Shehata H A, Ali M M, Evans-Jones J C, Upton G J, Manyonda I T
Department of Obstetrics and Gynaecology, Mayday University Hospital, Surrey, United Kingdom.
Int J Gynaecol Obstet. 1998 Jul;62(1):43-6. doi: 10.1016/s0020-7292(98)00069-1.
As part of an exercise in establishing normograms of hematological parameters in pregnancy, we studied the red cell distribution width (RDW) in healthy pregnant women.
A longitudinal study of RDW measurements in 121 pregnant women at 16 and 34 weeks gestation and during labor and at Days 3 and 7 postpartum. All the women had uncomplicated pregnancies, minimum hemoglobin (Hb) of 11.0 g/dl at recruitment and took iron supplements from 16 weeks of gestation and until 7 days after delivery. All subjects went into spontaneous labor, 110 achieving a normal vaginal delivery while the remaining 11 were delivered by cesarean section. Two-way analysis of variance was used to study the changes in RDW between any given gestations to test the variability between and within subjects.
RDW increased significantly (P < 0.0001) between 34 weeks of gestation and the onset of labor. No significant changes occurred between 16 and 34 weeks gestation, or during the 7 days postpartum.
This is the first longitudinal study analyzing the between and within women changes in RDW with progression of pregnancy. The unexpected rise in the RDW during the last 4-6 weeks leading up to the onset of labor suggests increased bone marrow activity. The stimulus is unknown, but as RDW changes are highly significant there may well be a useful indicator of impending parturition.
作为建立孕期血液学参数标准曲线工作的一部分，我们对健康孕妇的红细胞分布宽度（RDW）进行了研究。
对121名孕妇在妊娠16周、34周、分娩时以及产后第3天和第7天进行RDW测量的纵向研究。所有孕妇妊娠过程均无并发症，招募时最低血红蛋白（Hb）为11.0 g/dl，从妊娠16周开始直至分娩后7天服用铁补充剂。所有受试者均自然分娩，110例顺利阴道分娩，其余11例剖宫产。采用双向方差分析研究不同孕周间RDW的变化，以检验受试者之间和内部的变异性。
妊娠34周与分娩开始之间RDW显著增加（P < 0.0001）。妊娠16至34周期间以及产后7天内未发生显著变化。
这是第一项纵向研究，分析了随着妊娠进展女性体内和个体间RDW的变化。临产前最后4 - 6周RDW意外升高表明骨髓活动增加。刺激因素尚不清楚，但由于RDW变化非常显著，它很可能是即将分娩的有用指标。
