Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women
Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women
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DOI：
10.1016/j.arcmed.2005.11.011
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发表时间：
2006-07-01
影响因子：
7.7
通讯作者：
Valdes-Ramos, Roxana
中科院分区：
文献类型：
--
作者：
Casanueva, Esther;Viteri, Fernando E.;Valdes-Ramos, Roxana
背景我们进行了这项研究，以比较产前每日和每周补充铁，叶酸和维生素B-12的有效性和安全性，健康，孕妇在妊娠20周时没有贫血。将妊娠20周时血红蛋白（Hb）> 115 g/L（相当于海平面105 g/L）的单胎妊娠妇女随机分为两组，一组每天服用一片含60 mg铁、200 μ g叶酸和1 μ g维生素B12的片剂（DS，n = 56）;另一组每周服用两片片剂（WS，n = 60）。从第20 ~ 36周每4周检测一次血红蛋白（Hb）和血清铁蛋白（Fe）浓度，并评估妊娠结局。轻度贫血和低铁蛋白血症在整个妊娠期的发生率在DS组低于WS组。116名妇女中没有一名在任何评估点的Hb浓度< 103 g/L。相反，血液浓缩从孕28周开始，DS组和WS组中分别有11%和2%的新生儿出现血红蛋白（Hb > 145 g/L）。我们事后观察到，孕28周时的血液浓缩与低出生体重的相对风险显著升高相关（RR 6.23，95%CI 1.46-26.57）和早产（RR 7.78，95%CI 1.45-24.74）。结论。在妊娠20周时无贫血的妇女中，两种方案（DS和WS）均防止Hb水平< 100 g/L的发生。DS女性的血液浓缩发生率较高。血液浓缩与低出生体重和早产的风险增加有关。(c)2006年IMSS。爱思唯尔公司出版
Background. We undertook this study to compare the effectiveness and safety of antenatal daily and weekly supplementation with iron, folic acid, and vitamin B-12 in healthy, pregnant women who were not anemic at gestational week 20.Methods. Women with singleton pregnancies and blood hemoglobin (Hb) > 115 g/L at gestational week 20 (equivalent to 105 g/L at sea level) were randomly assigned to two groups, one consuming one tablet containing 60 mg iron, 200 mu g folic acid and 1 mu g vitamin B12 daily (DS, n = 56); the other consuming two tablets once weekly (WS, n = 60). Blood Hb and serum ferritin concentrations were measured every 4 weeks from weeks 20 to 36, and pregnancy outcomes were evaluated.Results. Mild anemia and hypoferritinemia throughout pregnancy occurred less frequently in DS than WS. None of the 116 women had Hb concentrations < 103 g/L at any evaluation point. In contrast, hemoconcentration (Hb > 145 g/L) from gestational week 28 onwards occurred in 11% in DS and 2% in WS. We observed ex post facto that hemoconcentration at gestational week 28 was associated with a significantly higher relative risk of low birth weight (RR 6.23, 95% CI 1.46-26.57) and premature delivery (RR 7.78, 95% CI 1.45-24.74).Conclusions. In women who were nonanemic at gestational week 20, both schemes (DS and WS) prevented the occurrence of Hb levels < 100 g/L. DS women had a higher incidence of hemoconcentration. Hemoconcentration was associated with increased risk of low birth weight and premature delivery. (c) 2006 IMSS. Published by Elsevier Inc.