妊娠中晚期缺铁性贫血情况及血清铁蛋白水平对缺铁性贫血和妊娠结局的影响

Study on the iron deficiency anemia status in the second and third trimester of pregnancy and the effect of Serum Ferritin level on iron deficiency anemia and pregnancy outcome

目的 观察妊娠中晚期缺铁性贫血现状并研究血清铁蛋白水平对缺铁性贫血、妊娠结局的影响效应。方法 选取2018年1月至2021年1月宁德师范学院附属宁德市医院门诊建档立卡的妊娠中晚期妇女190例作为研究对象。比较190例妊娠中晚期妇女贫血现状,分别按照不同妊娠时期及不同血清铁蛋白水平进行分组,分析血清铁蛋白水平与妇女妊娠中晚期缺铁性贫血发生及妊娠结局的关系,以及血清铁蛋白、血红蛋白水平及二者联合检测对妊娠结局的评估价值。结果 妊娠晚期缺铁性贫血发生率高于妊娠中期,差异有统计学意义(χ^(2)=7.161,P<0.05)。妊娠晚期轻度贫血发生率低于妊娠中期,中度及重度贫血发生率均高于妊娠中期,差异有统计学意义(Z=2.216,P<0.05)。随着血清铁蛋白水平升高,妊娠中晚期缺铁性贫血发生率逐渐下降,差异有统计学意义不同血清铁蛋白水平者妊娠晚期缺铁性贫血发生率比较,差异有统计学意义(χ^(2)=107.820,P<0.05)。妊娠期贫血妇女不良妊娠结局发生率明显高于正常妇女,血清铁蛋白水平10~19.9 ng/mL的妊娠期贫血妇女不良妊娠结局发生率明显高于正常者,差异有统计学意义(χ^(2)=7.797 P<0.05)。ROC曲线结果显示,血清铁蛋白、血红蛋白及其联合应用对妊娠结局的早期评估的AUC(0.95%CI)分别为0.728(0.512~0.950)、0.684(0.431~0.935)、0.805(0.635~0.976)。结论 妊娠晚期妇女缺铁性贫血患病率高于妊娠中期,加强血清铁蛋白水平检测能够为临床适时补充铁剂并监测妊娠期妇女体内铁含量、减少缺铁性贫血对不良妊娠结局的影响提供参考依据。

Objective To observe the status of iron deficiency anemia in the middle and late trimester of pregnancy and to study the effect of serum ferritin level on iron deficiency anemia and pregnancy outcome.Methods From January 2018 to January 2021,190 women in the middle and late trimester of pregnancy of Ningde City Hospital Affiliated to Ningde Normal University were selected as the research subjects.The present situation of anemia in 190 women in the middle and late trimester of pregnancy was compared to analyze the relationship between serum ferritin level and the occurrence and pregnancy outcome of iron deficiency anemia in women in the middle and late trimester of pregnancy,as well as the value of serum ferritin and hemoglobin level and their combined detection in the evaluation of pregnancy outcome.Results The incidence of iron deficiency anemia in the middle and late trimesters,late trimester was higher than middle trimester,the difference had statistical significance(X^(2)=7.161,P<0.05).The incidence of mild anemia in the late trimester was lower than that in the middle trimester,and the incidence of moderate and severe anemia was higher than that in the middle trimester,the overall difference had statistical significance(Z=2.216,P<0.05).With the increase of serum ferritin level,the incidence of iron deficiency anemia in the middle and late trimester of pregnancy decreased gradually,there was a significant difference in the incidence of iron deficiency anemia in late pregnancy with different serum ferritin levels(X^(2)=107.820,P<0.05).The incidence of adverse pregnancy outcome in women with anemia during pregnancy was significantly higher than that in normal women,the incidence of adverse pregnancy outcome in women with anemia during pregnancy with a serum ferritin level of 10-19.9 ng/mL was significantly higher than that in normal women,and the difference had statistical significance(X^(2)=7.797,P<0.05).The results of the ROC curve showed that the AUC(0.95%CI)of serum ferritin,hemoglobin,and their combined application in early evaluation of pregnancy outcome were 0.728(0.512-0.950),0.684(0.431~0.935),0.805(0.635~0.976),respectively.Conclusion The prevalence of iron deficiency anemia in women in the late stages of pregnancy is higher than that in the middle stage of pregnancy.Strengthening the detection of serum ferritin levels can provide a reference for timely clinical supplementation of iron and monitoring of iron content in pregnant women and reducing the impact of iron deficiency anemia on adverse pregnancy outcomes.