文章摘要
范春丽,罗家有,龚雯洁,刘小群,周书进,张芬芳,曾洁,李辉霞,冯娜.妊娠期并发贫血影响因素的巢式病例对照研究[J].中华流行病学杂志,2017,38(9):1269-1273
妊娠期并发贫血影响因素的巢式病例对照研究
Nested case-control study on associated factors for anemia during pregnancy
收稿日期:2017-01-13  出版日期:2017-09-09
DOI:10.3760/cma.j.issn.0254-6450.2017.09.025
中文关键词: 妊娠期并发贫血  影响因素  巢式病例对照研究
英文关键词: Anemia during pregnancy  Associated factor  Nested case-control study
基金项目:国家自然科学基金(81172680)
作者单位E-mail
范春丽 410078 长沙, 中南大学湘雅公共卫生学院儿少卫生与妇幼保健系  
罗家有 410078 长沙, 中南大学湘雅公共卫生学院儿少卫生与妇幼保健系 jiayouluo@126.com 
龚雯洁 410078 长沙, 中南大学湘雅公共卫生学院儿少卫生与妇幼保健系  
刘小群 410078 长沙, 中南大学湘雅公共卫生学院儿少卫生与妇幼保健系  
周书进 410300 湖南省浏阳市妇幼保健院  
张芬芳 410300 湖南省浏阳市妇幼保健院  
曾洁 410300 湖南省浏阳市妇幼保健院  
李辉霞 410078 长沙, 湖南省妇幼保健院  
冯娜 410078 长沙, 湖南省妇幼保健院  
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中文摘要:
      目的 探讨妊娠期并发贫血的影响因素。方法 将2013年6月至2014年11月在湖南省浏阳市医疗机构接受首次孕期保健,且经体检排除"贫血"的孕妇(怀孕≤ 12周)纳入孕妇人群队列,对观察对象进行基线调查,并随访至孕妇分娩。采用前瞻性巢式病例对照研究,将本次随访期间新发生贫血的380例孕妇作为病例组,按照1:2频数匹配,随机抽取年龄、孕期、常住地基本相同的760例正常孕产妇作为对照组,采用t检验、χ2检验和条件logistic回归分析方法,分析妊娠期并发贫血的影响因素。结果 多因素logistic回归模型分析结果表明,家庭人均年收入低(OR=2.08,95%CI:1.22~3.59)、文化程度低(OR=2.09,95%CI:1.22~3.59)、孕前烫发/染发(OR=2.23,95%CI:1.63~3.05)、早孕呕吐反应(OR=2.51,95%CI:1.56~4.03)是妊娠期并发贫血的危险因素;摄入维生素、微量元素补充剂(OR=0.69,95%CI:0.50~0.94),肉、鱼、虾、蛋类摄入频率高(OR=0.68,95%CI:0.49~0.92),豆奶、牛奶摄入频率高(OR=0.51,95%CI:0.27~0.95)是妊娠期并发贫血的保护因素。结论 妊娠期并发贫血与孕妇家庭经济、文化程度、有毒有害物质接触、早孕呕吐反应、营养物质的摄入等因素有关,应加强对孕妇妊娠期发生贫血影响因素的控制。
英文摘要:
      Objective To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy. Methods The pregnant women (≤ 12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study, and for them anemia had been excluded by physical examination. Baseline survey and follow up till childbirth were conducted for them. A queue-based nested case-control study (1:2) was conducted (380 pregnant women with anemia detected in this study as case group, 760 pregnant women without anemia randomly selected and matched by age, habitual residence during pregnancy as control group. And t test, χ2 test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy. Results Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08, 95%CI:1.22-3.59), low educational level (OR=2.09, 95%CI:1.22-3.59), pre-pregnancy perm/hair dye (OR=2.23, 95%CI:1.63-3.05), early pregnancy vomiting (OR=2.51, 95%CI:1.56-4.03) were the risk factors for anemia during pregnancy. Intake of vitamin and trace element supplements (OR=0.69, 95%CI:0.50-0.94), frequent meat, fish, shrimp, egg intakes (OR=0.68, 95%CI:0.49-0.92), frequent soy milk, milk intakes (OR=0.51, 95%CI:0.27-0.95) were the protective factors for anemia during pregnancy. Conclusion A number of factors, such as family annual income level, education level, poisonous and harmful material contact, pregnancy reaction, nutrition, are related to the incidence of anemia during pregnancy, it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.
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