妊娠期缺铁性贫血与铁剂补充对围生结局影响的临床研究

Clinical study on the effect of iron deficiency anemia in pregnancy and i ron supplementation on perinatal outcome

目的:探讨妊娠期缺铁性贫血(IDA)与铁剂补充对围生结局的影响。方法:选择2022年1月至2023年8月在佛山市高明区人民医院进行产检及分娩的妊娠期IDA孕妇作为研究对象,设为研究A组,给予规范性补充铁剂以纠正贫血;同时以70例同期、同孕周、依从性差未能规范补充铁剂的妊娠期IDA孕妇为研究B组,以同期、同孕周的正常孕妇80例为对照组(对照C组)。分别对三组研究对象铁蛋白(SF)、转铁蛋白(TRF)、血红蛋白(Hb)、铁调素(hepcidin)的表达水平及妊娠结局进行对比研究,并采用Pearson相关性分析法对妊娠期IDA与不良妊娠结局的关系进行分析。结果:A、B两组补充铁剂前SF、TRF、Hb比较无统计学差异(P>0.05),但与C组比较有统计学差异(P<0.05);妊娠结束时A组、C组的SF、TRF、Hb比较无统计学差异(P>0.05),但与B组比较有统计学差异(P<0.05);开始研究时A组、B组的铁调素均显著低于C组(P<0.05);妊娠结束时,A组、C组的铁调素比较无统计学差异(P>0.05),但与B组比较有统计学差异(P<0.05)。A、C两组的不良妊娠结局(包括低体重儿、胎儿窘迫、早产、产后出血、羊水污染)发生率均低于B组(P<0.05)。Pearson相关性分析显示,铁调素与SF、Hb呈明显正相关(r=0.591、0.485,P均<0.05),与TRF呈低度正相关(r=0.317,P<0.05);不良围生结局发生率与铁调素呈明显负相关(r=-0.493,P<0.05)。结论:补充铁剂能够有效纠正妊娠期IDA并减少不良妊娠结局的发生,铁调素下调可能是引起妊娠期IDA的潜在因素。

Objective:To investigate the effects of iron deficiency anemia(IDA)during pregnancy and iron supplementation on perinatal outcomes.Methods:Pregnant women with IDA who underwent antenatal examination and delivery in Gaoming District People’s Hospital of Foshan City from January 2022 to August 2023 were selected as study subjects.They were set as study group A and given normative iron supplement to correct anemia.At the same time,70 IDA pregnant women with poor compliance and failure to regulate iron supplementation during pregnancy were selected as study group B,and 80 normal pregnant women with the same period and same gestational week were selected as control group(control group C).The expression levels of ferritin(SF),transferrin(TRF),hemoglobin(Hb)and ferritin(hepcidin)and pregnancy outcomes of the three groups were compared,and the relationship between IDA and adverse pregnancy outcomes was analyzed by Pearson correlation analysis.Results:There were no statistical differences in SF,TRF and Hb between groups A and B before iron supplementation(P>0.05),but there were statistical differences compared with group C(P<0.05).At the end of pregnancy,there were no statistical differences in SF,TRF and Hb between group A and group C(P>0.05),but there were statistical differences compared with group B(P<0.05).At the beginning of the s tudy,the ferrim odulin levels in groups A and B were s ignificantly lower than thos e in group C(P<0.05).At the end of pregnancy,there was no statistical difference between group A and group C(P>0.05),but there was statistical difference between group A and group B(P<0.05).The incidence of adverse pregnancy outcomes(including low birth weight infants,fetal distress,premature delivery,postpartum hemorrhage and amniotic fluid contamination)in groups A and C were lower than those in group B(P<0.05).Pearson correlation analysis showed that ferriregulation was significantly positively correlated with SF and Hb(r=0.591,0.485,P<0.05),and was slightly positively correlated with TRF(r=0.317,P<0.05).The incidence of adverse perinatal outcomes was significantly negatively correlated with ferrimodulin(r=-0.493,P<0.05).Conclusion:Iron supplementation can effectively correct IDA during pregnancy and reduce the occurrence of adverse pregnancy outcomes,and down-regulation of iron regulation may be a potential factor causing IDA during pregnancy.