广西壮族孕妇血红蛋白水平变化及其对新生儿体重影响的分析

陈洁华; 郭雪峰; 刘顺; 龙静铧; 张国强; 黄美辰; 仇小强

Abstract

陈洁华,郭雪峰,刘顺,龙静铧,张国强,黄美辰,仇小强.广西壮族孕妇血红蛋白水平变化及其对新生儿体重影响的分析[J].Chinese journal of Epidemiology,2017,38(2):154-157

广西壮族孕妇血红蛋白水平变化及其对新生儿体重影响的分析

Impact and changes of maternal hemoglobin on birth weight in pregnant women of Zhuang Nationality, in Guangxi

Received:August 08, 2016

DOI：10.3760/cma.j.issn.0254-6450.2017.02.004

KeyWord: 血红蛋白新生儿体重孕妇

English Key Word: Hemoglobin Birth weight Pregnancy

FundProject:国家自然科学基金（81460517）

Author Name	Affiliation	E-mail
Chen Jiehua	Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China
Guo Xuefeng	Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China
Liu Shun	Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China
Long Jinghua	Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China
Zhang Guoqiang	Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China
Huang Meichen	Department of maternity, Pingguo County Child Health, Baise 531400, China
Qiu Xiaoqiang	Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China	xqqiu9999@sina.com

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Abstract:

目的探讨广西壮族孕妇血红蛋白（Hb）水平及其变化对新生儿体重的影响。方法研究对象为2013年5月至2015年5月在平果县医院孕检并分娩的壮族孕妇。采用回顾性分析方法收集孕期保健和妊娠结局的资料。运用多元线性回归方法和非条件logistic回归方法进行分析。结果壮族孕妇分娩的新生儿平均出生体重（3 135.92±435.84）g。经调整混杂因素后，孕早期Hb水平与新生儿体重呈正相关，Hb每增加1 g/dl，新生儿体重增加17.61（95%CI：0.60~34.67）g；孕晚期Hb水平与新生儿体重呈负相关，Hb每增加1 g/dl，新生儿体重减少19.61（95%CI：-37.53~-1.70）g。孕期Hb水平变化与新生儿体重呈负相关，孕期Hb每增加1 g/dl，新生儿体重减少32.63（95%CI：-48.93~-16.32）g。孕早期贫血组小于胎龄儿发生风险比非贫血组增加58%（OR=1.58，95%CI：1.08~2.32）；孕期Hb水平下降幅度的最高组比最低组小于胎龄儿发生风险增加87%（OR=1.87，95%CI：1.24~2.81），并且随着孕期Hb水平下降幅度降低，小于胎龄儿发生风险逐渐升高。结论广西壮族孕妇孕早期Hb水平与新生儿体重呈正相关，孕晚期及孕期Hb水平变化与新生儿体重呈负相关。孕早期贫血以及孕期Hb水平下降幅度过低是小于胎龄儿的危险因素。

English Abstract:

Objective To investigate the hemoglobin (Hb) levels during pregnancy and Hb changes from early pregnancy and association with birth weight on infants. Methods Mothers of Zhuang Nationality who participated in the pregnancy care program and delivered at the Pingguo County Hospital from May 2013 to May 2015 were included in this study. Retrospective analysis was applied to collect data of health care and pregnancy outcomes. Multiple regression analysis and unconditional logistic regression model were used for data analysis. Results The mean birth weight appeared as (313 5.92±435.84) grams. The Hb levels at early pregnancy showed significantly positive association with birth weight. Results from our study demonstrated that when Hb levels increased +1 g/dl at early pregnancy, birth weight would increase 17.61(95%CI:0.60-34.67) grams, in the adjusted model. The Hb levels at late pregnancy were significantly inversely associated with birth weight. Our findings suggested that when Hb levels increased +1 g/dl at late pregnancy, birth weight would reduce 19.61(95%CI:-37.53——1.70) grams in the adjusted model. Changes in Hb from early pregnancy stages were significantly inversely associated with birth weight after adjusting for confounders and Hb levels in the early pregnancy stages. The results also indicated that when Hb levels increased a +1 g/dl from early to late pregnancy, the birth weight would decrease 32.63 g(95%CI:-48.93——16.32). Compared to the non-anemia group, the anemia group showed significantly increase of small-for-gestational-age (SGA)(OR=1.58, 95%CI:1.08-2.32) in early pregnancy. Compared to women under the most reduction status, women with the least reduction had a significantly increase of SGA (OR=1.87, 95%CI:1.24-2.81) among their infants. With the magnitude of reduction on Hb concentration during pregnancy, the risk of delivering babies with SGA showed a gradual trends of increase. Conclusion Hb levels at early pregnancy were positively associated with birth weight, but the changes of Hb were inversely associated with birth weight at late pregnancy, in women of Zhuang Nationality. Anemia in early pregnancy and the low amplitude of decreased Hb concentration during pregnancy were both risk factors for newborns under less gestational ages.

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