| Objective:Gestational maternal blood volume increases approximately 40% ~ 45%.The plasma volume increases more than red blood cells,blood shows relatively diluted state,so the indexes parameter of the red blood cells are changed during pregnancy.Anemia in pregnancy belongs to high-risk pregnancy category,and it is closely related with a variety of adverse pregnancy outcomes.At present,there are great differences in the diagnosis of anemia in pregnancyat home and abroad.The paper analyzes retrospectively the hemoglobin(HB),hematocrit(HCT),mean corpuscular volume(MCV)and red cell distribution width(RDW)of the normal late pregnancy and late pregnancy with anemia in Changchun area,to study on the change rule and significance of red blood cell index in late pregnancy and to explore the reference range of women in late pregnancy in Changchun area and provide some guidance for clinical work.Methods:1.We randomly select women in the late pregnancy(? 28 < 41weeks)in a hospital of Changchun from December 2014 ~ 2016,with a total of 741 cases.At the same time,338 healthy non-pregnant women who go to the same hospital at the same time are randomly selected as the normal control group.2.According to HB ? 100g/L,679 cases belong to normal pregnancy,late gestational anemia group including 62 cases defined by HB < 100g/L.In the normal late pregnancy group,the ? 28 < 34 weeks group includes 70 cases,the ? 34 < 41 weeks group includes 609 cases.In the gestational anemia group,149 cases belong to the ? 28 < 37 weeks group,530 cases belong to the ? 37 < 41 weeks group.The ? 37 < 41 weeks pregnant women are divided into two groups according to the hemoglobin(HB)level,the normal late pregnancy group,HB? 100g/L,includes 532 cases;In the late gestation anemia group,HB <100g/L,includes 46 cases,and the ? 28 < 37 weeks group includes 16 cases,the ? 37 <41 weeks group includes 46 cases.All pregnant women are excluded from other complications of pregnancy,gynecological diseases,medical diseases and surgical diseases.We analyze and compare the HB,HCT,MCV and RDW among the groups.All data are analyzes by SPSS 17.0 software,the data is statistically significant if P<0.05.Result:1.General description: The median age of normal full-term pregnancy group of which the age range is 18 to 35 years old is 28.00 years old,the median gestational week is 39.10 weeks(? 37 < 41 weeks),the median age of women with the gestational anemia group is 27.00 years old,the median gestational week is 38.95 weeks,and the median age of the normal control group of which the age range is 18 to 35 years old is 28.00 years old,the age and gestational week are no significant difference among the groups(P>0.05).The median age of pregnant women is 27.00 years old in the ? 28 <34 group,the median age of ? 34 < 41 weeks pregnant women is 28.00 years old,there is no significant difference(P>0.05)in the two groups.The median age of pregnant women is 27.00 years old in the ? 28 < 37 groups,the median age of ? 37 < 41 weeks pregnant women is 28.00 years old,there is no significant difference(P>0.05)in the two groups.2.Comparison among the groups2.1 HB: The HB level of ? 37 < 41 weeks pregnant women in the normal late pregnancy group is lower than that of normal control group,the data is statistically significant(P=0.00);In the late gestation anemia group,the HB level of pregnant women at ? 37 < 41 weeks is lower than that of normal control group,the difference of HB is also statistically significant(P=0.00);The HB level of the gestational anemia group is lower than that of normal late pregnancy group,the difference is statistically significant(P=0.00).In the normal late pregnancy group,the HB level of ? 34 < 41 weeks pregnant women is higher than ? 28 < 34 weeks group.But there is nostatistical difference(P=0.13).The level of HB in ? 28 < 37 weeks group is lower than ? 37 < 41 weeks group,and there is significant difference(P=0.01).2.2 HCT: The HCT level of ? 37 < 41 weeks pregnant women in the normal late pregnancy group is lower than that of normal control group,the data is statistically significant(P=0.00);In the late gestation anemia group,the HCT level of pregnant women at ? 37 < 41 weeks is lower than that of normal control group,the difference of HCT is also statistically significant(P=0.00);The HCT level of the late gestation anemia group is lower than that of normal late pregnancy group,the difference is statistically significant(P=0.00).In the normal late pregnancy group,the HCT level of? 34 < 41 weeks pregnant women is higher than ? 28 < 34 week group.But there is no statistical difference(P=0.25).The level of HCT in ? 28 < 37 weeks group is lower than ? 37 < 41 weeks group,and there is significant difference(P=0.01).2.3 MCV: The MCV level of ? 37 < 41 weeks pregnant women in the normal late pregnancy group is higher than that of normal control group,the data is statistically significant(P=0.00);In the late gestation anemia group,the MCV level of pregnant women at ? 37 < 41 weeks is lower than that of normal control group,the difference of MCV is also statistically significant(P=0.00);The MCV level of the late gestation anemia group is lower than that of normal late pregnancy group,the difference is statistically significant(P=0.00).In the normal pregnancy late group,the MCV level of ? 34 < 41 weeks pregnant women is lower than ? 28 < 34 weeks group.But there is no statistical difference(P=0.09).The level of HCT in ? 28 < 37 weeks group is higher than ? 37 <41 weeks group,but there is no significant difference(P=0.10).2.4 RDW: The RDW level of ? 37 < 41 weeks pregnant women in the normal late pregnancy group is higher than that of normal control group,the data is statistically significant(P=0.00);In the late gestation anemia group,the RDW level of pregnant women at ? 37 < 41 weeks is higher than thatof normal control group,the difference of RDW is also statistically significant(P=0.00);The RDW level of the late gestation anemia group is higher than that of normal late pregnancy group,the difference is statistically significant(P=0.00).In the normal late pregnancy group,the RDW level of ? 34 < 41 weeks pregnant women is higher than ? 28 < 34 weeks group.And there is statistical difference(P=0.00).The level of HCT in ? 28 < 37 weeks group is lower than ? 37 < 41 weeks group,and there is significant difference(P=0.00).3.The correlation between RDW and MCV in late pregnancy There is a negative correlation between RDW level and MCV level in normal late pregnancy group,and the correlation is statistically significant(r=-0.44,P=0.00).There is also a negative correlation between RDW level and MCV level in the late gestation anemia group,and the correlation is statistically significant(r=-0.70,P=0.00).4.The correlation between RDW and gestational age in late pregnancy In the normal late pregnancy group,the level of RDW increases with the gestational age,there is a positive correlation between the RDW and gestational age,and the correlation is statistically significant(r=0.23,P=0.00).In the late gestation anemia group,the level of RDW increases with the gestational age,but there was no statistical significance(r=0.05,P=0.70).Conclusion:1.To provide basic data for the establishment of normal reference range of HB,HCT,MCV and RDW in women with late pregnancy(34~41weeks?37~41weeks)in Changchun area.2.MCV and RDW level increase in the late gestation anemia group,suggesting that the iron deficiency anemia is main anemia type in the late pregnancy.3.The increasing of MCV level in normal late pregnant women may be the compensatory response of red blood cell to hemodilution,and it plays a positive role in meeting the needs of fetal growth and maternal metabolism.4.The level of RDW increases with the gestational age in normal late pregnant women,and there is a negative correlation with MCV level.This shows maternal red bone marrow hyperplasia degree is closely related to fetal growth.5.The level of RDW and MCV,not effects by hemodilution,is an important indicator to response to the degree of maternal red bone marrow hyperplasia. |
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