昆山市妇女妊娠期铁缺乏和缺铁性贫血的现况及预防性补铁时机的研究
Prevalence of Iron Deficiency and Iron Deficiency Anemia in Women during Pregnancy in Kunshan City and Study on Timing of Preventive Iron Supplementation

目的：探讨昆山市妇女妊娠期铁缺乏和缺铁性贫血的现况及预防性补铁时机。方法：选择昆山市中医院2020年1月至2020年12月的孕妇329例进行研究。根据孕周将孕妇分为三组，其中孕早期21例，孕中期49例，孕晚期259例。采用自制一般情况调查表对患者从事职业、居住地、学历、孕期及收入进行记录，并对患者血常规、血清铁蛋白进行检测。结果：孕期Hb < 110 g/L共61例，贫血发病率为18.3%；孕期Hb < 110 g/L且SF < 20共57例，IDA发病率为17.3%；孕期SF < 20 μg/L但未贫血共188例，ID发病率为57.1%。多因素分析结果显示孕周与居住地为SF与Hb的独立性影响因素(P < 0.05)。孕早期Hb与SF水平均明显高于孕中期与孕晚期(均P < 0.05)，孕早期贫血、ID及IDA患病率均明显低于孕中期与孕晚期(均P < 0.05)，孕早期SF < 30、SF < 20比例均明显高于孕中期及孕晚期(均P < 0.05)。结论：昆山市妇女妊娠期铁缺乏及缺铁性贫血发生情况与全国平均水平相当，怀孕及居住地为该地区妇女妊娠期铁缺乏和缺铁性贫血的独立性影响因素，孕早期妇女铁缺乏及缺铁性贫血发生率均较低，建议孕妇在孕中期开始进行预防性补铁。
Objective: To investigate the status of iron deficiency and iron deficiency anemia during pregnancy in Kunshan City and the timing of preventive iron supplementation. Methods: A total of 329 pregnant women from January 2020 to December 2020 in Kunshan Chinese Medicine Hospital were selected for the study. According to gestational age, pregnant women were divided into three groups, including 21 in the early pregnancy, 49 in the second trimester and 259 in the third trimester. A self-made general condition questionnaire was used to record the occupation, place of residence, education, pregnancy, and income of the patient, and blood routine test and serum ferritin were detected. Results: During the pregnancy, Hb was less than 110 g/L in 61 cases, and the incidence of anemia was 18.3%. During the pregnancy, Hb was less than 110 g/L and SF was less than 20, and the incidence of IDA was 17.3%. During pregnancy, SF was less than 20 μg/L but not anemia. In 188 cases, the incidence rate of ID was 57.1%. Factor analysis showed that gestational age and place of residence were independent factors of SF and Hb (P < 0.05). The Hb and SF levels in the first trimester were significantly higher than those in the middle and third trimester (all P < 0.05). The prevalence of anemia, ID and IDA was significantly lower in the first trimester than in the second trimester and third trimester (all P < 0.05). The proportion of SF < 30, SF < 20 in early pregnancy was significantly higher than that in the second trimester and third trimester (all P < 0.05). Conclusion: The iron deficiency and iron deficiency anemia in women during the period of pregnancy in Kunshan City are similar to the national average. Pregnancy and place of residence are independent factors of iron deficiency and iron deficiency anemia during pregnancy in women in the region, and iron deficiency in women during early pregnancy. And the incidence of iron deficiency anemia is low. It is recommended that pregnant women start