Predictors of haemoconcentration at delivery: association with low birth weight
Predictors of haemoconcentration at delivery: association with low birth weight
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DOI：
10.1007/s00394-012-0468-4
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发表时间：
2013-09-01
影响因子：
5
通讯作者：
Arija, V.
中科院分区：
文献类型：
--
作者：
Aranda, N.;Ribot, B.;Arija, V.
为了评估与分娩时血液浓缩风险相关的因素，如初始血红蛋白水平和HFE基因的改变，以及补充中等剂量铁的孕妇对低出生体重的影响，对217名服用适量铁补充剂的健康孕妇及其新生儿进行了纵向研究。根据分娩时血液浓缩的风险对妇女进行分类，定义为Hb > 130 g/L。每个受试者的产科和临床病史，吸烟习惯，铁生化参数（血红蛋白（Hb），血清铁蛋白和转铁蛋白饱和度）记录在第1，第2和第3个三月和分娩。同时检测了HFE基因C282 Y、H63 D和S65 C多态性，所有妇女的平均补铁量为43.9mg/d（几何平均值，95%CI：43.6-44.1）。妊娠早期Hb水平较高和存在HFE突变与分娩时血液浓缩风险较高相关，校正比值比为1.14（95%CI：1.05-1.25）和5.35（95%CI：1.6-17.8）。分娩时血液浓缩与低出生体重的风险相关，校正比值比为11.48（95%CI：1.13-116.6）。对于HFE基因改变且妊娠开始时血红蛋白水平良好的妇女，每日适量补充铁可能对胎儿生长有害。总的来说，这表明在怀孕早期确定妇女的铁状态以建立更合适的补充模式的重要性。
To assess the factors associated with risk of haemoconcentration at delivery, such as initial haemoglobin levels and alterations in the HFE gene, and its effect on low birth weight in pregnant women supplemented with moderate doses of iron.Case-control study nested in a longitudinal study conducted on 217 healthy pregnant women taking moderate iron supplementation and their newborns. Women were classified according to the risk of haemoconcentration at delivery, defined as Hb > 130 g/L. Each subject's obstetric and clinical history, smoking habit, and iron biochemical parameters (haemoglobin (Hb), serum ferritin and transferrin saturation) were recorded at 1st, 2nd and 3rd trimester and at delivery. Polymorphisms of the HFE gene (C282Y, H63D and S65C) were also measured.The average of iron supplementation of all the women was 43.9 mg/dia (geometric mean, 95 % CI: 43.6-44.1). Higher levels of Hb at early gestation and the presence of HFE mutations were associated with greater risk of haemoconcentration at delivery, adjusted odds ratios of 1.14 (95 % CI: 1.05-1.25) and 5.35 (95 % CI: 1.6-17.8). Haemoconcentration at delivery was associated with a greater risk of low birth weight, adjusted odd ratio of 11.48 (95 % CI: 1.13-116.6).Moderate daily doses of supplementary iron may be harmful for foetal growth in women with alterations in HFE gene and who started pregnancy with good haemoglobin levels. Overall, this suggests the importance of determining a woman's iron status early in her pregnancy in order to establish a more appropriate pattern of supplementation.