妊娠期贫血与早产、低出生体重关系的meta分析

Anemia During Pregnancy and Preterm Birth and Low Birth Weight:A Meta Analysis

目的 为了验证贫血与早产、低出生体重的关系 ,对已发表的文献进行了meta分析。方法 通过MED LINE .CBM和人工检索 ,检索了 1975～ 1999年间有关贫血与早产、低出生体重关系的 14份研究 (发展中国家 2份 ,发达国家 12份 )。按贫血诊断时的孕龄 ,将贫血与早产、低出生体重的比数比 (OR)综合。结果 妊娠早期贫血可轻微增加早产、低出生体重的危险 ,两者的综合ORs和 95 %可信限 (CI)分别为 1.4 5 (1.16～ 1.82 )和 1.76(1.4 7～ 2 .0 9) ;妊娠晚期贫血与早产、低出生体重无关 ,综合ORs:早产为 0 .92 (0 .6 9～ 1.2 2 ) ,低出生体重为 0 .77(0 .5 0～ 1.17)。结论 妊娠早期贫血可轻微增加早产、低出生体重的危险 ,妊娠晚期贫血不增加早产、低出生体重的危险。但尚需深入的研究以证实这些结论和澄清存在的问题。

Objective To make meta analysis of the data published in order to identify the relation between anemia and preterm birth and low birth weight. Methods From 1975 through 1999, 14 studies (two in developing countries) of anemia and poor pregnancy outcomes (preterm birth and low birth weight) were found by MEDLINE and manual search. Odds ratio (ORs) of poor birth outcome with anemia were pooled according to the gestational age at anemia diagnosis.Results Anemia during early pregnancy could slightly increase the risk of preterm birth (pooled ORs:1.45, 95%CI: 1.16～1.82), low birth weight (pooled ORs:1.76,95%CI:1.47～2.09) and fetal growth retardation; anemia during late pregnancy was not associated with these outcomes: pooled ORs:0.92(0.69～1.22) for preterm birth, and 0.77(0.50～1.17) for low birth weight. Conclusion Early pregnancy anemia can slightly increase the risk of preterm birth and low birth weight. Anemia during late pregnancy does not increase the risk of poor birth outcomes. Further study is needed to confirm these conclusions and clarify remaining questions and, in particular, more studies need to be conducted in developing countries to assess the association between anemia and poor birth outcomes.