohi, IND.

Department of Biochemistry, Dr. Sampurnanand Medical College, Jodhpur, IND.

出版信息

Cureus. 2024 Apr 7;16(4):e57766. doi: 10.7759/cureus.57766. eCollection 2024 Apr.

Abstract

BACKGROUND

Pregnant women constitute a high-risk group for nutrient deficiency anemia which may be associated with detrimental effects on maternal and infant health.

OBJECTIVES

This study aimed to assess and compare hematological and biochemical changes across trimesters in pregnant women, considering parameters such as hemoglobin, serum iron, unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), ferritin, vitamin B12, and folic acid. The research sought to identify mean value differences, correlations, and potential implications for maternal healthcare practices.

METHODS

A hospital-based prospective observational study was conducted, involving 60 primigravida women with singleton pregnancies. The subjects were assessed during the first, second, and third trimesters. Biochemical parameters were assessed using standard methods, and statistical analysis was performed to identify significance and correlations.

RESULTS

The study revealed a significant decline in hemoglobin, serum iron, ferritin, vitamin B12, and folic acid as pregnancy advanced. Hemoglobin levels decreased from 11.40 g/dl (first trimester) to 10.43 g/dl (third trimester). Serum iron exhibited a decline from 109.73 µg/dl (first trimester) to 94.03 µg/dl (third trimester). Serum ferritin decreased from 24.93 ng/ml (first trimester) to 18.21 ng/ml (third trimester). Vitamin B12 levels dropped from 255.92 pg/ml (first trimester) to 92.13 pg/ml (third trimester). Folic acid levels decreased from 13.82 ng/ml (first trimester) to 11.77 ng/ml (third trimester). UIBC and TIBC concentrations increased progressively across trimesters. Statistical evaluations confirmed the significance of these trends. The coefficient of correlation indicated positive relationships between hemoglobin and serum iron, ferritin, folic acid, and vitamin B12. Positive correlation between serum iron and ferritin, vitamin B12, and negative with folic acid. Serum ferritin negatively correlated with vitamin B12 and folic acid. Serum folic acid and vitamin B12 are positively correlated.

CONCLUSION

The findings emphasize the dynamic nature of hematological and biochemical changes during pregnancy. The observed trends have profound implications for maternal healthcare practices, urging targeted interventions, early monitoring, and supportive supplementation. Recognizing these variations contributes to the optimization of health outcomes for both mother and child.

摘要

背景

孕妇是营养缺乏性贫血的高危人群,这可能会对母婴健康产生不利影响。

目的

本研究旨在评估和比较孕妇孕期各阶段的血液学和生化变化,考虑血红蛋白、血清铁、不饱和铁结合力(UIBC)、总铁结合力(TIBC)、铁蛋白、维生素B12和叶酸等参数。该研究试图确定均值差异、相关性以及对孕产妇保健实践的潜在影响。

方法

进行了一项基于医院的前瞻性观察研究,纳入60名单胎初产妇。在孕早期、孕中期和孕晚期对受试者进行评估。使用标准方法评估生化参数,并进行统计分析以确定显著性和相关性。

结果

研究显示,随着孕期进展,血红蛋白、血清铁、铁蛋白、维生素B12和叶酸显著下降。血红蛋白水平从孕早期的11.40 g/dl降至孕晚期的10.43 g/dl。血清铁从孕早期的109.73 µg/dl降至孕晚期的94.03 µg/dl。血清铁蛋白从孕早期的24.93 ng/ml降至孕晚期的18.21 ng/ml。维生素B12水平从孕早期的255.92 pg/ml降至孕晚期的92.13 pg/ml。叶酸水平从孕早期的13.82 ng/ml降至孕晚期的11.77 ng/ml。UIBC和TIBC浓度在孕期各阶段逐渐升高。统计评估证实了这些趋势的显著性。相关系数表明血红蛋白与血清铁、铁蛋白、叶酸和维生素B12之间呈正相关。血清铁与铁蛋白、维生素B12呈正相关,与叶酸呈负相关。血清铁蛋白与维生素B12和叶酸呈负相关。血清叶酸和维生素B12呈正相关。

结论

研究结果强调了孕期血液学和生化变化的动态性质。观察到的趋势对孕产妇保健实践具有深远影响,促使进行有针对性的干预、早期监测和支持性补充。认识到这些变化有助于优化母婴健康结局。

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本文引用的文献

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Hematological indexes and iron status in pregnant mares.怀孕母马的血液学指标和铁状态
Arch Anim Breed. 2023 Jul 27;66(3):197-205. doi: 10.5194/aab-66-197-2023. eCollection 2023.
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Current concepts in preoperative anemia management in obstetrics.产科术前贫血管理的当前概念。
Curr Opin Anaesthesiol. 2023 Jun 1;36(3):255-262. doi: 10.1097/ACO.0000000000001252. Epub 2023 Feb 27.
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Nutrient Requirements during Pregnancy and Lactation.怀孕和哺乳期的营养需求
Nutrients. 2021 Feb 21;13(2):692. doi: 10.3390/nu13020692.

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