高原地区妊娠期贫血孕妇孕晚期红细胞、铁参数对妊娠结局的预测价值

Predictive value of red blood cell and iron parameters in the third trimester of pregnancy for maternal outcomes in pregnant women with anemia in a high⁃altitude plateau region

目的 探究高原地区妊娠期贫血孕妇孕晚期红细胞、铁参数对妊娠结局的预测价值。方法 回顾性分析2021年1月至2023年1月阿坝藏族羌族自治州人民医院接收的390例高原地区妊娠期孕妇的临床资料,根据孕妇妊娠期贫血情况将其分为研究组(妊娠期贫血孕妇)和对照组(妊娠期血红蛋白正常孕妇),比较两组孕妇孕晚期血清红细胞(RBC)水平、血红蛋白(Hb)、铁蛋白(SF)水平,再根据孕妇妊娠结局情况将研究组分为正常妊娠组(正常妊娠孕妇)与不良妊娠组(不良妊娠孕妇),比较两亚组孕妇孕晚期血清RBC、Hb、SF水平,采用ROC曲线分析孕晚期血清RBC、Hb、SF水平对高原地区妊娠期贫血孕妇妊娠结局的预测效能。结果 390例高原地区妊娠期孕妇中,共确诊妊娠期贫血孕妇107例,高原地区孕妇妊娠期贫血发病率为27.43%。研究组孕晚期血清RBC、Hb、SF水平均低于对照组,差异有统计学意义(P<0.05)。107例妊娠期贫血孕妇中,65例孕妇正常妊娠,42例孕妇出现非正常妊娠,正常妊娠组孕晚期血清RBC、Hb水平均高于不良妊娠组,差异有统计学意义(P<0.05),两亚组孕晚期SF水平比较差异无统计学意义(P>0.05)。孕晚期血清RBC、Hb水平均对高原地区妊娠期贫血孕妇妊娠结局有一定预测价值(AUC>0.5),其cut-off值分别为312.88×10^(12)/L、80.53 g/L。结论 高原地区妊娠期贫血孕妇孕晚期RBC、Hb水平对不良妊娠结局有一定预测价值,临床应加强孕晚期孕妇血清RBC、Hb水平的监测,及时补充,避免不良妊娠结局的出现。

Objective To explore the predictive value of red blood cell and iron parameters in the third trimester of pregnancy for maternal outcomes in pregnant women with anemia in a high-altitude plateau re-gion.Methods The clinical data of 390 pregnant women in a plateau area who were treated at Aba Tibetan and Qiang Autonomous Prefecture People’s Hospital were retrospectively analyzed from January 2021 to Janu-ary 2023.Based on the presence of anemia during pregnancy,the pregnant women were divided into two groups:the study group(pregnant women with anemia during pregnancy)and the control group(pregnant women with normal hemoglobin levels during pregnancy).The levels of serum red blood cells(RBC),hemo-globin(Hb)and serum ferritin(SF)were compared between the groups in the third trimester of pregnancy.Additionally,based on the pregnancy outcomes of the pregnant women,those in the study group were further classified into two groups:the pregnancy subgroup(women with normal pregnancy outcomes)and the adverse pregnancy subgroup(women with adverse pregnancy outcomes).Serum RBC,Hb and SF levels in the third trimester of pregnancy were compared between these two subgroups.Furthermore,ROC curve analysis was conducted to assess the predictive efficiency of serum RBC,Hb,and SF levels in the third trimester of preg-nancy on the pregnancy outcomes of pregnant women with anemia during pregnancy in a plateau area.Results Among 390 pregnant women in a plateau area,107 cases were diagnosed with anemia during pregnancy,re-sulting in an incidence rate of 27.43%.The levels of serum RBC,Hb and SF in the study group during the third trimester of pregnancy were lower than those in the control group(P<0.05).Out of the 107 pregnant women with anemia during pregnancy,65 had a normal pregnancy while 42 pregnant had an abnormal preg-nancy.Serum RBC and Hb levels in the normal pregnancy subgroup were higher than those in the adverse pregnancy subgroup(P<0.05),but there was no statistical significance in SF levels between the two sub-groups during the third trimester of pregnancy(P>0.05).Serum RBC and Hb levels in the third trimester of pregnancy showed a certain predictive value for pregnancy outcomes in pregnant women with anemia during pregnancy in plateau areas(AUC>0.5),with cut-off values of 312.00×10^(12)/L and 80.53 g/L respectively.Conclusion The levels of RBC and Hb in pregnant women with anemia during pregnancy in plateau areas have a certain predictive value for adverse pregnancy outcomes.Clinically,it is necessary to enhance the monitoring of RBC and Hb levels in late pregnancy and provide timely supplementation to prevent adverse pregnancy outcomes.