Maternal and perinatal outcomes in second hemoglobin measurement in nonanemic women at first booking: effect of altitude of residence in peru.
Maternal and perinatal outcomes in second hemoglobin measurement in nonanemic women at first booking: effect of altitude of residence in peru.
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DOI：
10.5402/2012/368571
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Fort AL
中科院分区：
文献类型：
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作者：
Gonzales GF;Tapia V;Fort AL
目标。在低海拔和高海拔地区怀孕期间，第一次检测血红蛋白浓度正常后，确定第二次测量血红蛋白浓度的变化。方法。这是对从秘鲁围产期信息系统获得的一个大型数据库的二次分析，该数据库包括秘鲁43个产科单位的379,816名孕妇及其婴儿。结果。大多数女性在第二次检测时血红蛋白值保持正常（75.1%）。然而，21.4%的女性在第二次检测时出现贫血。其中，2.8%为中度/重度贫血，3.5%为红细胞增多（血红蛋白血红蛋白为14.5 g/dL）。在所有病例中，Hb随海拔升高而升高。第二次测量血红蛋白时较高胎龄、BMI <19.9 kg/m2、无伴侣生活、产前保健次数<5次、第一胎、多胎和先兆子痫增加了中度/重度贫血的风险。居住在中、高海拔地区，首次登记时Hb水平正常且BMI较高，中、重度贫血的风险较低。结论。随着妊娠的进展，贫血的发生率会增加，并且由于整个妊娠期间都应观察Hb值，因此第一次预约时的正常值可能不被认为是足够的。在第二次测量中，BMI是贫血的风险因素。
Objective. To determine changes in hemoglobin concentration at second measurements after a normal hemoglobin concentration was detected at first booking during pregnancy at low and at high altitudes. Methods. This is a secondary analysis of a large database obtained from the Perinatal Information System in Peru which includes 379,816 pregnant women and their babies from 43 maternity units in Peru. Results. Most women remained with normal hemoglobin values at second measurement (75.1%). However, 21.4% of women became anemic at the second measurement. In all, 2.8% resulted with moderate/severe anemia and 3.5% with erythrocytosis (Hb>14.5 g/dL). In all cases Hb was higher as altitude increased. Risk for moderate/severe anemia increased associated with higher gestational age at second measurement of hemoglobin, BMI <19.9 kg/m2, living without partner, <5 antenatal care visits, first parity, multiparity, and preeclampsia. Lower risk for moderate/severe anemia was observed with normal high Hb level at first booking living at moderate and high altitude, and high BMI. Conclusion. Prevalence of anemia increases as pregnancy progress, and that a normal value at first booking may not be considered sufficient as Hb values should be observed throughout pregnancy. BMI was a risk for anemia in a second measurement.