肖祯^1,2,,
许晓光^1,3,,,
扎西多吉¹,
其美卓嘎¹,
隆芳¹
1. 西藏自治区那曲市人民医院 高原医学研究院, 西藏 那曲 852000
2. 大连医科大学附属第一医院 妇产科, 辽宁 大连 116011
3. 大连医科大学附属第二医院 神经外科, 辽宁 大连 116027

基金项目: 中央引导地方项目（地方科技创新项目示范，XZ202001YD0005C）；西藏自治区自然科学基金组团式援藏医学项目[XZ2020ZR-ZY78(Z)]


详细信息 作者简介: 肖祯(1982-), 男, 副主任医师。E-mail: seriousdoc@163.com





通讯作者: 许晓光, 教授。E-mail: drxgxu@163.com 中图分类号: R737.33


摘要:目的调查统计西藏那曲市（平均海拔4 500 m）妊娠妇女及非妊娠妇女血红蛋白水平情况，分析妊娠期妇女血红蛋白与不良妊娠结局之间的关系。方法选取2017年1月至2019年12月期间在西藏那曲市人民医院妇产科就诊妊娠产检及分娩的女性6 865名及同期体检中心就诊的无明显疾病的非妊娠期育龄女性340名（作为本地正常对照），比较不同组间血红蛋白及相关参数水平，并对妊娠期妇女的不良妊娠结局情况进行分析。结果那曲市孕期女性的贫血人群所占比例（9.9%）明显高于非孕期（8.8%），而孕期女性高原性红细胞增多症（高红症）的比例（9.4%）则低于非孕期（3.1%），差异均具有统计学意义，P < 0.05；血红蛋白水平在早孕期最高（143.54±25.66）g/L，晚孕期最低（129.97±29.14）g/L。贫血孕妇不良妊娠结局的发生率更高，差异具有统计学意义，P < 0.05。结论那曲市孕期女性血红蛋白水平情况与平原地区大致相似，但高红症比例较高。贫血与不良妊娠结局具有明显关联。
关键词: 高原/
西藏那曲/
孕产妇/
血红蛋白/
妊娠结局


Abstract:ObjectiveTo investigate hemoglobin(Hb) level in pregnant and non-pregnant women and its association with adverse pregnancy outcomes in patients at Naqu, Tibet.MethodsThe study totally recruited 6 865 pregnant women in the Department of Gynecology and Obstetrics at Naqu People's Hospitalfrom January 2017 to December 2019. In addition, 340 non-pregnant women of childbearing age with no obvious diseases who were present for regular checkup during the same period were recruited as local normal controls.The patients' red blood cell count information and adverse pregnant outcome data were collected for further analysis.ResultsPregnant women were in high risk of anemia compared with the non-pregnant women, with the incidence of 9.9% in pregnant women and 8.8% in non-pregnant women. Pregnant women werein low risk (3.1%) suffering from high altitude polyerythocytosis (HAPC) compared with non-pregnant counterparts (9.4%), the difference was statistically significant. Hb levels were highest in the first trimester (143.54±25.66) g/L and lowest in the third trimester (129.97±29.14) g/L. Anemia was significantly associated with adverse pregnant outcomes, P < 0.05.ConclusionThe Hb profile of pregnant women in high altitude is very similar with that of women in low altitude. Pregnant women in high altitude have higher proportion of HAPC. In high altitude area, anemia is significantly associated with adverse pregnant outcomes such as still birth, preterm birth and low birth weight infants.
Keywords:high altitude/
pregnancy/
hemoglobin level/
adverse pregnant outcome/


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https://journal.dmu.edu.cn/data/article/export-pdf?id=dlykdxxb_20210304