东南亚缺失型α-地中海贫血孕妇孕期血清铁蛋白水平变化及妊娠结局分析

Serum ferritin level changes and pregnancy outcome in pregnant women withα-thalassemia of Southeast Asian type deletion

目的分析东南亚缺失型α-地中海贫血孕妇孕期各阶段血清铁蛋白(SF)水平的变化情况及妊娠结局。方法选取2018年6月至2020年2月在广西壮族自治区人民医院产科门诊定期规范产检确诊为东南亚缺失型α-地中海贫血孕妇138例为观察组,同期规范产检无妊娠并发症的孕妇156例为对照组。比较两组孕妇早孕期(11~14周)、中孕期(24~28周)、晚孕期(28周至分娩)的SF和血红蛋白(Hb)水平,同时比较两组孕妇SF及Hb异常的患病率及妊娠结局。结果观察组孕妇早孕期SF水平为(81.38±51.91)μg/L,明显高于对照组的(69.74±38.25)μg/L,差异有统计学意义(P<0.05);观察组孕妇中孕期和晚孕期的SF水平分别为(21.41±19.72)μg/L、(15.55±12.70)μg/L,与对照组的(20.74±21.27)μg/L、(15.27±12.18)μg/L比较差异均无统计学意义(P>0.05);观察组孕妇早、中、晚孕期的Hb水平分别为(111.67±8.14)g/L、(103.01±7.32)g/L、(105.50±9.11)g/L,明显低于对照组的(122.87±9.91)g/L、(111.92±8.88)g/L、(113.69±10.30)g/L,差异均有统计学意义(P<0.05);观察组孕妇的妊娠期糖尿病(GDM)率和妊娠期高血压疾病(HDP)率分别为35.51%、5.80%,明显高于对照组的24.36%、1.28%;产后出血(PPH)率和剖宫产率分别为7.25%、34.06%,明显高于对照组的1.92%、22.44%,新生儿出生体质量为(3035.00±499.54)g,明显低于对照组的(3298.88±405.24)g,差异均有统计学意义(P<0.05);观察组和对照组孕妇的早产率分别为5.07%、1.92%,差异无统计学意义(P>0.05)。结论东南亚缺失型α-地中海贫血孕妇的孕早期SF明显偏高,孕期的Hb明显偏低,GDM率、HDP率、PPH率、剖宫产率明显升高,新生儿出生体质量明显偏低。

Objective To analyze the changes of serum ferritin(SF)level and pregnancy outcome in different stages of pregnancy in pregnant women withα-thalassemia of Southeast Asian(SEA)type deletion.Methods A total of 138 pregnant women withα-thalassemia of Southeast Asian(SEA)type deletion who were registered in Department of Obstetrics,People’s Hospital of Guangxi Zhuang Autononmous Region for regular pregnant health checkup during the period from June 2018 to February 2020 were selected as observation group.During the same period,156 pregnant women without pregnancy complications were taken as control group.The differences of serum ferritin and hemoglobin(Hb)were compared between the two groups in early pregnancy(11-14 weeks),middle pregnancy(24-28 weeks),late pregnancy(28 weeks to delivery),and the prevalence of SF and Hb abnormalities and pregnancy outcome were compared.Results The SF level of the observation group in early pregnancy were(81.38±51.91)μg/L,which was significantly higher than(69.74±38.25)μg/L of the control group(P<0.05).The SF levels in the observation group during the middle and late pregnancy were(21.41±19.72)μg/L and(15.55±12.70)μg/L,respectively,which were not significantly different from(20.74±21.27)μg/L and(15.27±12.18)μg/L in the control group(P>0.05).The Hb levels in the observation group during early,middle and late pregnancy were(111.67±8.14)g/L,(103.01±7.32)g/L,(105.50±9.11)g/L,which were significantly lower than(122.87±9.91)g/L,(111.92±8.88)g/L,(113.69±10.30)g/L in the control group,and the differences were statistically significant(P<0.05).The gestational diabetes mellitus(GDM)rate of the observation group was35.51%,which was significantly higher than 24.36%of the control group;the hypertensive disorders of pregnancy(HDP)rate was 5.80%,which was significantly higher than 1.28%of the control group;the postpartum haemorrhage(PPH)rate was 7.25%,significantly higher than 1.92%of the control group;the cesarean section rate was 34.06%,significantly higher than 22.44%of the control group;the birth weight of the newborns was(3035.00±499.54)g,significantly lower than(3298.88±405.24)g of the control group(P<0.05).The preterm birth rates of the two groups were 5.07%and1.92%,respectively,with no significant difference(P>0.05).Conclusion SF was significantly higher in the early pregnancy and Hb was significantly lower in pregnant women withα-thalassemia of Southeast Asian(SEA)type deletion.GDM rate,HDP rate,PPH rate,and cesarean section rate of the patients were significantly higher,and the birth weight of newborns was significantly lower.