2016年上海地区部分孕妇贫血情况调查分析

doi:10.3969/j.issn.1673-8640.2020.02.005

摘要/Abstract

摘要：

目的研究2016年上海市部分孕妇不同孕期贫血的患病率,以及贫血和孕妇年龄的关系。方法回顾性分析2016年1—12月在上海交通大学医学院附属国际和平妇幼保健院分娩的10 691例孕妇不同孕期的临床检验数据。贫血的定义是血红蛋白（Hb）<110 g/L。结果孕早期孕妇妊娠期贫血的患病率为4.5%,孕中期孕妇贫血的患病率为28.7%,孕晚期则为23.7%。妊娠期贫血的总体患病率为37.3%。高龄产妇妊娠期贫血的患病率高于<35岁的孕妇。结论孕中期和孕晚期孕妇妊娠期贫血的患病率高于孕早期,妊娠期贫血患病率与孕妇年龄存在相关性。

关键词: 妊娠期, 贫血, 高龄, 上海

Abstract:

Objective To investigate the prevalence of gestational anemia in different gestation trimesters in Shanghai,2016 and the relationship between age and gestational anemia. Methods The clinical data of 10 691 pregnant women who gave birth in the International Peace Maternity and Child Health Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2016 were analyzed retrospectively. Anemia was defined as hemoglobin（Hb）<110 g/L. Results The prevalence rates of anemia were 4.5% in the first trimester,28.7% in the second trimester and 23.7% in the third trimester. Totally,37.3% of pregnant women had gestational anemia. The prevalence rate of gestational anemia was higher in women with advanced age than in women <35-year-old. Conclusions The prevalence rates of gestational anemia in the second and the third trimesters are higher than that in the first trimester. The prevalence rate of gestational anemia is correlated with the age of pregnant women.

Key words: Gestation trimester, Anemia, Advanced age, Shanghai

中图分类号:

R446.1

唐琳, 张晓璟, 唐振华. 2016年上海地区部分孕妇贫血情况调查分析[J]. 检验医学, 2020, 35(2): 116-119.

TANG Lin, ZHANG Xiaojing, TANG Zhenhua. Investigation of gestational anemia in Shanghai,2016[J]. Laboratory Medicine, 2020, 35(2): 116-119.

图/表 3

参考文献 21

[1]	MCLEAN E,COGSWELL M,EGLI I,et al.Worldwide prevalence of anaemia,WHO vitamin and mineral nutrition information system,1993-2005[J]. Public Health Nutr,2009,12(4):444-454.
[2]	LI F,ZHANG C,CHEN Y G,et al.Analysis on maternal anemia rate and related factors in Taicang of Jiangsu province in 2014-2016[J]. Zhonghua Yu Fang Yi Xue Za Zhi,2018,52(7):703-708.
[3]	JWA S C,FUJIWARA T,YAMANOBE Y,et al.Changes in maternal hemoglobin during pregnancy and birth outcomes[J]. BMC Pregnancy Childbirth,2015,15:80.
[4]	ZHANG X J,WANG Y H,GAO S,et al.Relationship between gestational glucose,lipid metabolism parameters and fetal distress[J]. Zhonghua Liu Xing Bing Xue Za Zhi,2016,37(6):876-879.
[5]	RICHMOND S,NISWANDER K,SNODGRASS C A,et al.The obstetric management of fetal distress and its association with cerebral palsy[J]. Obstet Gynecol,1994,83(5 Pt 1):643-646.
[6]	SATO A.Pathophysiology of fetal distress[J]. No to Hattatsu Brain and Development,1994,26(2):119-124.
[7]	NAIR K M,IYENGAR V.Iron content,bioavailability & factors affecting iron status of Indians[J]. Indian J Med Res,2019,130(5):634-645.
[8]	何国琳,孙鑫,谭婧,等. 中国部分城市妊娠期铁缺乏和缺铁性贫血患病率的调查[J]. 中华妇产科杂志,2018,53(11): 761-767.
[9]	WANG H,INNES H,HUTCHINSON S J,et al.The prevalence and impact of thrombocytopenia,anaemia and leucopenia on sustained virological response in patients receiving hepatitis C therapy:evidence from a large 'real world' cohort[J]. Eur J Gastroenterol Hepatol,2016,28(4):398-404.
[10]	XIONG X,BUEKENS P,ALEXANDER S,et al.Anemia during pregnancy and birth outcome:a meta-analysis[J]. Am J Perinatol,2000,17(3):137-146.
[11]	BLACK R E,VICTORA C G,WALKER S P,et al.Maternal and child undernutrition and overweight in low-income and middle-income countries[J]. Lancet,2013,382(9890):427-451.
[12]	HARVEY T,ZKIK A,AUGES M,et al.Assessment of iron deficiency and anemia in pregnant women:an observational French study[J]. Womens Health(Lond),2016,12(1):95-102.
[13]	BENCAIOVA G,BURKHARDT T,BREYMANN C.Anemia-prevalence and risk factors in pregnancy[J]. Eur J Intern Med,2012,23(6):529-533.
[14]	TUNKYI K,MOODLEY J.Anemia and pregnancy outcomes:a longitudinal study[J]. J Matern Fetal Neonatal Med,2018,31(9):2594-2598.
[15]	CANTOR A G,BOUGATSOS C,DANA T,et al.Routine iron supplementation and screening for iron deficiency anemia in pregnancy:a systematic review for the U.S. preventive services task force[J]. Ann Intern Med,2015,162(8):566-576.
[16]	CHESLEY L C.Plasma and red cell volumes during pregnancy[J]. Am J Obstet Gynecol,1972,112(3):440-450.
[17]	HYTTEN F.Blood volume changes in normal pregnancy[J]. Clin Haematol,1985,14(3):601-612.
[18]	FRASER R.Nutrition in pregnancy[J]. Practitioner,1990,234(1490):586-590.
[19]	PEÑA-ROSAS J P,DE-REGIL L M,GOMEZ MALAVE H,et al. Intermittent oral iron supplementation during pregnancy[J]. Cochrane Database Syst Rev,2015,(10):CD009997.
[20]	DAWSON E B,MCGANITY W J.Protection of maternal iron stores in pregnancy[J]. J Reprod Med,1987,32(6 Suppl):478-487.
[21]	金锐,甄霞,顾红燕,等. 妊娠期妇女缺铁性贫血治疗用药特点的横断面调查[J]. 实用药物与临床,2017,20(10):1202-1204.

