Liao Xing, Xiu Xiaoyan, Xu Guizhen, Wu Ling, Fang Zhuanji, Huang Huihui
Xing Liao, Department of Pediatrics, Fujian Children's Hospital, Fuzhou, Fujian Province 350001, China. Fujian Maternity and Child Health Hospital; College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics,Fujian Medical University, Fuzhou, Fujian Province 350001, China.
Xiaoyan Xiu Department of Obstetrics, Fujian Maternity and Child Health Hospital; College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province 350001, China.
Pak J Med Sci. 2024 Aug;40(7):1485-1492. doi: 10.12669/pjms.40.7.9160.
To investigate the association of altered serum ferritin during pregnancy with chorioamnionitis and neonatal sepsis.
This retrospective cohort study included 78,521 pregnant women who attended antenatal check-ups at maternal and child health centers in Fujian Province, China. Study lasted from January 2014 to January 2019. A total of 59,812 pregnant women were followed up. Patients with suspected infection before the delivery were selected and divided into the chorioamnionitis and non-chorioamnionitis groups according to placental pathology. Differences in late and early pregnancy serum ferritin between the two groups were compared. Multiple logistics regression was used to adjust for confounding factors and to analyze the association between serum ferritin changes and pregnancy outcomes. Importance of altered serum ferritin during pregnancy was assessed by receiver operating characteristic (ROC) curve and net reclassification index (NRI).
Clinical records of 8506 pregnant women were included in the study. there were 1010 (11.9%) cases of confirmed chorioamnionitis and 263 (3.1%) cases of neonatal sepsis. There was a significant difference in maternal serum ferritin changes between the groups with and without chorioamnionitis. No significant difference was detected in cases with or without neonatal sepsis. Multiple logistic regressions, corrected for confounding factors yielded similar conclusions. Maternal serum ferritin difference NRI 12.18% (p = 0.00014) was similar to the ROC results in predicting the occurrence of chorioamnionitis.
Differential serum ferritin during pregnancy may predict chorioamnionitis but does not correlate well with neonatal sepsis.
探讨孕期血清铁蛋白改变与绒毛膜羊膜炎及新生儿败血症的关联。
这项回顾性队列研究纳入了78521名在中国福建省妇幼保健中心进行产前检查的孕妇。研究时间为2014年1月至2019年1月。共对59812名孕妇进行了随访。选取分娩前疑似感染的患者，根据胎盘病理结果分为绒毛膜羊膜炎组和非绒毛膜羊膜炎组。比较两组妊娠晚期和早期血清铁蛋白的差异。采用多因素logistic回归分析调整混杂因素，并分析血清铁蛋白变化与妊娠结局的关联。通过受试者工作特征（ROC）曲线和净重新分类指数（NRI）评估孕期血清铁蛋白改变的重要性。
本研究纳入了8506名孕妇的临床记录。确诊绒毛膜羊膜炎1010例（11.9%），新生儿败血症263例（3.1%）。有绒毛膜羊膜炎组和无绒毛膜羊膜炎组孕妇血清铁蛋白变化存在显著差异。有或无新生儿败血症的病例中未检测到显著差异。校正混杂因素后的多因素logistic回归得出了类似的结论。孕妇血清铁蛋白差异NRI为12.18%（p = 0.00014），与预测绒毛膜羊膜炎发生的ROC结果相似。
孕期血清铁蛋白差异可能预测绒毛膜羊膜炎，但与新生儿败血症的相关性不佳。
