早孕期血红蛋白水平对妊娠结局的影响

Effect of hemoglobin levels in early pregnancy on pregnancy outcomes

目的评估早孕期血红蛋白(hemoglobin,Hb)水平对妊娠结局的影响。方法回顾性分析2016年1月至2017年5月在暨南大学附属第一医院定期产检和分娩的1306例女性的临床资料,根据Hb水平将其分为3组:低Hb组(Hb<110 g/L,490例),中Hb组(110≤Hb<130 g/L,673例),高Hb组(Hb≥130 g/L,143例)。再将低Hb组分为2个亚组:极低Hb组(Hb≤90 g/L,64例)和较低Hb组(Hb>90 g/L,426例)。分析比较各组的一般资料及妊娠结局。结果3组孕妇的妊娠期高血压疾病发生率、早产率、NICU住院率、产后出血率、分娩孕周、新生儿出生体重、Apgar评分比较,差异有统计学意义(P<0.05)。组间比较,中Hb组的分娩孕周、出生体重、1 min Apgar评分均较低Hb组和高Hb组高,高Hb组的妊娠期高血压疾病发生率较低Hb组和中Hb组高,差异有统计学意义(P<0.05)。高Hb组的早产率、NICU住院率较高,低Hb组的产后出血发生率较高。极低Hb组和较低Hb组妊娠期高血压疾病患病率比较,差异有统计学意义(P<0.05)。结论Hb水平过高或过低都与不良妊娠结局有关,建议在妊娠期间筛查Hb水平以减少不良妊娠结局,确保母儿平安。

Objective To assess the impact of hemoglobin(Hb)levels in early pregnancy on pregnancy outcomes.Methods Retrospective analysis of clinical data of 1306 women who performed regular checkups and deliveries at the First Affiliated Hospital of Jinan University from January 2016 to May 2017.They were divided into 3 groups according to Hb level:low Hb group(Hb<110 g/L,490 cases),middle Hb group(110<Hb<130 g/L,673 cases),and high Hb group(Hb≥130 g/L,143 cases).The low Hb component was divided into two subgroups:the very low Hb group(Hb≤90 g/L,64 cases)and the lower Hb group(Hb≥90 g/L,426 cases).Analyzed and compared the general information and pregnancy outcomes of these groups.Results There were statistically significant differences in the incidence of hypertension during pregnancy,premature delivery,NICU hospitalization rate,postpartum hemorrhage rate,gestational weeks,newborn birth weight,and Apgar score among the three groups of pregnant women(P<0.05).Comparison between groups,the gestational weeks,newborn birth weight,and 1-minute Apgar score in the middle Hb group were higher in the low Hb group and the high Hb group,and the high Hb group had a higher incidence of hypertension during pregnancy than the low Hb group and the middle Hb group,the difference was statistically significant(P<0.05).The preterm birth rate and NICU hospitalization rate were higher in the high Hb group,and the incidence of PPH was higher in the low Hb group.There was a statistically significant difference in the prevalence of hypertension during pregnancy between the very low Hb group and the lower Hb group(P<0.05).Conclusion Too high or too low Hb levels are related to adverse pregnancy outcomes.Screening for Hb levels during pregnancy is recommended to reduce adverse pregnancy outcomes and ensure mother and child safety.