The relationship between the changes of hemoglobin and ferritin in different stages of pregnancy and adverse pregnancy outcomes / 中国医师杂志

ABSTRACT

Objective:To study the relationship between the changes of hemoglobin concentration and serum ferritin concentration during pregnancy and the adverse pregnancy outcome, and to guide iron supplementation during pregnancy.Methods:122 parturient women who delivered in the Aerospace Center Hospital from August 2016 to may 2018 were prospectively selected. Data on hemoglobin concentration in each trimester and first day after delivery, ferritin concentration in first and second trimester, pregnancy outcomes of 122 parturient women was collected. Gestational diabetes mellitus, gestational hypertension (gestational hypertension and preeclampsia-eclampsia), preterm labor, premature rupture of membranes, postpartum hemorrhage, and neonatal weight were collected for statistical analysis.Results:⑴ There were significant differences in hemoglobin concentration among the early, middle, late pregnancy and the first day after delivery in 122 cases of parturient women ( P<0.01). There was significant difference in serum ferritin between early and middle pregnancy ( P<0.01). ⑵ There was a significant difference in hemoglobin between the gestational diabetes group and the non-gestational diabetes group ( P<0.05). Hemoglobin between pregnancy-induced hypertension (PIH) disease group and the normal hypertension group in early pregnancy have significant difference ( P<0.05), while hemoglobin between the preterm and term groups have significant difference ( P<0.05). ⑶ Patients with iron deficiency (ferritin ≥ 20 μg/L) were more likely to have premature rupture of membranes than those with iron deficiency, and those with anemia in late pregnancy were more likely to have premature delivery. ⑷ The risk factors of gestational diabetes mellitus were high body mass index (BMI) before pregnancy ( OR=3.578, 95% CI 1.604-7.985) and high hemoglobin concentration during middle pregnancy ( OR=1.425, 95% CI 1.058-1.918). High BMI before pregnancy ( OR=5.313, 95% CI 1.746-16.169) and early high hemoglobin concentration ( OR=1.975, 95% CI 1.048-3.720) were risk factors for PIH. The independent risk factor of PROM was serum ferritin ≥15 μg/L ( OR=2.836, 95% CI 1.05-7.637). The independent risk factor of preterm birth was anemia in late pregnancy ( OR=13.625, 95% CI 2.470-75.161). Conclusions:It is necessary to master the time and reasonable dose of iron supplement during pregnancy. Individualized iron supplement is the most appropriate method. Close monitoring should be carried out in the process of iron supplement to avoid adverse pregnancy outcomes.