孕期	x±s	第25百分位数	第50百分位数	第75百分位数	第95百分位数	数据范围
孕早期
Hb/（g/L）	124.4±8.8	119.0	125.0	130.0	138.0	71.2~159.0
MCH/pg	29.9±1.7	29.2	30.0	30.9	32.0	18.1~37.0
MCHC/（g/L）	336.2±9.9	330.0	336.0	343.0	352.0	268.2~406.4
MCV/fL	88.8±4.8	86.4	89.2	91.8	95.4	57.2~109.5
孕中期
Hb/（g/L）	114.0±8.3	109.0	114.0	119.0	127.0	74.2~155.0
MCH/pg	31.0±1.7	30.2	31.1	32.0	33.2	18.9~39.2
MCHC/（g/L）	326.7±8.6	321.0	327.0	332.0	341.0	274.2~387.4
MCV/fL	94.7±4.7	92.3	95.0	97.6	101.4	64.3~118.4
孕晚期
Hb/（g/L）	116.0±9.3	110.0	116.0	122.0	131.0	75.2~156.0
MCH/pg	30.6±1.9	29.8	30.9	31.9	33.3	19.0~41.6
MCHC/（g/L）	328.5±8.4	323.0	329.0	334.0	342.0	278.2~363.0
MCV/fL	93.4±4.9	90.7	93.7	96.5	100.5	61.3~122.5

孕期	x±s	第25百分位数	第50百分位数	第75百分位数	第95百分位数	数据范围
孕早期
Hb/（g/L）	124.4±8.8	119.0	125.0	130.0	138.0	71.2~159.0
MCH/pg	29.9±1.7	29.2	30.0	30.9	32.0	18.1~37.0
MCHC/（g/L）	336.2±9.9	330.0	336.0	343.0	352.0	268.2~406.4
MCV/fL	88.8±4.8	86.4	89.2	91.8	95.4	57.2~109.5
孕中期
Hb/（g/L）	114.0±8.3	109.0	114.0	119.0	127.0	74.2~155.0
MCH/pg	31.0±1.7	30.2	31.1	32.0	33.2	18.9~39.2
MCHC/（g/L）	326.7±8.6	321.0	327.0	332.0	341.0	274.2~387.4
MCV/fL	94.7±4.7	92.3	95.0	97.6	101.4	64.3~118.4
孕晚期
Hb/（g/L）	116.0±9.3	110.0	116.0	122.0	131.0	75.2~156.0
MCH/pg	30.6±1.9	29.8	30.9	31.9	33.3	19.0~41.6
MCHC/（g/L）	328.5±8.4	323.0	329.0	334.0	342.0	278.2~363.0
MCV/fL	93.4±4.9	90.7	93.7	96.5	100.5	61.3~122.5

组别	例数	妊娠期贫血/[例（%）]
孕早期	10 691	478（4.5）
<30岁组	3 886	164（4.2）
30~35岁组	4 632	196（4.2）
≥35岁组	2 173	118（5.4）
孕中期	10 691	3 069（28.7）
<30岁组	3 886	1 083（27.9）^*
30~35岁组	4 632	1 310（28.3）^*
≥35岁组	2 173	676（31.1）
孕晚期	10 691	2 537（23.7）
<30岁组	3 886	876（22.5）^*
30~35岁组	4 632	1 098（23.7）^*
≥35岁组	2 173	563（25.9）

组别	例数	妊娠期贫血/[例（%）]
孕早期	10 691	478（4.5）
<30岁组	3 886	164（4.2）
30~35岁组	4 632	196（4.2）
≥35岁组	2 173	118（5.4）
孕中期	10 691	3 069（28.7）
<30岁组	3 886	1 083（27.9）^*
30~35岁组	4 632	1 310（28.3）^*
≥35岁组	2 173	676（31.1）
孕晚期	10 691	2 537（23.7）
<30岁组	3 886	876（22.5）^*
30~35岁组	4 632	1 098（23.7）^*
≥35岁组	2 173	563（25.9）

孕期	例数	Hb/（g/L）	MCH/pg	MCHC/（g/L）	MCV/fL
孕早期	478	104.3±5.5	27.3±3.9	326.7±13.7	83.4±10.0
孕中期	3 069	104.2±4.7	30.5±2.3	323.7±9.0	94.2±6.2
孕晚期	2 537	103.9±4.8	29.7±2.4	322.8±8.3	91.9±6.4