中国孕妇、育龄妇女铁缺乏症患病率调查

Prevalence of iron deficiency in pregnant and premenopausal women in China: A nationwide epidemiological survey

目的 调查我国孕妇、育龄妇女铁减少 (ID)、缺铁性贫血 (IDA)及铁缺乏症 (ID +IDA)患病率。方法 采用分层抽样的方法 ,以全国 15个省 ,2 6个市县为调查点 ,随机抽取 35 91例孕妇、372 1例育龄妇女为调查对象 ,检测末梢血血红蛋白浓度、锌原卟啉、血清铁蛋白等指标。结果 孕妇ID、IDA、铁缺乏症患病率分别为 4 2 .6 %、19.1%、6 1.7% ;育龄妇女ID、IDA、铁缺乏症患病率分别为34.4 %、15 .1%、4 9.5 %。孕妇ID、IDA、铁缺乏症患病率显著高于育龄妇女 (P <0 .0 1)。早孕ID、IDA、铁缺乏症患病率分别为 39.9%、9.6 %、4 9.5 % ;中孕ID、IDA、铁缺乏症患病率分别为 38.8%、19 .8%、5 8.6 % ;晚孕ID、IDA、铁缺乏症患病率分别为 5 1.6 %、33.8%、85 .4 %。不同孕期孕妇IDA、铁缺乏症患病率差异有显著性 (P <0 .0 1)。晚孕ID患病率显著高于早、中孕 (P <0 .0 1) ,但早、中孕之间差异无显著性 (P >0 .0 5 )。农村早孕ID、IDA患病率为 36 .1%、12 .2 % ,IDA者Hb 99.3± 8.0 g/L ;城市早孕ID、IDA患病率为 4 1.9%、8.2 % ,IDA者Hb 10 1.7± 6 .7g/L。农村育龄妇女ID、IDA患病率为 32 .4 %、17.4 %、IDA者Hb 10 5 .9± 11.8g/L ;城市育龄妇女ID、IDA患病率为 35 .6 %、13.8%、IDA者Hb 10 9.9± 8.8g/L。

Objective In order to better understand the iron status in pregnant and premenopausal nonpregnant women in China. Methods A nationwide epidemiological survey was undertaken in the year 2000 to investigate the prevalence rates(PR) of iron depletion (ID), iron deficiency anemia (IDA) and iron deficiency (ID+IDA). 3591 pregnant women and 3721 premenopausal women were selected by multistratification and random sampling from 26 cities and counties of 15 provinces. Hb was measured by cyanmethemoglobin assay, zinc protoporphorin by hemofluoresceine assay and serum ferritin by radioimmunoassay. Results The PR of ID and IDA were 42.6% and 19.1% in pregnant women, while 34.4% and 15.1% in premenopausal nonpregnant women respectively. There were statistical differences in the PR of IDA and ID+IDA in pregnant women between different trimesters (P<0.01), with the highest in the third trimester (33.8%, 85.4%), followed by the second and the first trimesters. The prevalence rate of ID was also the highest during late pregnancy (51.6%), which was statistically different from that of early and mid pregnancies ( 39.9 % and 38.8% respectively), whereas there was no significant difference between the PR in early and mid pregnancies. The PR of ID, IDA and ID+IDA in pregnant women were all significantly higher than that in premenopausal non pregnant women (P<0.01). The PR of ID in urban first-trimester pregnant women (41.9%) and premenopausal non pregnant women(35.6%) were significantly higher than that in their rural counterparts (36.1% and 32.4% respectively P<0.05). On the other hand, the PR of IDA in rural pregnant women in first trimester (12.2%) and premenopausal non pregnant women (17.4%) were significantly higher than that in their urban counterparts (8.2% and 13.8% respectively, P<0.05). However, there was no significant difference between the PR of ID+IDA in urban pregnant women (62.0%), premenopausal nonpregnant women (49.4%) and then rural counterparts (61.1% and 49.7%). Conclusions IDA and latent iron deficiency are still quite common in Chinese pregnant and premenopausal nonpregnant women. Pregnant women in mid and late pregnancies are at risk for iron deficiency. Latent iron deficiency is more prevalent in urban pregnant and nonpregnant premenopausal women, but their rural counterparts were prone to the development of IDA.