妊娠期补充铁剂的临床观察

目的观察孕期补充铁剂的效果及对妊娠结局的影响。方法将３６９例孕妇根据补充铁剂前血红蛋白水平分为预防组和治疗组。预防组（血红蛋白≥１１０ｇ／Ｌ）随机分成玛特那１组（９６例,从孕２０～２４周开始口服玛特那）与空白对照组（９５例）。治疗组（血红蛋白＜１１０ｇ／Ｌ）随机分成玛特那２组（９３例）、硫酸亚铁组（５０例）、福乃得组（３５例）。均于孕３６周前开始服药,并分别于服药前查血红蛋白及血清铁蛋白,观察期间每４周复查１次血红蛋白,分娩时分别查母血及脐血血清铁蛋白并观察临床结局。结果玛特那１组服药后母血清铁蛋白明显高于服药前,且明显高于空白对照组（Ｐ＜０．０５）。玛特那２组服药后母血清铁蛋白明显高于服药前（Ｐ＜０．０５）,且明显高于硫酸亚铁组（Ｐ＜０．０５）及福乃得组（Ｐ＜０．０５）。各组的妊娠结局差异无显著性（Ｐ＞０．０５）。结论玛特那可增加孕妇体内的铁储备和有效地改善铁缺乏症状,而对妊娠结局无影响。

Clinical experience with iron supplementation in pregnancy

OBJECTIVE: To study the efficacy of iron supplementation during pregnancy and its influences on the outcome of pregnancy. METHODS: A total of 369 pregnant women were enrolled in this study. According to the hemoglbin levels at recruitment, there were 2 groups: preventive (Hb > or = 110 g/L) and treatment (Hb < 110 g/L) groups. In the preventive group, women entered the study from 20-24 gestational weeks and were randomly assigned to materna treatment (n = 96) who took materna 1 tablet daily or control group (n = 95) who took no other supplementation. In the treatment groups, women less than 36 gestational weeks were accepted. They were randomly divided as materna (n = 93) 1 tablet/d, ferrous sulfate 0.3 g tid/d (n = 50) or Ferroids 1 tablet/d (n = 35) groups. Both Hb and serum ferritin concentrations were determined at admission and immediately after delivery. In some cases serum ferritin in the umbilical vein were measured as well. Hemoglobin levels were examined every 4 weeks during the observational period. RESULTS: In the preventive groups, maternal serum ferritin levels after materna treatment were significantly higher than that before treatment and the control group (P < 0.05). As for the anemia women, compared the serum ferritin concentration, materna treatment had significantly higher levels than that at admission (P < 0.05), and also higher than that in the ferrous sulfate or ferroids tratment groups (P < 0.05). The s-ferritin in the umbilical vein had no correlation with the paired maternal levels. There were no significant differences in the pregnancy outcomes among all the groups. CONCLUSION: Materna can increase the iron storage and effectively improve the iron deficiency during pregnancy, and has no impact on the prgnancy outcomes.