Siega-Riz A M, Adair L S, Hobel C J
Department of MCH, University of North Carolina School of Public Health, Chapel Hill, USA.
Am J Perinatol. 1998;15(9):515-22. doi: 10.1055/s-2007-993976.
This study was conducted to document the prevalence of anemia and high hematocrit during pregnancy and examine their effect on delivering preterm in a predominantly Hispanic population. The sample consisted of women receiving prenatal care from the public health clinics in the West Los Angeles from 1983 to 1986 (n = 7589). Multivariate logistic regression was used to isolate the role of anemia and high hematocrit from other factors that may influence birth outcome. The prevalence of anemia was approximately 9% at the initiation of prenatal care and at 28-32 weeks' gestation. Only anemia at 28-32 weeks was significantly associated with a preterm birth, even after adjusting for several confounders [Adjusted Odds Ratio (AOR) 1.83 95% Cl = 1.21, 2.77]. A high hematocrit that occurred in 9.6% of the population at 28-32 weeks was inversely associated with a preterm birth (AOR 0.78, 95% Cl = 0.44, 1.39). There was little differentiation of these risk factors when analyzing the etiological pathways of a preterm birth. These results indicate for the first time in a predominantly Hispanic population that despite routine iron supplementation, anemia still occurs in pregnant women and it can predict a preterm delivery.
本研究旨在记录孕期贫血和高血细胞比容的患病率,并在以西班牙裔为主的人群中研究它们对早产的影响。样本包括1983年至1986年在西洛杉矶公共卫生诊所接受产前护理的妇女(n = 7589)。采用多因素逻辑回归分析,以区分贫血和高血细胞比容与其他可能影响分娩结局的因素的作用。产前护理开始时以及妊娠28 - 32周时贫血患病率约为9%。即使在调整了几个混杂因素后,仅妊娠28 - 32周时的贫血与早产显著相关[调整优势比(AOR)1.83,95%可信区间(Cl)= 1.21,2.77]。在28 - 32周时,9.6%的人群出现高血细胞比容,其与早产呈负相关(AOR 0.78,95% Cl = 0.44,1.39)。在分析早产的病因途径时,这些危险因素几乎没有差异。这些结果首次表明,在以西班牙裔为主的人群中,尽管常规补充铁剂,但孕妇仍会发生贫血,且贫血可预测早产。