昌吉少数民族妊娠期缺铁性贫血发病及贫血程度的危险因素及母婴结局探究

发布时间：2018-06-10 01:08

本文选题：少数民族 + 缺铁性贫血　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨新疆昌吉少数民族（回族与哈萨克族）孕妇和汉族孕妇妊娠期缺铁性贫血（iron deficiency anemia，IDA）发病和贫血程度的危险因素，及其对妊娠结局的影响。为制定适宜当地孕产妇的围产期保健指南提供临床依据。方法：本研究采用回顾性分析、病例对照研究设计。选择2012年7月至2013年6月在昌吉州人民医院产科住院分娩，确诊为妊娠期缺铁性贫血的孕妇300例（回族100例、哈萨克族100例、汉族100例）作为病例组，随机选择同期住院分娩的健康孕妇300例（回族100例、哈萨克族100例、汉族100例）作为对照组，探讨各因素对回族、哈萨克族和汉族妊娠期缺铁性贫血发病的影响，再分别比较回族、哈萨克族、汉族病例组与对照组母儿的结局，分析妊娠期缺铁性贫血对母儿结局的影响。结果：1.经过各民族贫血程度的单因素分析筛选出差异有统计学意义的研究因素，再进行相关性分析结果表明：回族IDA孕妇的产次、流产次数，哈萨克族、汉族IDA孕妇的产次，与其贫血程度呈正相关；回族、哈萨克族、汉族IDA孕妇的产前保健、居住区域、文化程度、经济独立能力与其贫血程度呈负相关。2.多因素逐步logistic回归分析显示：居住区域及文化程度是回族、哈萨克族IDA孕妇贫血程度的独立危险因素，文化程度是汉族IDA孕妇贫血程度的独立危险因素。3.用卡方检验分别比较回族、哈萨克族与汉族病例组与对照组的妊娠并发症及分娩结局，发现回族、哈萨克族IDA孕产妇子痫前期、胎膜早破、羊水污染、产褥感染的发生率增加，产后出血量增加，新生儿出生Apgar评分降低，差别有统计学意义（均P0.05）；汉族IDA孕产妇羊水污染、产褥感染发生率增加，新生儿出生体重降低，差别有统计学意义（均P0.05）。结论：1.居住区域和文化程度是回族及哈萨克族孕妇IDA贫血程度的危险因素，文化程度是汉族孕妇IDA贫血程度的危险因素。2.回族、哈萨克族IDA孕妇的子痫前期、胎膜早破、羊水污染、产褥感染发生率增加，产后出血量增加，，新生儿出生Apgar评分降低，汉族IDA孕妇的羊水污染、产褥感染发生率增加，新生儿出生体重降低。针对高危人群、危险因素积极采取预防、干预及控制措施，降低孕产妇贫血的发生有重要意义。
[Abstract]:Objective: to investigate the risk factors of iron deficiency anemia (IDA) and its influence on pregnancy outcome of pregnant women in Changji minority (Hui and Kazak) and Han women in Xinjiang. To provide clinical basis for the development of perinatal health care guidelines suitable for local pregnant and lying-in women. Methods: retrospective analysis and case-control study were used in this study. From July 2012 to June 2013, 300 pregnant women (100 Hui, 100 Kazak and 100 Han) who were diagnosed as iron deficiency anemia during pregnancy were selected as the case group. 300 healthy pregnant women (100 Hui, 100 Kazakh, 100 Han) were randomly selected as control group. The effects of various factors on the incidence of iron deficiency anemia during pregnancy were investigated. The maternal and fetal outcomes of Hui, Kazak and Han nationality were compared with those of control group, and the effects of iron deficiency anemia during pregnancy on maternal and fetal outcomes were analyzed. The result is 1: 1. According to the single factor analysis of anemia degree of different nationalities, the difference was statistically significant. The results of correlation analysis showed that: the number of births, the number of miscarriages, the births of IDA pregnant women of Kazak and Han nationalities, the number of births of IDA pregnant women of Hui nationality, Han nationality, Kazak nationality and Han nationality, The antenatal care, living area, education level and economic independence ability of pregnant women of Hui, Kazak and Han nationality were negatively correlated with anemia degree. Multivariate stepwise logistic regression analysis showed that the living area and education level were independent risk factors of anemia among pregnant women of Hui nationality and Kazak nationality, and education level was the independent risk factor of anemia degree of pregnant women of Han nationality. The pregnancy complications and delivery outcome of Hui, Kazak and Han nationality were compared by chi-square test. The results showed that the incidence of preeclampsia, premature rupture of membranes, amniotic fluid pollution and puerperal infection in Hui and Kazakh women were increased. The amount of postpartum hemorrhage increased, the Apgar score of newborn decreased, the difference was statistically significant (all P 0.05), and the incidence of maternal amniotic fluid and puerperal infection in Han nationality was increased, and the birth weight of newborn was decreased (all P 0.05). Conclusion 1. The living area and education level were the risk factors of IDA anemia of Hui and Kazak pregnant women, and the education level was the risk factor of IDA anemia degree of Han nationality pregnant women. The preeclampsia, premature rupture of membranes, amniotic fluid contamination, increased incidence of puerperal infection, increased postpartum bleeding, decreased Apgar score at birth, and increased incidence of puerperal infection in pregnant women of Han nationality. Newborns lose weight at birth. It is important to take prevention, intervention and control measures to reduce the incidence of anemia in pregnant and parturient women.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.254

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