北京市孕妇缺铁性贫血的研究

本文通过对100名妊娠早期孕妇的追踪观察发现,孕妇妊娠中、晚期的铁营养状况普遍较差,血红蛋白、红细胞计数、血浆铁蛋白的平均值均明显低于未婚女青年;红细胞游离原卟啉明显高于未婚青年;妊娠晚期的血浆铁水平和运铁蛋白饱和度较妊娠中期明显下降,红细胞游离原卟啉明显升高。膳食调查的结果表明,妊娠早、中、晚期的营养素多摄入不足,唯铁、维生素C、维生素B_1达到供给量标准。本文结合上述资料从孕前铁营养状况、孕期膳食构成和机体铁状况的动态变化等角度重点讨论了北京城区孕妇贫血的性质和原因,并提出了相应的对策。

STUDY ON IRON DEFICIENCY ANEMIA DURING PREGNANCY IN BEIJING

One hundred healthy primiparous pregnant women were observed longitudinally from the 1st trimester, and 68 healthy nonpregnant women were served as controls in the urban area of Beijing relatively poor iron status among these primiparas could be seen through hematological parameters. The mean hemoglobin, red blood cell and plasma ferritin values were 11.40 ±1.17ng/dl, 369.0 ±32.6 104/mm3 and 10.5×÷3.80 ng/ml respectively in the 2nd trimester, and 11.28±1.24g/dl, 382.2±39.4 104/mm3 and 10.0×÷3.83 ng/ml in the 3rd trimester, which were lower than the results of non-pregnant women respectively being 13.46 ± 1.28g/dl, 429.3±35.0 104/mm8 and 46.2×÷2.03ng/ml (P<0.001). The mean free erythrocyte protoporphyrin was 47.9 1.63 μg/dl and 66.8×÷ 1.57 μg/dl in the 2nd and 3rd trimester, being significantly higher than 38.4×÷1.40 μg/dl of non-pregnant women (P<0.005 andP<0.001). The worst nutritional status of iron in pregnant women in the 3rd trimester was reflected by the obvious decrease of plasma iron and tra-nsferrin saturation (P<0.005 and P<0.002) and the increase of free eryth-rocyte protoporphyrin (P<0.001).The results of 6-day-record dietary surveys throughout the three trimesters indicated that the intakes of iron and ascorbic acid were higher than the RDA although many other nutrients, such as energy and protein, were relatively lower.Available data analyses suggested that the iron status during pregnancy was not only related to iron and ascorbic acid intakes, but also to many other nutrient intakes. In addition, a more significant influence on the iron status of pregnant women was probably due to their poor iron status before pregnancy.The changes in hematological parameters during pregnancy and dietary data analyses suggested that the character of anemia among Beijing urban pregnant women was not due to haemodilution, but rather to iron deficiency, which was probably caused by less bodily iron store before pregnancy and no extra iron supplementation during pregnancy. The iron supplement in iron-fortified drinks or other iron-fortified foods from the 2nd trimester of pregnancy was strongly suggested.