妊娠期贫血与早产

Anemia during pregnancy and risk of preterm birth

目的分析妊娠期贫血及严重程度与早产的关系。方法对江苏和浙江省4个县市1995～2000年102489名孕产妇孕期各个阶段贫血与非贫血及不同贫血程度早产的发生率进行分析;并采用Logistic回归控制年龄、文化程度、孕次、妊娠高血压疾病等因素的影响,估计孕期各阶段贫血严重程度与早产的关联程度。结果孕早期贫血组早产发生率高于孕早期非贫血组,孕晚期贫血组早产发生率低于孕晚期非贫血组,差异均有统计学意义(P<0.01),孕中期贫血组与孕中期非贫血组早产率比较,差异无统计学意义(P>0.01)。孕早期随着贫血程度的增加,早产的风险逐渐升高,重度贫血孕妇早产风险是非贫血孕妇的5.4倍;孕中期非贫血组、轻度贫血组和中度贫血组早产发生率没有明显差别,重度贫血组早产发生率最高,与非贫血孕妇相比早产风险增加60%;孕晚期轻度贫血组早产发生率最低,重度贫血组早产发生率最高,与非贫血孕妇相比早产风险增加30%。结论孕早期轻度以上贫血,孕中、晚期重度贫血与早产风险增加有关;预防孕期贫血应从孕早期开始。

Objective To examine the association between maternal anemia during pregnancy and the risk of preterm birth in a Chinese population. Methods Subjects were women who delivered in the years 1995 -2000 in four cities or counties in Jiangsu Province and Zhejiang Province, China. Maternal anemia was defined as hemoglobin concentration lower than 110 g/L during pregnancy. Incidence of preterm birth was calculated and compared among women with non - anemia, mild, moderate, and severe anemia in three different trimesters. Multiple logistic regression analysis was used to address the relationships between the severity of anemia and the risk of preterm birth while controlling for potential confounding factors. Results Anemia in the first trimester was associated with an increased risk of preterm birth. The risk of pre- term birth was increased with the severity of anemia. The risk of preterm birth associated with severe anemia was 5.4 times that of the non - anemia. Anemia in the second trimester was not associated with an elevated risk of preterm birth, and anemia in the third trimester was associated with an decreased risk of preterm birth. Although mild anemia in the second and the third trimester was not associated with an increase risk of preterm birth, severe anemia was associated with 30 % - 60 % increase in the risk of preterm birth com- pared to the non - anemia group. Conclusion Mild anemia during early pregnancy and severe anemia during late pregnancy increases the risk of preterm birth. Anemia prevention should be initiated from early pregnancy.