妊娠中の貧血 - 全て鉄欠乏性貧血か?
Moupali Ghosh1, Maitreyee Bhattacharyya1
1DM Clinical Hematology, Institute of Haematology and Transfusion Medicine, Medical College Kolkata, MCH Building 3rd Floor, Medical College Kolkata, 88, College Street, Kolkata, 700083 India.
まとめ
東インド都市部の母親の44.16%が妊娠中の貧血に罹患しており、特に10代や初産婦でその割合が高い。貧血管理のためには、標的を絞った介入が不可欠である。
科学分野:
- 産婦人科
- 血液学
- 公衆衛生
背景:
- 妊娠中の貧血は、特に資源の乏しい地域において、世界的な健康問題となっている。
- 東インドでは、妊婦の貧血の有病率とその決定要因に関するデータは限られている。
- 鉄欠乏性貧血が一般的な原因であるが、サラセミアなどの他の要因も寄与している。
研究 の 目的:
- 東インドの都市部における妊婦の貧血の有病率と原因因子を決定すること。
- 特に、思春期や初産婦などの特定のリスクグループを特定すること。
- 貧血管理のための公衆衛生戦略に情報を提供すること。
主な方法:
- 2010年6月から2021年12月までの11.5年間に、コルカタのレディ・ダファリン病院で実施された観察的横断研究。
- 42,349人の妊婦を対象とした。
- 診断検査には、完全血球計算、HPLC、血清フェリチン、ビタミンB12、葉酸レベルが含まれた。
主要な成果:
- 貧血の有病率は44.16%(18,703/42,349)であり、重度1.5%、中等度35.46%、軽度63.02%であった。
- 10代の母親(59.78%)と初産婦(63.02%)で貧血の有病率が高かった。
- 貧血の母親の52.3%で血清フェリチン値(<30ug/dl)が低く、9.5%はサラセミアキャリアであった。
結論:
- 都市部であるにもかかわらず、本研究の貧血有病率は世界基準を超えている。
- 特に初産婦の思春期および若い妊婦は、より高いリスクにさらされている。
- 強化された貧血管理プログラムと公衆啓発キャンペーンが不可欠である。
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