Abstract
韦良家,刘顺,黄东萍,郭雪峰,王娜,盛勇红,莫美乐,梁军,宋妍烨,仇小强.孕妇血红蛋白浓度与早产关联强度剂量反应关系[J].Chinese journal of Epidemiology,2019,40(4):471-474
孕妇血红蛋白浓度与早产关联强度剂量反应关系
Dose-response relationship between maternal hemoglobin concentration and preterm birth, in pregnant women
Received:October 08, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2019.04.019
KeyWord: 血红蛋白  早产  剂量反应关系  限制性立方样条
English Key Word: Hemoglobin  Preterm birth  Dose-response relationship  Restricted cubic spline
FundProject:国家自然科学基金(81460517);广西壮族自治区科技计划(桂科AB17195012)
Author NameAffiliationE-mail
Wei Liangjia 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  
Huang Dongping 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  
Wang Na Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Sheng Yonghong Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Mo Meile Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Liang Jun Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Song Yanye Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, 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 探讨孕妇血红蛋白浓度与早产关联强度的剂量反应关系。方法 选取广西壮族自治区武鸣、平果、靖西、德保、隆安、田东等县级医院2015年1月至2017年12月入院的12 780例壮族孕妇及其分娩的新生儿作为研究对象,回顾性地收集研究对象的一般人口学资料、孕期产检资料以及出生结局资料。采用非条件logistic回归方法初步分析孕期贫血对早产的影响,采用限制性立方样条模型分析孕期血红蛋白浓度与早产关联强度剂量反应关系。结果 排除2 053例高血压或年龄≥ 35岁的孕妇,非条件logistic回归分析显示,孕早期贫血组发生早产的风险是非贫血组的1.29倍(OR=1.29,95% CI:1.04~1.59,P=0.019);限制性立方样条模型显示,孕早期血红蛋白浓度与早产的关联呈非线性"L"形剂量反应关系(非线性检验:P<0.001),孕晚期血红蛋白浓度与早产的关联呈非线性"U"形剂量反应关系(非线性检验:P<0.001)。结论 孕妇孕早期和孕晚期血红蛋白浓度与早产的关联呈非线性剂量反应关系。
English Abstract:
      Objective To investigate the dose-response relationship between hemoglobin concentration and preterm birth, during pregnancy. Methods With Zhuang ethnicity, a total of 12 780 pregnant women and their infants that admitted to Wuming、Pingguo、Jingxi、Debao、Longan and Tiandong hospitals, were recruited, in Guangxi Zhuang Autonomous Region, from January 2015 to December 2017. Non-conditional logistic regression method was used to analyze the effect of anemia on preterm birth during pregnancy. Dose-response relationship between hemoglobin concentration and preterm birth was explored, using the restrictive cubic spline model. Results After excluding 2 053 pregnant women with hypertension or aged 35 years and over, results from the non-conditional logistic regression analysis showed that the risk of preterm birth in the anemia group was 1.29 times (OR=1.29, 95% CI:1.04-1.59, P=0.019) of the non-anemia group in the first trimester. Data from the restricted cubic sample showed that there appeared nonlinear "L" dose-response relationship between hemoglobin concentration and preterm birth in the first trimester and "U" shape in the third trimester (non-linearity test P<0.001). Conclusion There appeared nonlinear dose-response relationship between the hemoglobin concentration and preterm birth, both in the first and third trimesters.
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