Association between maternal hemoglobin concentration and placental weight to birthweight ratio: The Japan Environment and Children's Study (JECS)
Association between maternal hemoglobin concentration and placental weight to birthweight ratio: The Japan Environment and Children's Study (JECS)
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DOI：
10.1016/j.placenta.2020.09.014
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发表时间：
2020-11-01
期刊：
影响因子：
3.8
通讯作者：
Suganuma, Narufumi
中科院分区：
文献类型：
--
作者：
Mitsuda, Naomi;Awn, Naw J-P;Suganuma, Narufumi
引言：过去的研究表明，母体贫血与胎盘重或胎盘重量/出生体重（PW/BW）比值较高有关。虽然这些研究结果表明，产妇血红蛋白浓度和PW/BW比之间的非线性关系，这种关系还没有被密切examined.Methods：我们评估了83,354单胎和他们的母亲在全国范围内的出生队列研究，日本环境和儿童的研究（JECS）。母体血红蛋白浓度和胎盘重量，出生体重，PW/BW ratio之间的关联进行了assessed.Results：平均胎盘重量显着较高的妇女与中度或重度贫血（576 [183] g），但不是在妇女与血红蛋白水平升高（564 [117] g），与妇女与正常血红蛋白水平（560 [115] g）。相比之下，中度或重度贫血（0.190 [0.049]）或血红蛋白水平升高（0.189 [0.033]）的女性的平均PW/BW比值显著高于血红蛋白水平正常的女性（0.185 [0.033]）。在三次样条回归分析中，发现母体血红蛋白浓度和PW/BW ratio.Discussion之间存在U形关系：我们证明了母体血红蛋白浓度与胎盘重量，出生体重和PW/BW ratio之间的非线性和浓度依赖性关系。虽然这些相关性的机制还不完全清楚，但我们认为血红蛋白浓度低或升高可能导致胎盘代偿性肥大和胎儿生长受限。在怀孕前和怀孕期间预防和适当管理贫血对胎盘功能良好和胎儿生长有利是重要的。
Introduction: Past studies have shown that maternal anemia is associated with a heavy placenta or a higher placental weight/birthweight (PW/BW) ratio. Although these findings suggest a non-linear relationship between maternal hemoglobin concentration and PW/BW ratio, this relationship has not been closely examined.Methods: We evaluated 83,354 singletons and their mothers in a nation-wide birth cohort study, the Japan Environment and Children's Study (JECS). The associations between maternal hemoglobin concentration and placental weight, birthweight, and PW/BW ratio were assessed.Results: Mean placental weight was significantly higher in women with moderate or severe anemia (576 [183] g), but not in women with elevated hemoglobin levels (564 [117] g), compared with in women with normal hemoglobin levels (560 [115] g). In contrast, mean PW/BW ratio was significantly higher in women with moderate or severe anemia (0.190 [0.049]) or elevated hemoglobin levels (0.189 [0.033]) than in women with normal hemoglobin levels (0.185 [0.033]). In a regression analysis with cubic spline, a U-shaped relationship was found between maternal hemoglobin concentration and PW/BW ratio.Discussion: We demonstrated non-linear and concentration-dependent relationships between maternal hemoglobin concentration and placental weight, birthweight, and PW/BW ratio. Although the mechanisms underlying these associations are not fully understood, we suggest that low or elevated hemoglobin concentration may lead to placental compensatory hypertrophy and fetal growth restriction. Prevention and proper management of anemia before and during pregnancy are important for a well-functioning placenta and favorable fetal growth.