怀孕期间母亲的血红蛋白度和死产风险
O Stephansson1, P W Dickman, A Johansson
1Department of Medical Epidemiology, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden. olof.stephansson@mep.ki.se
JAMA
|November 22, 2000
概括
怀孕期间母亲的高血红蛋白水平与死产的风险增加有关,特别是早产和妊娠年龄较小的死产 (SGA). 在这项研究中,低血红蛋白 (贫血) 与死产风险没有显著关联.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 怀孕中的血液学
背景情况:
- 高和低的母体血红蛋白水平与妊娠年龄较小 (SGA) 出生的风险增加有关.
- SGA出生是已知的死产的预测因素.
- 母体血红蛋白度与死产风险之间的确切关系尚不清楚.
研究的目的:
- 调查在第一次产前测量时母亲血红蛋白度与死产风险之间的关联.
- 检查怀孕期间血红蛋白度变化对死产风险的影响.
- 将这些关联与各种死产分类 (有缺陷,产前,产后,早产,SGA) 进行分析.
主要方法:
- 在瑞典进行了一项基于人口的,匹配的病例控制研究.
- 包括702名初生妇女与死产 (妊娠28周以上) 和702名初生妇女与活产.
- 分析了第一个产前测量和每周变化的母亲血红蛋白水平,并根据母亲年龄,BMI和吸烟等共变量进行调整.
主要成果:
- 在第一次产前测量时,高母体血红蛋白度 (≥146 g/L) 与死产风险增加有关 (OR,1.8;95% CI,1.0-3.3).
- 这种关联在没有缺陷的产前死胎中更为强烈,特别是早产和SGA病例 (ORs高达4.2).
- 贫血 (<110 g/L) 与死产风险没有显著关联;每周血红蛋白变化没有显著关联,尽管下降趋向于保护性.
结论:
- 在初次产前检查时,母亲血红蛋白度升高与死产风险更高有关.
- 这种风险在早产和孕期较小 (SGA) 的产前死产中尤为明显.
- 进一步的研究可能是有必要的,以了解这种关联背后的机制.
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