بررسی میزان سطح هموگلوبین مادران باردار، تعیین cut off point هموگلوبین و ارتباط با زایمان زودرس و وزن کم نوزاد در هنگام تولد

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دستیار تخصصی زنان و مامایی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی بابل، بابل، ایران.

2 دانشیار گروه زنان و مامایی، مرکز تحقیقات بهداشت باروری و ناباروری، پژوهشکده سلامت، واحد توسعه تحقیقات بیمارستان آیت‌الله روحانی، دانشکده پزشکی، دانشگاه علوم پزشکی بابل، بابل، ایران.

3 استاد گروه زنان و مامایی، مرکز تحقیقات بهداشت باروری و ناباروری، پژوهشکده سلامت، واحد توسعه تحقیقات بیمارستان آیت‌الله روحانی، دانشکده پزشکی، دانشگاه علوم پزشکی بابل، بابل، ایران.

4 استادیار گروه آمار و اپیدمیولوژی، مرکز تحقیقات بهداشت باروری و ناباروری، پژوهشکده سلامت، دانشگاه علوم پزشکی بابل، بابل، ایران.

چکیده

مقدمه: کم‌خونی، خطر پیامدهای زیان‌بار بارداری از جمله زایمان زودرس و وزن کم هنگام تولد را افزایش می‌دهد. مطالعه حاضر با هدف بررسی ارتباط بین شدت آنمی با زایمان زودرس و وزن کم نوزاد هنگام تولد و سطحی از هموگلوبین که باعث بروز این پیامدها می‌شود، انجام شد.
روش‌کار: این مطالعه مقطعی در سال 99-۱۳۹۸ بر روی ۷۳۷ زن باردار مراجعه­کننده به بیمارستان آیت‌الله روحانی بابل که تحت زایمان قرار گرفتند، انجام شد. اطلاعات دموگرافیک، میزان هموگلوبین مادران، سن بارداری، نوع زایمان، وزن، قد، دور سر و آپگار نوزاد هنگام تولد در چک‌لیست ثبت گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 25) و آزمون‌های تک‌متغیره آنووا، تی‌تست، کای دو و ضریب همبستگی انجام شد.
یافته ­ها: شیوع آنمی در مادران باردار ۱۵/۲۴% برآورد گردید. با اختلاف معنی‌دار، سن بارداری، وزن، قد، دور سر و آپگار نوزاد در گروه آنمیک کمتر بود (۰۰۱/۰>p). با تقسیم مادران به دو گروه ترم و پره‌ترم، اختلاف معنی‌داری در میزان هموگلوبین آن‌ها وجود نداشت (۱۱/۰=p)؛ اما با تقسیم مادران پره‌ترم به دو گروه پره‌ترم زودهنگام و دیرهنگام، هموگلوبین در مادران پره‌ترم زودهنگام پایین‌تر گزارش شد (۰۰۴/۰=p). مشخص شد که هموگلوبین کمتر از ۷/۱۱ گرم بر دسی‌لیتر در مادر باردار، باعث افزایش خطر زایمان پره‌ترم زودهنگام (کمتر از ۳۴ هفته) و وزن کمتر از ۲۵۰۰ گرم در هنگام تولد می‌شود.
نتیجه ­گیری: به‌نظر می‌رسد با وجود رساندن هموگلوبین به میزان حداقل نرمال، هنوز هم احتمال بروز پیامدهای نامطلوب نوزادی به میزان قابل‌توجهی وجود دارد، لذا باید سعی شود که میزان هموگلوبین بالاتر از حداقل نرمال نگه ‌داشته شود.

کلیدواژه‌ها

عنوان مقاله [English]

The level of hemoglobin in pregnant mothers, the cut-off point of hemoglobin and its relationship with preterm delivery and low birth weight

نویسندگان [English]

  • Fakhri Khalighi 1
  • Shahnaz Barat 2
  • Shahla Yazdani 3
  • Soraya Khafri 4
1 Resident, Department of Obstetrics and Gynecology, Student Research Committee, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
2 Associate Professor, Department of Obstetrics and Gynecology, Reproductive Health and Infertility Research Center, Health Research Institute, Research Development Unit of Ayatollah Rouhani Hospital, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
3 Professor, Department of Obstetrics and Gynecology, Reproductive Health and Infertility Research Center, Health Research Institute, Research Development Unit of Ayatollah Rouhani Hospital, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
4 Assistant Professor, Department of Statistics and Epidemiology, Fertility and Infertility Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
چکیده [English]

Introduction: Anemia increases the risk of adverse pregnancy outcomes including preterm delivery and low birth weight. This study was performed with aim to determine the relationship between the severity of anemia with preterm delivery and low birth weight and the level of hemoglobin which causes these consequences.
Methods: This cross-sectional study was conducted in 2019-2020 on 737 pregnant women referred to Ayatollah Rouhani Hospital in Babol who underwent delivery. Demographic information, hemoglobin level of mothers, gestational age, type of delivery, weight, height, head circumference and Apgar of the newborn were recorded in the checklist. Data were analyzed by SPSS (version 25) and univariate ANOVA, t-test, Chi-square and correlation coefficient tests.
Results: The prevalence of anemia in pregnant mothers was estimated at 24.15%. Gestational age, weight, height, head circumference, and Apgar of the newborn were significantly lower in the anemic group (p<0.001). By dividing the mothers into two groups of term and pre-term, there was no significant difference in their hemoglobin level (p=0.11); however, by dividing preterm mothers into early and late preterm groups, hemoglobin was reported to be lower in early preterm mothers (p=0.004). It was found that hemoglobin less than 11.7 g/dL in a pregnant mother increases the risk of preterm delivery (less than 34 weeks) and birth weight less than 2500 g.
Conclusion: It seems that despite reaching the hemoglobin to the minimum normal level, there is still a significant possibility of adverse outcomes in the newborn, so one should try to keep the hemoglobin level above the minimum normal level.

کلیدواژه‌ها [English]

  • Anemia
  • Gestational age
  • Infant low birth weight
  • Premature birth

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 10
دی 1401
صفحه 21-30

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