孕中期血红蛋白水平与妊娠高血压疾病的关系

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1、孕中期血红蛋白水平与妊娠高血压疾病的关系作者：张振叶荣伟刘建蒙杨瑞兰章斐然张檀张静波任爱国【摘要】目的分析孕中期血红蛋白水平(Hb)与孕晚期妊娠高血压疾病(PIH)之间的关系。方法比较1995～2000年浙江省和江苏省4个县(市)单胎分娩的95620例妇女孕中期不同Hb水平孕妇的PIH发病率;采用logistic回归模型控制年龄、职业、文化程度、产次和体质指数(BMI)等因素后，估计Hb水平与PIH之间的关联程度。结果孕晚期及产时孕妇PIH的发病率为9.7%;Hb水平为100～109g/L时，PIH的发病率最低;Hb水平升高或者降低，PIH的发病率均呈增加趋势，Hb<

2、;80g/L的孕妇PIH的发病风险增加79%(OR=1.79，95%CI:1.29～2.49)，Hb≥150g/L的孕妇PIH的发病风险增加47%(OR=1.47，95%CI:1.00～2.21)。结论孕中期Hb水平与PIH的发生风险之间呈“U”型关系，重度贫血以及高水平Hb都可能会增加PIH的发生风险。【关键词】血红蛋白;贫血;妊娠高血压疾病　　【Abstract】ObjectiveToexaminetheassociationbetweensecondtrimesterhemoglobin(Hb)concentrationandtheriskofpregnancy

3、inducedhypertensionsyndrome(PIH)ina13Chinesepopulation.MethodsSubjectswerewomenwhodeliveredasingletonbabyinfourcitiesorcountiesinJiangsuProvinceandZhejiangProvince,China,duringtheperiodof19952000.Hbconcentrationwasthelowestconcentrationmeasuredinthesecondtrimester.Atotalof95620womenwerei

4、ncluded.PIHwasdiagnosedaccordingtothecriteriaproposedbytheSecondConferenceoftheTaskForceonthePreventionandCareofPregnancyinducedHypertension,heldin1983inShanghai,China.IncidenceofPIHwascalculatedandcomparedbetweengroupsofwomenwithdifferentconcentrationsofsecondtrimesterHb.Multiplelogist

5、icregressionwasusedtoaddresstherelationshipbetweensecondtrimesterHbconcentrationandtheriskofPIHwhilecontrollingforage,occupation,education,parityandBMI.ResultsTheoverallPIHincidencewas8.0%.WomenwithsecondtrimesterHbconcentrationsof100109g/LhadlowestPIHincidence.Theincidenceincreasedwit

6、heitherincreasingordecreasinghemoglobinconcentrations.ComparedwithwomenwithHbconcentrationsof100109g/L,womenwithHbconcentrationsoflowerthan80g/Lhad79%higherrisk(OR=1.79,95%CI:1.29-2.49),andwomenwithHbconcentrationof150g/Lorhigherhad47%higherrisk(OR=1.47,95%CI:1.00-2.21)ofPIH.ConclusionAU

7、shapedrelationshipispresentbetween13secondtrimesterHbconcentrationandtheriskofPIH.SevereanemiaaswellashighHbconcentrationisassociatedwithanincreasedriskofPIH.　　【Keywords】Hemoglobin;Anemia;Pregnancyinducedhypertensionsyndrome　　妊娠高血压疾病(pregnancyinducedhypertension