妊娠中期缺铁对母婴结局的影响：一项丹麦队列研究

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-04-26 DOI:10.1016/j.ejogrb.2025.114004

Celina Pforr Ibsen , Cathrine Scavenius , Katrine Dige Frederiksen , Laura Wonsbek , Ida Lise Arevad Ammitzbøll , Fie Juhl Vojdeman , Andreas Glenthøj , Mette Calundann Noer , Jeannet Lauenborg , Camilla Maria Mandrup , Tine Dalsgaard Clausen

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引用次数: 0

摘要

目的：铁是孕期的基本元素；然而，缺乏了解铁缺乏（ID）如何在中期妊娠影响母婴结局。我们的目的是调查妊娠中期孕妇中ID的患病率，并评估其与孕产妇和婴儿不良结局的关系。研究设计：本研究是对一项纵向队列研究数据的探索性分析，该研究包括单一中心的单胎孕妇，在该研究中，研究人员分析了妊娠24至28周抽取的血液样本中的p -铁蛋白。采用Bonferroni校正的多变量回归分析来评估妊娠中期ID （p -铁蛋白<；15µg/L）与母婴结局之间的关系。结果449例妇女中有182例（40.5%）出现妊娠中期妊娠障碍，其中4.4%出现贫血。患有ID的女性更容易多产（73.1%对52.4%），随后接受静脉输铁治疗（5.5%对1.1%）。与铁水平正常的女性相比，ID女性所生婴儿的胎盘重量（700 g对630 g）、出生体重（3713 g对3522 g）、出生体重z-score（0.3对- 0.1）明显更高，胎龄小的患病率（2.7%对9.8%）明显更低。妊娠中期的ID与产妇或婴儿的不良结局（如紧急剖宫产、引产、早产或胎儿酸中毒）无关。结论：尽管推荐从妊娠10周开始补充铁，但妊娠中期的丹麦孕妇中，缺铁很常见，并与胎盘和婴儿生长加速有关，但没有不良妊娠结局。这项研究表明，目前丹麦孕妇妊娠中期ID的临界值的临床相关性需要进一步研究。

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Impact of second trimester iron deficiency on maternal and infant outcomes: A Danish cohort study

Objective

Iron is a fundamental component during pregnancy; however, there is a lack of understanding of how iron deficiency (ID) during the second trimester affects maternal and infant outcomes. We aimed to investigate the prevalence of ID among pregnant women during the second trimester of pregnancy and to evaluate the associations with adverse maternal and infant outcomes.

Study design

This was an exploratory analysis of data from a longitudinal cohort study including singleton pregnant women at a single center, where P-ferritin was analyzed in blood samples drawn between 24 and 28 weeks gestation. Multivariable regression analyses with Bonferroni corrections were used to evaluate the association between ID (P-ferritin <15 µg/L) in the second trimester and maternal and infant outcomes.

Results

Second trimester ID was found in 182 of the 449 included women (40.5 %), among whom anemia was present in 4.4 %. Women with ID were more often multiparous (73.1 % vs. 52.4 %) and subsequently treated with intravenous iron infusion (5.5 % vs. 1.1 %). Infants born to women with ID had a significantly higher placental weight (700 g vs. 630 g), higher birth weight (3713 g vs. 3522 g), birth weight z-score (0.3 vs. −0.1), and significantly lower prevalence of small for gestational age (2.7 % vs. 9.8 %) compared to women with normal iron levels. ID in the second trimester of pregnancy was not associated with adverse maternal or infant outcomes such as emergency cesarean section, induction of labor, preterm birth, or fetal acidosis.

Conclusion

Despite recommended iron supplements from 10 weeks gestation, ID was frequent among pregnant Danish women in the second trimester and associated with accelerated placental and infant growth, but not adverse pregnancy outcomes. This study indicates that the clinical relevance of the current cut-off level for ID in the second trimester of pregnancy among pregnant Danish women needs further investigation.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.