妊娠合并贫血及产褥期贫血的影响因素分析

目的　探讨妊娠合并贫血及产褥期贫血的影响因素。方法　选择2019年2~12月于首都医科大学附属北京地坛医院建档进行常规产前检查、分娩及产后随访的孕产妇240例为研究对象。记录受试者孕期及产褥期贫血发生情况，并根据是否发生贫血分为妊娠合并贫血组与妊娠未合并贫血组，产褥期贫血组与产褥期未贫血组。采用单因素和多因素logistic回归分析妊娠合并贫血及产褥期贫血的影响因素。结果　孕期贫血总发生率为24.58%（59/240）；产褥期贫血发生率为18.33%（44/240）。单因素分析结果显示，妊娠合并贫血组与妊娠未合并贫血组受试者的年龄、受孕方式、孕期体质量增加情况比较差异无统计学意义（P>0.05）;2组受试者的孕次、产次、孕前体质量指数（BMI）、胎儿个数、乙型肝炎病毒感染情况比较差异有统计学意义（P<0.05）。 多因素logistic回归分析结果显示，多孕次、多产次、孕前低BMI、多胎、合并乙型肝炎病毒感染是妊娠期合并贫血的独立危险因素（P<0.05）。单因素分析结果显示，产褥期贫血组与产褥期未贫血组受试者的年龄、孕前BMI、孕次及新生儿体质量比较差异无统计学意义（P>0.05）；2组受试者的产次、胎儿个数、是否合并乙型肝炎病毒感染、分娩方式、是否母乳喂养比较差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，多产次、多胎、合并乙肝病毒感染是产褥期贫血的独立危险因素，母乳喂养、顺产是产褥期贫血的保护因素（P<0.05）。结论　多孕次、多产次、孕前低BMI、多胎、合并乙型肝炎病毒感染是妊娠合并贫血的独立危险因素；多产次、多胎、合并乙型肝炎病毒感染是产褥期贫血的独立危险因素，母乳喂养、顺产是产褥期贫血的保护因素。

Influencing factors of anemia during pregnancy and puerperal period

Objective　To investigate the influencing factors of anemia during pregnancy and puerperal period.
Methods　A total of 240 maternal who were filed in Beijing Ditan Hospital Affiliated to Capital Medical University from February to December 2019 for routine prenatal examination,delivery and postpartum follow-up were selected as the study subjects.The incidence of anemia of subjects during pregnancy and puerperium was recorded.According to whether anemia occurred,the subjects were divided into pregnancy with anemia group and pregnancy without anemia group,puerperium with anemia group and puerperium without anemia group.The influencing factors of anemia during pregnancy and puerperium were analyzed by univariate and multivariate logistic regression analysis.
Results　The total incidence of anemia during pregnancy was 24.58%(59/240);the incidence of puerperal anemia was 18.33%(44/240).The results of univariate analysis showed that there was no significant difference in the age,the way of conception,and the increase of body mass during pregnancy between the pregnancy with anemia group and the pregnancy without anemia group (P>0.05);there were significant difference in gravida,parity,body mass index(BMI) before pregnancy,the number of fetus and hepatitis B virus infection between the two groups (P<0.05).Multivariate logistic regression analysis showed that multiple gravidity,multiple parity,low BMI before pregnancy,polyembryony,and hepatitis B virus infection were independent risk factors for anemia during pregnancy (P<0.05).The results of univariate analysis showed that there was no significant difference in the age,BMI before pregnancy，gravida and body mass of neonates between the puerperium with anemia group and the puerperium without anemia group (P>0.05) ;there were significant difference in gravidity，the number of fetuses，whether there was hepatitis B virus infection,the mode of delivery，breastfeeding or not between the two groups(P<0.05).Multivariate logistic regression analysis showed that multiple parity,polyembryony and hepatitis B virus infection were independent risk factors for puerperal anemia,while breast feeding and natural labour were protective factors for puerperal anemia (P<0.05).
Conclusion　The multiple gravidity,multiple parity,low BMI before pregnancy,polyembryony,and hepatitis B virus infection were independent risk factors for anemia during pregnancy.The multiple parity,polyembryony and hepatitis B virus infection were independent risk factors for puerperal anemia,while breast feeding and natural labour were protective factors for puerperal anemia.