缺铁性贫血与严重孕产妇发病之间的关联：一项回顾性队列研究。
Association between iron deficiency anemia and severe maternal morbidity: A retrospective cohort study.
作者信息
Nyarko Samuel H, Greenberg Lucy T, Saade George R, Phibbs Ciaran S, Buzas Jeffrey S, Lorch Scott A, Rogowski Jeannette, Passarella Molly, Boghossian Nansi S
机构信息
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
Vermont Oxford Network, Burlington, VT, United States.
出版信息
Ann Epidemiol. 2024 Dec;100:10-15. doi: 10.1016/j.annepidem.2024.10.006. Epub 2024 Oct 21.
PURPOSE
We examined the association between iron deficiency anemia (IDA) and severe maternal morbidity (SMM) during delivery and up to 1-year postpartum.
METHODS
In a retrospective cohort study across 3 states, we computed adjusted relative risks (aRR) for SMM comparing individuals with IDA versus those without, using modified Poisson regression models.
RESULTS
Among 2459,106 individuals, 10.3 % (n = 252,240) had IDA. Individuals with IDA experienced higher rates of blood transfusion and non-transfusion SMM (329 and 122 per 10,000 deliveries, respectively) than those without IDA (33 and 46 per 10,000 deliveries, respectively). The risk of blood transfusion (aRR: 8.2; 95 % CI 7.9-8.5) and non-transfusion SMM (aRR: 1.9; 95 % CI: 1.8-2.0) were higher among individuals with IDA. The attributable risk per 10,000 deliveries due to IDA for blood transfusion and non-transfusion SMM during delivery were 29.5 (95 % CI: 28.9-30.0) and 5.7 (95 % CI: 5.3-6.2), respectively. Within 1-year postpartum, the relative risk of non-transfusion SMM (aRR:1.3; 95 % CI: 1.2-1.3) was 30 % higher among individuals with IDA.
CONCLUSION
IDA is associated with increased SMM risk. Addressing IDA in pregnant individuals may reduce SMM rates.
目的
我们研究了分娩期间及产后1年内缺铁性贫血（IDA）与严重孕产妇发病（SMM）之间的关联。
方法
在一项横跨3个州的回顾性队列研究中，我们使用改良泊松回归模型计算了患有IDA与未患IDA个体的SMM调整相对风险（aRR）。
结果
在2459106名个体中，10.3%（n = 252240）患有IDA。患有IDA的个体输血性和非输血性SMM发生率（分别为每10000例分娩329例和122例）高于未患IDA的个体（分别为每10000例分娩33例和46例）。患有IDA的个体输血风险（aRR：8.2；95%CI 7.9 - 8.5）和非输血性SMM风险（aRR：1.9；95%CI：1.8 - 2.0）更高。分娩期间因IDA导致的每10000例分娩输血性和非输血性SMM的归因风险分别为29.5（95%CI：28.9 - 30.0）和5.7（95%CI：5.3 - 6.2）。产后1年内，患有IDA的个体非输血性SMM的相对风险（aRR：1.3；95%CI：1.2 - 1.3）高出30%。
结论
IDA与SMM风险增加相关。解决孕妇的IDA问题可能会降低SMM发生率。
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