铁蛋白在妊娠晚期贫血筛查中的应用[j]

Isabelle Crary, Chloe Koski, Asha Rijhsinghani
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引用次数: 0

摘要

简介:本研究的目的是评估妊娠患者在妊娠后期对血红蛋白(Hgb)和红细胞压积(Hct)筛查铁蛋白(妊娠20周)的效用。方法:回顾性分析2019年至2021年妊娠未满20周接受非诊断性铁蛋白检测的孕妇。如果铁蛋白检测用于诊断目的或患者有贫血史,则排除患者。对登记时、妊娠28周和分娩时的实验室进行分析。贫血定义为血红蛋白低于11 g/dL。本研究已获得华盛顿大学伦理委员会的批准,患者已放弃同意。结果:44例患者在登记时进行了常规铁蛋白筛查,铁蛋白水平范围为10至136 ng/mL(平均52.5 ng/mL)。登记时平均Hgb/Hct分别为12.6 g/dL和37.3%。妊娠28周时,42例患者获得Hgb/Hct,其中9例诊断为贫血。诊断为贫血的患者筛查铁蛋白水平为33.6 ng/mL,非贫血患者筛查铁蛋白水平为57.4 ng/mL (P = 1)。当研究以50 ng/mL的临界值来比较铁蛋白“低”与“正常”的患者时,与铁蛋白大于50 ng/mL的患者相比,铁蛋白小于或等于50 ng/mL的患者在28周时Hgb水平显著降低(P = 0.013)。在分娩(L&D)时,44例患者获得Hgb/Hct,其中14例诊断为贫血。与非贫血患者相比,服用L&D的贫血患者筛查铁蛋白水平明显降低,分别为31.9和62.2 ng/mL (P = 0.016)。结论:妊娠早期铁蛋白筛查有助于预测妊娠后期Hgb的降低。在妊娠早期使用较高的铁蛋白临界值(50 ng/mL)来识别妊娠晚期有贫血风险的患者可能是有保证的。需要更大的前瞻性研究来进一步评估铁蛋白筛选的效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utility of Ferritin at Registration as a Screen for Development of Anemia in Third Trimester [ID: 1362276]
INTRODUCTION: The objective of this study was to assess the utility of screening ferritin (<20 weeks of gestation) in pregnant patients on hemoglobin (Hgb) and hematocrit (Hct) later in gestation. METHODS: Pregnant patients who received nondiagnostic ferritin labs at less than 20 weeks of gestation from 2019 to 2021 were retrospectively identified. Patients were excluded if ferritin testing was conducted for diagnostic purposes or if the patient had a history of anemia. Labs at the time of registration, 28 weeks of gestation, and at delivery were analyzed. Anemia was defined as Hgb less than 11 g/dL. This study was approved by the University of Washington IRB, and patient consent was waived. RESULTS: Forty-four patients underwent routine ferritin screening at registration, with ferritin levels ranging from 10 to 136 ng/mL (average 52.5 ng/mL). Average Hgb/Hct at registration were 12.6 g/dL and 37.3%, respectively. At 28 weeks of gestation, Hgb/Hct were obtained on 42 patients, of whom 9 patients were diagnosed with anemia. Patients diagnosed with anemia had a screening ferritin level of 33.6 ng/mL, and nonanemic patients had a ferritin level of 57.4 ng/mL ( P =.1). When a cutoff of 50 ng/mL was studied to compare patients with “low” versus “normal” ferritin, ferritin less than or equal to 50 ng/mL had significantly lower Hgb levels at 28 weeks compared to those with ferritin greater than 50 ng/mL ( P =.013). On labor and delivery (L&D), Hgb/Hct was obtained on 44 patients, and 14 were diagnosed with anemia. Anemic patients on L&D had significantly lower screening ferritin compared to nonanemic, 31.9 and 62.2 ng/mL, respectively ( P =.016). CONCLUSION: Ferritin screening in early pregnancy may help predict lower Hgb in later gestation. Using a higher ferritin cutoff of 50 ng/mL in early pregnancy for identifying patients at risk for anemia in the third trimester may be warranted. Larger prospective studies are needed to evaluate further the utility of ferritin screening.
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