Liu Lulu, Li Xiaoqing
Department of Anesthesiology, Tongzhou Maternal and Child Health Hospital, Beijing, 101100, People's Republic of China.
Department of Obstetrics, Tongzhou Maternal and Child Health Hospital, Beijing, 101100, People's Republic of China.
Int J Womens Health. 2025 Jun 17;17:1829-1835. doi: 10.2147/IJWH.S530428. eCollection 2025.
Anemia affects over 30% of pregnancies globally and is associated with adverse maternal-fetal outcomes, underscoring the critical need for early risk prediction.
This study aimed to assess the predictive value of early pregnancy hemoglobin levels for anemia development in mid- and late pregnancy.
We conducted a retrospective cohort analysis of 1999 singleton pregnancies with neuraxial labor analgesia at Beijing Tongzhou District Maternal and Child Health Hospital (January 2022-January 2023). Inclusion criteria included age ≥18 years, BMI 19.0-44.3 kg/m², and ASA II classification. Exclusions comprised multifetal gestations, chronic hematologic disorders, or incomplete data. Hemoglobin trends were analyzed using Sankey diagrams, and predictive thresholds were determined via ROC curves (R 4.4.1).
The cohort included 76.94% primiparas and 45.47% with comorbidities (hypertension, diabetes, thyroid disorders). Hemoglobin levels declined significantly from early pregnancy (median 131.00 g/L) to mid- and late pregnancy (118.00 g/L; P<0.001). ROC analysis identified early-pregnancy hemoglobin thresholds for anemia prediction: <126.5 g/L (mid-pregnancy AUC 0.82, 95% CI 0.80-0.84) and <127.5 g/L (late-pregnancy AUC 0.71, 95% CI 0.68-0.74).
Early pregnancy hemoglobin thresholds provide a clinically actionable tool for identifying high-risk pregnancies, enabling timely interventions to reduce anemia-related complication.
全球超过30%的孕妇受贫血影响，且贫血与母婴不良结局相关，这凸显了早期风险预测的迫切需求。
本研究旨在评估孕早期血红蛋白水平对孕中晚期贫血发生的预测价值。
我们对北京通州区妇幼保健院1999例接受椎管内分娩镇痛的单胎妊娠进行了回顾性队列分析（2022年1月至2023年1月）。纳入标准包括年龄≥18岁、体重指数19.0 - 44.3kg/m²以及美国麻醉医师协会（ASA）Ⅱ级分类。排除标准包括多胎妊娠、慢性血液系统疾病或数据不完整。使用桑基图分析血红蛋白变化趋势，并通过ROC曲线（R 4.4.1）确定预测阈值。
该队列中初产妇占76.94%，合并症（高血压、糖尿病、甲状腺疾病）患者占45.47%。血红蛋白水平从孕早期（中位数131.00g/L）到孕中晚期（118.00g/L）显著下降（P<0.001）。ROC分析确定了预测贫血的孕早期血红蛋白阈值：<126.5g/L（孕中期AUC 0.82，95%CI 0.80 - 0.84）和<127.5g/L（孕晚期AUC 0.71，95%CI 0.68 - 0.74）。
孕早期血红蛋白阈值为识别高危妊娠提供了一种临床可操作的工具，有助于及时干预以减少贫血相关并发症。
