妇女围受孕期服用营养补充剂与孕早期贫血的关系

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摘要目的了解北京市通州区妇女孕早期贫血患病率,评价围受孕期服用单纯叶酸片(PFA)或含叶酸的多种微量营养素补充剂(MMFA)与孕早期贫血的关系。方法以2013—2018年37 034例在通州区妇幼保健院分娩妇女的孕期保健和孕早期血常规化验数据为基础进行研究,采用Logistic回归模型分析围受孕期PFA或MMFA服用情况与孕早期贫血的关系。结果妇女孕早期贫血患病率为1.8%,以轻度及小细胞低色素性贫血为主。与服用PFA妇女相比,服用MMFA者孕早期患贫血(aOR=0.79, 95% CI:0.66～0.95)和小细胞低色素性贫血风险(aOR=0.69, 95% CI:0.53～0.91)均更低。在服用MMFA的妇女中,孕前开始服用者较孕后开始服用者总贫血和小细胞低色素性贫血风险低,aOR分别为0.69(95% CI:0.53～0.90)和0.47(95% CI:0.30～0.75),且高频服用MMFA者较未服用者总贫血和小细胞低色素性贫血风险低,aOR分别为0.59(95% CI:0.41～0.86)和0.42(95% CI:0.23～0.76)。在服用MMFA的妇女中,孕前开始服用者血清铁水平更高(aβ=4.25, 95% CI:1.70～6.80)。结论 2013—2018年北京市通州区妇女孕早期贫血患病率较低。妇女围受孕期服用MMFA可降低孕早期贫血,尤其是小细胞低色素性贫血患病风险。

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关键词 ：贫血, 患病率, 营养补充剂, 围受孕期, 妊娠

Abstract：Objective To investigate the prevalence of anemia in first trimester of gestational period among women in Tongzhou district of Beijing and evaluate the association between pure folic acid (PFA) or multiple micronutrients containing folic acid (MMFA) supplementation and the prevalence of anemia in first trimester. Methods The study was based on the information of 37 034 pregnant women in pregnancy health care system and the first-trimester laboratory system of Tongzhou Maternal and Child Health Hospital of Beijing during 2013 to 2018. Logistic regression model was used to analyze the relationship between status of PFA or MMFA consumption during periconceptional period and the risk of anemia in early pregnancy. Results The overall prevalence of anemia among the participants in first trimester of gestational period was 1.8%. Mild and microcytic hypochromic anemia were the predominant cases. Compared with women taking PFA, women taking MMFA had lower risk of overall anemia (aOR=0.79, 95% CI:0.66-0.95) and microcytic hypochromic anemia (aOR=0.69, 95% CI:0.53-0.91) in first trimester of gestational period. Among women who took MMFA, the women who started taking MMFA before pregnancy had lower risk of overall anemia (aOR=0.69, 95% CI:0.53-0.90) and microcytic hypochromic anemia (aOR=0.47, 95% CI:0.30-0.75) than those who started taking MMFA after pregnancy. Women who took MMFA frequently had lower risk of overall anemia (aOR=0.59, 95% CI:0.41-0.86) and microcytic hypochromic anemia (aOR=0.42, 95% CI:0.23-0.76) in first trimester of gestational period than those who did not take it. Among women taking MMFA, those who started taking it before pregnancy had higher serum iron levels (aβ=4.25, 95% CI:1.70-6.80). Conclusion The prevalence of anemia among pregnant women in first trimester of gestational period in Tongzhou district of Beijing was lower from 2013 to 2018. Periconceptional MMFA supplementation could reduce the risk of anemia in first trimester of gestational period, especially microcytic hypochromic anemia.

Key words： anemia prevalence nutritional supplements periconceptional period pregnancy

收稿日期: 2023-02-08

ZTFLH:

R17

基金资助:国家重点研发计划(2021YFC2700700, 2021YFC2700704)

通讯作者: 靳蕾(jinlei@bjmu.edu.cn)

引用本文:

栗思思, 刘春毅, 金蕾, 焦明远, 张杰, 孟文颖, 靳蕾. 妇女围受孕期服用营养补充剂与孕早期贫血的关系[J]. 中国生育健康杂志, 2024, 35(2): 108-114. LI Sisi, LIU Chunyi, JIN Lei, JIAO Mingyuan, ZHANG Jie, MENG Wenying, JIN Lei. Association between periconceptional micronutrient supplementation and anemia in first trimester of gestational period. Chinese Journal of Reproductive Health, 2024, 35(2): 108-114.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2024/V35/I2/108

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