论著

晚期早产儿中小于胎龄儿的铁代谢状态分析

Analysis of iron metabolism status of small for gestational age among late preterm infants

:782-786
 
       目的  探讨晚期早产儿中小于胎龄儿(SGA)与适于胎龄儿(AGA)出生时的铁代谢状态。方法 取2020年1—12月合肥市妇幼保健院收治的150例晚期早产儿(胎龄34~36+6周)作为研究对象。按照出生体质量和胎龄将早产儿分为SGA组(36例)和AGA组(114例),分析比较两组早产儿出生时的铁代谢状态,并应用多因素线性回归分析血清铁的影响因素。结果  与AGA组相比,SGA婴儿的更低的血清铁[14.5 μmol /L (11.4,17.1) vs 16.4 μmol /L(14.1,18.4),P=0.004]、更低的血清铁蛋白[135.6 μg/L(101.8,176.2) vs 172.5 μg/L(123.0,218.3),P=0.009]和更低的总铁结合力[30.4 μmol/L(26.8,34.9)vs 35.4 μmol/L(29.5,44.6),P=0.001]。两组早产儿的血红蛋白、平均红细胞体积、平均红细胞血红蛋白含量和平均红细胞血红蛋白浓度比较差异均无统计学意义(P>0.05)。在早产儿围生期特征中,胎盘异常(β= –1.949,P=0.009)和母亲糖尿病的发生(β= –2.324,P=0.001)与血清铁水平呈负相关。结论  与早产AGA相比,早产SGA铁储备水平较低,适量补充铁元素对小于胎龄新生儿身体发育有促进作用。
      Objective   To explore the iron metabolism status in late preterm infants who are small for gestational age(SGA)compared to those appropriate for gestational age(AGA)at birth.Methods   A total of 150 late preterm infants(gestational age 34 to 36+6 weeks)admitted to the Maternal and Child Health Hospital of Hefei from January to December 2020 were selected as the study subjects.The preterm infants were divided into the SGA group(36 cases)and the AGA group(114 cases)according to birth weight and gestational age.The iron metabolism status at birth was analyzed and compared between the two groups of preterm infants,and multiple linear regression analysis was applied to identify the influencing factors of serum iron.Results   Compared with the AGA group,SGA infants had lower serum iron(14.5[11.4,17.1] vs 16.4 [14.1,18.4],P=0.004),lower serum iron protein(135.6[101.8,176.2] vs 172.5[123.0,218.3],P=0.009),and lower total iron binding capacity(30.4[26.8,34.9] vs35.4[29.5,44.6]P=0.001).There were no statistically significant differences in hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,and mean corpuscular hemoglobin concentration between the two groups of preterm infants(P>0.05).Among the perinatal characteristics of preterm infants,placental abnormalities(β= –1.949,P=0.009)and the occurrence of maternal diabetes(β= –2.324,P=0.001)were significantly negatively correlated with serum iron levels.Conclusions  Compared with preterm infants appropriate for gestational age,preterm infants who are small for gestational age have lower iron reserves at birth.Adequate supplementation of iron has a promoting effect on the physical development of small for gestational age newborns.
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