孕早期女性铁营养状况及其影响因素分析  

Analysis on the iron status and associated factors during the first trimester of pregnancy

作　　者：林咏惟 周雅琳[1] 赵润茏 许雅君[1,2] 刘燕萍 LIN Yong-wei;ZHOU Ya-lin;ZHAO Run-long;XU Ya-jun;LIU Yan-ping(Department of Nutrition and Food Hygiene,School of Public Health,Peking University,Beijing 100191,China;Laboratory of Toxicological Research and Risk Assessment for Food Safety,Beijing 100191,China;Department of Clinical Nutrition,Peking Union Medical College Hospital,China Academic Medical Science and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]北京大学公共卫生学院营养与食品卫生学系,北京100191 [2]食品安全毒理学研究与评价北京市重点实验室,北京100191 [3]中国医学科学院北京协和医院临床营养科,北京100730

出　　处：《北京大学学报（医学版）》2023年第4期600-605,共6页Journal of Peking University:Health Sciences

基　　金：中国营养学会-振东国人体质与健康研究基金(CNS-ZD2020-163)。

摘　　要：目的:探讨膳食等因素对孕早期女性铁营养状况的影响,为预防铁缺乏及缺铁性贫血,降低相关不良母婴健康结局发生风险提供研究依据。方法:在2018年11月至12月于北京儿童医院顺义妇儿医院建档产检的孕早期女性中共招募到388名孕早期女性为研究对象,收集其人口统计特征、人体测量特征、分娩史、孕早期铁营养状况指标和膳食频率信息。统计分析采用SPSS 26.0软件,各组间铁营养状况差异分析采用Fisher精确概率检验或单因素方差分析,均为双侧概率检验,P<0.05为差异有统计学意义。采用主成分分析提取膳食模式,计算各膳食模式因子得分。以血清铁蛋白(serum ferritin,SF)<30μg/L为铁缺乏标准,采用Logistic回归方法分析上述因素对孕早期铁缺乏症的影响。结果:研究对象平均血清铁蛋白水平为(50.4±35.3)μg/L,共有铁缺乏者121例(31.2%),其中铁减少(iron depletion,ID)、缺铁性红细胞生成(iron deficiency erythropoiesis,IDE)和缺铁性贫血(iron deficiency anemia,IDA)分别为107例(27.6%)、8例(2.1%)和6例(1.5%)。分娩史是孕早期女性铁缺乏的危险因素,OR=3.90(95%CI:1.81~8.42,P=0.001)。反之,孕妇年龄每增加1岁,患病风险即降低4%(95%CI:0.94~0.97,P<0.001),年龄是铁缺乏症的保护因素。服用含铁营养补充剂对有分娩史的女性存在显著保护作用(OR=0.27,95%CI:0.09~0.83,P=0.022)。荤素均衡膳食模式(OR=0.81,95%CI:0.66~1.00,P=0.054)对铁缺乏症的影响具有边缘显著性。结论:应对经产妇及年轻孕妇的铁营养状况予以充分关注,对于育龄女性群体,特别是经产妇,在备孕期及孕早期推荐使用含铁补充剂,以预防孕期铁缺乏症;荤素均衡膳食模式对孕早期铁缺乏症的影响仍需进一步研究予以确定。Objective:To investigate the impact of dietary and underlying factors on the iron status of women in early pregnancy and to provide evidence for preventing iron deficiency and iron deficiency anemia,thereby reducing the incidence of associated adverse outcomes.Methods:From November to December 2018,women in the first trimester of pregnancy(<12 weeks gestation)who established prenatal records at the Shunyi District Maternal and Child Health Hospital,Beijing,were enrolled in this study,in which 388 participants were accessed for data including demographic characteristics,anthropometric measurements,parity,biomarkers reflecting iron status,and food-frequency questionnaire.SPSS 26.0 were used for statistical analysis.Dietary patterns were extracted using principal component analysis,and factor scores of each dietary pattern were calculated.Two-sided Fisher exact probability test and one-way ANOVA were conducted to access differences in iron status among the groups,and the differences were significant if P<0.05.Iron deficiency was defined as serum ferritin(SF)<30μg/L.To analyze the potential role of dietary factors on iron deficiency during the first trimester,the collected data listed above were adopted as independent factors for the cross-sectional Logistic regression.We used Logistic regression to analyze the potential effects of baseline characteristics and dietary factors on iron status.Results:Among the 388 participants included in the analysis,121(32.2%)were iron deficient,in which 107(27.6%)were iron depletion(ID),8(2.1%)were iron deficiency erythropoiesis(IDA),6(1.5%)were iron deficiency anemia.The mean SF concentration was(50.4±35.3)μg/L.Multiparity(OR=3.9,95%CI:1.81-8.42,P=0.001)was a risk factor for iron deficiency during early pregnancy.No significant iron status differences were found among the participants with different educational levels and anthropometric measurements.In contrast,age(OR=0.96,95%CI:0.94-0.97,P<0.001)was a protective factor.For multiparas,taking iron-containing supplements might hav

关 键 词：铁缺乏 缺铁性贫血 患病率 危险因素 孕期 

分 类 号：R153.1[医药卫生—营养与食品卫生学]