Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality?
Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality?
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DOI：
10.1093/jn/131.2.590s
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发表时间：
2001-02-01
影响因子：
4.2
通讯作者：
Rasmussen, KM
中科院分区：
文献类型：
--
作者：
Rasmussen, KM
我们进行了广泛的文献综述，以确定缺铁、缺铁性贫血和任何原因引起的贫血是否与低出生体重、早产或围产儿死亡有关。有强有力的证据表明，母体血红蛋白浓度与出生体重之间以及母体血红蛋白浓度与早产之间存在关联。无法确定这种关联在多大程度上可归因于缺铁性贫血。在一些研究中，低出生体重和早产的最低值出现在母亲血红蛋白浓度低于目前妊娠期贫血的临界值(110g/L)时，特别是在那些母亲的血红蛋白值在妊娠期间没有得到控制的研究中。对贫血或非贫血孕妇补充铁、叶酸或两者都补充似乎不会增加出生体重或妊娠持续时间。然而，必须谨慎地解读这些研究，因为大多数研究都倾向于假阴性的研究结果。因此，尽管在怀孕期间给妇女补充铁可能还有其他原因，但目前从研究中获得的证据不足以支持或拒绝这种用于增加出生体重或降低早产率的特定目的的做法。
An extensive literature review was conducted to identify whether iron deficiency, iron-deficiency anemia and anemia from any cause are causally related to low birth weight, preterm birth or perinatal mortality. Strong evidence exists for an association between maternal hemoglobin concentration and birth weight as well as between maternal hemoglobin concentration and preterm birth. it was not possible to determine how much of this association is attributable to iron-deficiency anemia in particular. Minimal values for both low birth weight and preterm birth occurred at maternal hemoglobin concentrations below the current cut-off value for anemia during pregnancy (110 g/L) in a number of studies, particularly those in which maternal hemoglobin values were not controlled for the duration of gestation. Supplementation of anemic or nonanemic pregnant women with iron, folic acid or both does not appear to increase either birth weight or the duration of gestation. However, these studies must be interpreted cautiously because most are subject to a bias toward false-negative findings. Thus, although there may be other reasons to offer women supplemental iron during pregnancy, the currently available evidence from studies with designs appropriate to establish a causal relationship is insufficient to support or reject this practice for the specific purposes of raising birth weight or lowering the rate of preterm birth.