Investigation On The Status Of Prenatal Anemia And Prognosis Of Iron Deficiency Anemia In Late Pregnancy Due To Ferrous Supplement Method

Objective: To investigate the epidemiologic profile and influence factors of prenatal anemia of term pregnant women in Shijiazhuang.Explore the difference between oral iron treatment and intravenous iron treatment.Methods: Part one: A total of 610 term pregnant women from March2014 to October 2015(hospital delivery,in the First Hospital of Shijiazhuang)were included.339 women were normal.271 women were diagnosed as iron deficiency anemia.Diagnostic criteria were according to the guide line issued in 2014 by the perinatal medicine association the branch of the Chinese medical association.Each participant underwent blood routine and serum ferritin in ante partum and post-delivery.Analyze the relationship between prenatal anemia,gestational age,body mass index,education level,frequency of antenatal examination,birth order,fetal body weight and postpartum hemorrhage.Part two: Pregnant women intrauterine pregnancy 36 weeks and in our hospital for prenatal care and delivery from March 2014 to December2015 were collected.All the subjects were 54.Medical histories were collected during hospitalization period.Pregnant women who were in intrauterine pregnancy 36-37 weeks and diagnosed with moderate iron deficiency anemia were divided into two groups.The groups were named with oral iron group and intravenous iron group.Blood routine and serum ferritin were tested during ante partum,delivery and post-delivery 1 day respectively.The difference between oral iron treatment and intravenous iron treatment were assessed by blood routine and serum ferritin after 2 weeks.The oral iron group,27 patients,treated with Sheng xuening pian(0.5g Bid)and Polysaccharide-iron Capsule(0.3g Qd).The intravenous iron group,27 patients,treated with iron sucrose 200 mg diluted 250 ml saline.Results: A total of 610 cases were included in the study.17 patients were excluded because of macrocytic anemia,gastrointestinal diseases or premature rupture of membranes.The morbidity of mild anemia was 30.3%(n=185)before delivery.Pregnant women who suffered with moderate iron deficiency about 19.1%(n=195)before delivery.The blood routine was normal(n=118,19.3%)after delivery.On the other hand,the morbidity of Iron deficiency anemia was about 30.3%(n=492).The morbidity of mild anemia was 32%(n=195)after delivery.Pregnant women who suffered with moderate iron deficiency about 47.7%(n=291)after delivery.Pregnant women who suffered with severe iron deficiency about 1.0%(n=6)after delivery.The attributing factors were analyzed by logistic regression model.The multivariable stepwise analysis extracted frequency of antenatal examination,birth order,eating habits,taking vitamin as major risk factors for prenatal anemia.Other factors such as gestational age,body mass index,education level,fetal body weight and postpartum hemorrhage were abandoned.The morbidity of prenatal anemia has the positive correlation between low birth weight and postpartum hemorrhage.Age,gestational age and education level has no statistical difference between oral iron group and intravenous iron group.Pregnant women who suffered with iron deficiency labor low birth weight infant(15.5%),Normal body weight infant(55.7%),postpartum hemorrhage(5.9%)and giant infant(28.8%).Pregnant women without iron deficiency labor low birth weight infant(10.3%),Normal body weight infant(64.9%),postpartum hemorrhage(2.7%)and giant infant(24.8%).The level of hemoglobin and serum ferritin was rise after iron supplement therapy before delivery either in oral iron group or intravenous iron group(P<0.05).The difference of hemoglobin in intravenous iron group was significant after delivery(P<0.05).On the other hand,the level of hemoglobin and serum ferritin in cord blood has no different in intravenous iron group.Maternal mild anemia had no effect on the fetus.Intravenous iron supplementation was better than oral iron supplementation for neonatal iron reserve.Conclusion: The morbidity of prenatal anemia is high.Prenatal anemia is mainly about mild anemia before delivery.But,pregnant women suffered with moderate iron deficiency majority after delivery.Iron supplementation is essential during pregnancy.Frequency of antenatal examination,birth order,eating habits and taking vitamin are the major risk factors for prenatal anemia.Gestational age,body mass index,education level,fetal body weight and postpartum hemorrhage are not included.The morbidity of prenatal anemia has the positive correlation between low birth weight and postpartum hemorrhage.Severe anemia affects fetal weight.Incidence of postpartum hemorrhage is rise in severe anemia.Pregnant women with anemia are in poor performance on labor,uterine contraction.Intravenous iron supplementation has obvious advantages.Intravenous iron supplementation was better than oral iron supplementation for neonatal iron reserve or pregnant women.