目的 探讨6+0～13+6孕周母体不同血红蛋白(hemoglobin，Hb)水平对新生儿结局的影响。方法 选取2019年1月-2022年1月三门峡市中心医院进行产检并住院分娩的4789名产妇，根据妇女6+0～13+6孕周时的Hb水平分别将其分为70～89 g/L组、90～109 g/L组、110～129 g/L组、(≥130)g/L组。对比分析6+0～13+6孕周妇女不同血红蛋白水平下新生儿不良结局，包括:早产、死产、新生儿死亡、小于胎龄儿(small for gesta-tional age infant，SGA)、低出生体重(Low Birth Weight，LBW)的发病率。应用logisitic回归分析探讨不同血红蛋白水平对新生儿不良结局的影响。结果 出现早产、死产、SGA等3种结局的均以母体Hb水平较低者为多。且3种结局分布比例差异均有统计学意义(P＜0。05);建立非条件logistic回归模型，①Hb水平最低(70～89 g/L)是早产、死产、SGA的危险影响因素(OR＞1，P＜0。05)。②Hb水平中等略低(90～109 g/L)，则是早产的保护影响因素(OR＜1，P＜0。05)，是SGA的不利影响因素(OR＞1，P＜0。05)。③Hb水平较高(≥ 130 g/L)是死产的危险影响因素(OR＞1，P＜0。05)、是SGA的有利因素(OR＜1，P＜0。05)。结论 6+0～13+6孕周较低或较高的母体血红蛋白水平与新生儿不良结局相关，而低血红蛋白水平的关系似乎更一致且更强。
Effects of different maternal hemoglobin levels at 6+0-13+6 gestational weeks on neonatal outcomes
Objective To investigate the effects of maternal hemoglobin(Hb)levels in 6+0-13+6 gestational weeks on neonatal outcomes.Methods From January 2019 to January 2022,a total of 4789 women were selected from Sanmenxia Central Hospital.According to Hb levels at 6+0～13+6 gestational weeks,women were divided into(70-89)g/L group,(90-109)g/L group,(110-129)g/L group and(≥ 130)g/L group.The adverse outcomes of newborns with different hemoglobin levels at 6+0～13+6 gestational weeks were compared and analyzed,including:incidence of pre-term Birth,stillbirth,neonatal death,small for gestational age infants(SGA),and low birth weight(LBW).logisitic re-gression analysis was used to investigate the effect of hemoglobin level on neonatal adverse outcomes.Results Preterm birth,stillbirth and SGA were more common in patients with low maternal Hb level.There was significant difference in the distribution ratio of the three outcomes(P＜0.05).The unconditioned logistic regression model was established.① The lowest Hb level(70-89 g/L)was the risk factor for premature birth,stillbirth and SGA(OR＞1,P＜0.05).②Moderately low Hb level(90-109 g/L)was a protective factor for preterm birth(OR＜1,P＜0.05),and an ad-verse factor for SGA(OR＞1,P＜0.05).③ Higher Hb level(≥ 130 g/L)was a risk factor for stillbirth(OR＞1,P＜0.05)and a favorable factor for SGA(OR＜1,P＜0.05).Conclusions Lower or higher maternal hemoglobin levels at 6+0 to 13+6 weeks of gestation are associated with adverse neonatal outcomes,while the association with lower hemoglobin levels appears to be more consistent and stronger.
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