妊娠期女性血清铁蛋白水平现况调查

A cross-sectional survey of serum ferritin level in pregnant women

目的调查河南省不同妊娠阶段女性血清铁蛋白水平,探讨妊娠期铁缺乏与过量现况。方法收集2018年1月至2020年12月期间就诊于郑州大学第三附属医院健康妊娠期女性13756例,分析不同妊娠时期血清铁蛋白水平分布情况。参考中华医学会妊娠期铁缺乏和缺铁性贫血诊治指南定义血清铁蛋白<20μg/L为铁缺乏,多数文献中定义>200μg/L为铁过量,分析不同妊娠时期血清铁蛋白缺乏和过量情况。结果13756例妊娠期女性血清铁蛋白呈偏态分布,血清铁蛋白水平为25.20(11.70,50.80)μg/L。5813例妊娠早期血清铁蛋白为47.00(28.10,76.00)μg/L,铁缺乏为891例(占比15.33%),铁过量为111例(占比1.91%);4760例妊娠中期铁蛋白为18.90(10.20,35.20)μg/L,铁缺乏者2512例(占比52.77%),铁过量29例(占比0.61%);3183例妊娠晚期血清铁蛋白水平为11.30(7.60,20.40)μg/L,铁缺乏者2373例(占比74.32%),铁过量7例(占比0.22%)。血清铁蛋白随妊娠的进展而明显下降,妊娠早期、中期和晚期血清铁蛋白水平具有显著性差异。结论不同妊娠时期血清铁蛋白水平差异明显,应动态监测血清铁蛋白水平,对铁缺乏者合理补铁。

Objective To investigate the status of serum ferritin levels in pregnant women at different gestation period of Henan Province,and to explore the status of iron deficiency and excess during pregnancy.Methods Totally 13756 subjects were collected from prenatal examination database of the Third Affiliated Hospital of Zhengzhou University between January 2018 to December 2020.The distribution of serum ferritin levels in different pregnancy periods was analyzed.According to the guidelines for Diagnosis and Treatment of iron deficiency in pregnancy and iron deficiency anemia of Chinese Medical Association,serum ferritin<20μg/L was defined as iron deficiency,and serum ferritin>200μg/L is defined as iron excess,the deficiency and excess of serum ferritin in different pregnancy periods were analyzed.Results The distribution of serum ferritin in 13756 pregnant women was skewed.The serum ferritin level was 25.20(11.70,50.80)μg/L.The serum ferritin levels of 5813 patients in the first pregnancy were 47.00(28.10,76.00)μg/L.891 cases of iron deficiency(accounting for 15.33%)and 111 cases of iron excess(accounting for 1.91%);The serum ferritin levels of 4760 patients in the second trimester were 18.90(10.20,35.20)μg/L,2512 cases of iron deficiency(accounting for 52.77%)and 29 cases of iron excess(accounting for 0.61%);The serum ferritin levels of 3183 patients in the third trimester were 11.30(7.60,20.40)μg/L,2373 cases of iron deficiency(accounting for 74.32%)and 7 cases of iron excess(accounting for 0.22%).Serum ferritin decreased significantly with the progression of pregnancy,and there were significant differences in serum ferritin levels in the first,second and third trimesters of pregnancy.Conclusion The difference of serum ferritin level in different pregnancy period is significant,the serum ferritin level should be dynamically monitored,and the iron deficiency should be reasonably supplemented.