妊娠中期母亲铁营养对婴儿早期铁营养状况影响的研究

目的 研究母亲妊娠中期铁营养对婴儿早期铁营养状况的影响.方法 测定母亲妊娠中、后期及脐血血清铁蛋白(zerum ferritin,SF)及血常规,随访至婴儿3～5月龄测婴儿血常规、血清可溶性转铁蛋白受体(soluble transferrin receptor,sTIR).比较母亲不同铁营养状况与婴儿血清sTIR水平关系.结果 (1)100对母亲-婴儿完成全程随访,婴儿有39例铁缺乏,92.31%(36/39)的母亲妊娠中期铁缺乏.(2)母亲妊娠中期患铁缺乏症的婴儿早期铁缺乏检出率明显高于母亲中期铁营养正常婴儿(X2=11.567,P<0.005),母亲妊娠中期为缺铁性贫血的婴儿铁缺乏症检出率明显高于母亲妊娠中期为隐性铁缺乏的婴儿铁缺乏症检出率(X2=7.356,P<0.01);母亲妊娠中期缺铁的婴儿早期血清sTIR值明显增高(P<0.005);妊娠中期母亲存在缺铁性贫血、隐性铁缺乏的婴儿血清sTfR值差异无统计学意义(P>0.05).(3)妊娠中期母亲SF水平与3～5月龄婴儿sTIR值存在负相关性(r=-0.7552,P<0.01).结论 3～5月龄健康婴儿的贫血可能同胎儿期铁贮存不足有关;母亲妊娠中期缺铁可减少胎儿期铁贮存,影响婴儿早期的铁营养水平.

Effect of maternal iron status on infant's iron level:a prospective study

Objective To investigate the effect of maternal iron levels in second trimester of pregnancy on the infants' early iron status,explore the relationship between maternal and infant's iron status,and analyze the main factor influencing anemia of the infants.Methods Totally 100 couples of mother-baby were followed up from the second trimester of the mothers' pregnancy till the babies were 3-5 months old in the Department of Primary Child Care from March 2006 to February 2007.The maternal venous blood samples were collected in the second and the third trimesters and were analyzed for Hb at the same time.The infants' venous blood samples were collected at the end of the follow-up visit and were analyzed for Hb.The values of sTfR of the infants were compared with the maternal iron status diagnostic criteria.The infant's weight was measured during the visits by two professional staff members.The physical growth was assessed with CDC2000 reference.Results (1) Among 100 couples of mother-baby,none of the Hb values was lower than 90 g/L during the whole period of survey.The prevalence of ID in the babies at the ages of 3-5 months was 39%.Among them 36 cases (36/39,92.31%) were born to the mother with ID during pregnancy;26 couples of mother-infant had normal iron status during the following study.(2) The ID' prevalence in the infants born to the mothers with ID was higher than in the babies born to the healthy mothers (X2=11.567,P<0.005).The ID' prevalence in the infants born to the mothers with IDA was higher than in the babies born to the mothers with LID (X2= 7.356,P<0.01).(3) The sTIR values of infants born to the mother with ID during pregnancy were increased significantly (P<0.01);the iron nutritional status did not show any significant difference between babies whose mothers were IDA and LID (P>0.05).(4) The SF value of maternal venous blood was negatively correlated with the sTIR value of infant (r=-0.7552,P <0.01).Conclusions (1)The anemia of the infants aged 3-5 months was correlated with the iron shortage during the fetal stage.(2)The mild iron deficiency in the pregnant women during the second trimester could decrease the iron storage of fetus and then also could affect the iron status of the early infancy and cause anemia.