The relationship between maternal anemia and umbilical cord oxygen content at delivery.
The relationship between maternal anemia and umbilical cord oxygen content at delivery.
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DOI：
10.1016/j.ajogmf.2020.100270
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发表时间：
2021-01
影响因子：
6.3
通讯作者：
Raghuraman N
中科院分区：
文献类型：
--
作者：
Watkins VY;Frolova AI;Stout MJ;Carter EB;Macones GA;Cahill AG;Raghuraman N
本研究通过脐带pO 2检测母体贫血和分娩时胎儿氧合状态之间的关系。这是对2010年至2014年期间普遍入院CBC和脐带气的单胎足月分娩前瞻性队列研究的二次分析。母体贫血定义为入院时血红蛋白≤ 10 g/dl。主要结局为脐动脉（UA）和静脉（UV）pO 2;次要结局为酸血症（UA pH<7.1）、低氧血症（UA/UV pO 2 <第5百分位数）和高氧血症（UA/UV pO 2>第90百分位数）。结果进行了比较患者之间有和没有贫血。母体贫血与UA pO 2 [中位数（IQR）20（16，24）vs 19（15，24）mmHg，p=0.01]和UV pO 2 [30（25，36）vs 29（23，34）mmHg，p<0.01]显著升高相关。贫血母亲所生的新生儿更容易发生UV高氧血症（15.7% vs 10.9%，aOR 1.51，95% CI 1.26-1.81），UA高氧血症无差异。UA或UV低氧血症的发生率无差异。虽然母体贫血与UA pH值的显著差异相关（7.28 ± 0.060 vs 7.27 ± 0.065，p<0.01），但两组新生儿酸血症的发生率无差异（1.6% vs 1.9%，aOR 0.93，95% CI 0.55-1.55）。贫血母亲脐带中的O2含量较高。母体贫血可能导致母体、胎盘和胎儿生理学的适应性变化，使O2更容易卸载到胎盘，并增加O2转移到胎儿。
This study examined the relationship between maternal anemia and fetal oxygenation status at delivery as measured by umbilical cord pO2. This is a secondary analysis of a prospective cohort study of singleton term deliveries with universal admission CBC and umbilical cord gases between 2010 and 2014. Maternal anemia was defined as hemoglobin ≤ 10 g/dl on admission. The primary outcomes were umbilical artery (UA) and vein (UV) pO2; secondary outcomes were acidemia (UA pH<7.1), hypoxemia (UA/UV pO2 <5th percentile), and hyperoxemia (UA/UV pO2>90th percentile). Outcomes were compared between patients with and without anemia. Maternal anemia was associated with a significantly higher UA pO2 [median (IQR) 20 (16, 24) vs 19 (15, 24) mmHg, p=0.01] and UV pO2 [30 (25, 36) vs 29 (23, 34) mmHg, p<0.01]. Neonates born to anemic mothers were more likely to have UV hyperoxemia (15.7% vs 10.9%, aOR 1.51, 95% CI 1.26-1.81) with no difference in UA hyperoxemia. There was no difference in rates of UA or UV hypoxemia. Although maternal anemia was associated with a significant difference in UA pH (7.28 ± 0.060 vs 7.27 ± 0.065, p<0.01), there was no difference in the rate of neonatal acidemia between groups (1.6% vs 1.9%, aOR 0.93, 95% CI 0.55-1.55). Umbilical cord O2 content is higher in anemic mothers. Maternal anemia may lead to adaptations in maternal, placental and fetal physiology allowing for easier unloading of O2 to the placenta and increased O2 transfer to the fetus.
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影响因子：
9.8
作者：
Cahill AG;Tuuli MG;Stout MJ;López JD;Macones GA
通讯作者：
Macones GA
影响因子：
7.1
作者：
SCHOLL, TO;HEDIGER, ML;SHEARER, JW
通讯作者：
SHEARER, JW
影响因子：
15.9
作者：
KENNEDY, AC;VALTIS, DJ
通讯作者：
VALTIS, DJ
影响因子：
5.9
作者：
PITKIN, RM
通讯作者：
PITKIN, RM
影响因子：
--
作者：
MOSTELLO, D;CHALK, C;CLARK, KE
通讯作者：
CLARK, KE