妊娠晚期贫血的影响因素研究

Influencing factors for anemia in the third trimester of pregnancy

目的分析妊娠晚期贫血的影响因素,为预防妊娠晚期贫血提供依据。方法选择2019年10—12月在杭州市妇产科医院足月分娩的产妇为调查对象,通过产科电子病历系统收集基本信息,分别于妊娠中期和晚期检测血清铁蛋白、维生素B12、叶酸和血红蛋白;采用多因素Logistic回归模型分析妊娠晚期贫血的影响因素。结果纳入产妇1143人,年龄M(QR)为29(4)岁;孕前体重正常1050人,占91.86%;经产267人,占23.36%。发生妊娠晚期贫血74例,发生率为6.92%。多因素Logistic回归分析结果显示,经产(OR=1.714,95%CI:1.032~2.848)、妊娠中期铁缺乏(OR=3.301,95%CI:1.401~7.781)、妊娠晚期铁缺乏(OR=14.134,95%CI:1.944~102.774)和妊娠晚期叶酸不足(OR=2.960,95%CI:1.295~6.766)与妊娠晚期贫血存在统计学关联。结论妊娠晚期发生贫血与妊娠中期和晚期铁缺乏、妊娠晚期叶酸不足和经产有关。

Objective To explore the influencing factors for maternal anemia during the third trimester of pregnancy,so as to provide the evidence for the effective prevention of anemia.Methods Data of parturients,who received prenatal care and delivered at Hangzhou Women's Hospital from October to December of 2019 were retrospectively collected and analyzed.The obstetric electronic medical record system of this hospital was used to collect general information of the subjects.Serum ferritin,serum vitamin B12,serum folic acid and hemoglobin were determined at the second and third trimester.A multivariate logistic regression model was used to analyze the influencing factors for anemia in the third trimester.Results A total of 1143 parturients were enrolled,with a median age of 29(interquartile range:4)years.Among them,1050 cases had normal weight before pregnancy,accounting for 91.86%;267 cases were multipa⁃ras,accounting for 23.36%;74 cases of anemia occurred during the third trimester of pregnancy,accounting for 6.92%.Multivariate logistic regression analysis indicated that the multipara(OR=1.714,95%CI:1.032-2.848),iron deficiency duiring the second trimester(OR=3.301,95%CI:1.401-7.781),iron deficiency during the third trimester(OR=14.134,95%CI:1.944-102.774)and folate deficiency during the third trimester(OR=2.960,95%CI:1.295-6.766)were influencing factors for anemia during the third trimester.Conclusion Anemia during the third trimester of preg⁃nancy is related to iron deficiency during the second and third trimesters,folic acid deficiency during the third trimes⁃ter,and multipara.