A Study Of Screening And Treatment Of Iron Deficiency In Pregnancy

Objective:Iron deficiency anemia(IDA)is the most common form of anemia in pregnancy.It is a nutritional deficiency disease caused by iron deficiency.Iron deficiency anemia during pregnancy has adverse effects on maternal and infant health and pregnancy outcomes.Therefore,prevention and treatment of iron deficiency anemia during pregnancy has far-reaching public significance.In this study,pregnant women with iron deficiency were screened through the detection of serum iron content in each pregnancy,and the cases with iron deficiency in early pregnancy were treated,so as to reduce the occurrence of iron deficiency anemia during pregnancy.Methods:41450 cases of pregnancy women's hemoglobin results and 16620 cases of pregnancy women's serum ferritin results were analyzed retrospective.Randomly selected 120 women in the first trimester(study group).According to the results of hemoglobin and serum ferritin,the study group were treated with different doses of oral iron.SF?30?g/L,Hb?110g/L,observed;20?g/L?SF<30?/L,Hb?110g/L,oral iron 150mg twice a week;SF<20?g/L,Hb>110g/L,oral iron 150mg/day;SF<20?g/L,70g/L ? Hb<110g/L,oral iron 300mg/day;Hb<70g/L,the patient should be given blood transfusion.When Hb>70g/L,the patient should be treated as above.(oral iron selected Polysaccharide Iron Complex capsule).Review iron indicators every 4-8 weeks.Follow up the changes of iron indicators of these pregnant women in the second trimester,third trimester and postpartum,and to compare the hemoglobin,serum ferritin and other indicators with 120 women in the second trimester and 120 women in the third trimester randomly collected at the same period.The results as the blood loss,neonatal weight and Apgar score were recorded.Results:Retrospective analysis of 41450 pregnancy women's hemoglobin results showed that iron deficiency anemia cases in early pregnancy,middle pregnancy and late pregnancy accounted for11.2%,28.6%and 25.3%,respectively.Analysis of serum ferritin in 16220 pregnancy accounted for 33.3%,61.0%and 71.5%,respectively.The 120 cases of early pregnancy,which were followed up by treatment,15 cases were lost and 105 cases were effective.The incidence of iron deficiency in the first,second and third trimester and postpartum was 13.33%,58.33%,71.67%and 81.67%.Respectively,the incidence of anemia was 7.62%,34.17%,25.83%and 36.67%.The levels of hemoglobin(113.12±8.39g/L),serum ferritin(36.30±13.39ug/L),serum iron(24.15±5.73umol/L),serum femtin(17.95±9.43ug/L)and serum iron(11.57±4.01 umol/L)in the treatment group were significantly higher than those in the control group at the second trimester,with significant differences(p<0.05).The soluble transferrin concentration in the treatment group(16.84±7.81 nmol/L)was lower than that in the control group(29.10±13.01 nmol/L),and the difference was statistically significant(p<0.05).The levels of hemoglobin(120.30±12.14g/L),serum ferritin(36.04±6.71ug/L),serum iron(15.63±7.51umol/L),compared with the hemoglobin(101.00±11.81g/L),serum ferritin(13.26±8.38 ug/L)and serum iron(8.27±3.42 umol/L)in the treatment group were significantly higher than those in the control group.The soluble transferrin concentration in the treatment group(12.76±7.31 nmol/L)was lower than that in the control group(38.63±19.49 nmol/L),and the difference was statistically significant(p<0.05).The levels of hemoglobin(112.68±7.62g/L),serum ferritin(33.65±6.31 ug/L),serum iron(12.34±3.12umol/L),compared with the hemoglobin(101.00±11.81g/L),serum ferritin(11.05±7.84 ug/L)and serum iron(6.81 ±2.37 umol/L)in the postpartum3 days after pregnancy were significantly higher than those in the late pregnancy control group(p<0.05).The soluble transferrin concentration in the treatment group(21.37±11.65 nmol/L)was lower than that in the control group(38.05±18.54nmol/L),and the difference was statistically significant(p<0.05).Postpartum blood loss in the treatment group(183.57±45.82ml)and the incidence of postpartum anemia(23.80%)were significantly lower than that in the control group(387.82±103.40ml),the incidence of anemia(36.67%)(p<0.05),the incidence of low birth weight in the treatment group(6.67%)and the incidence of low birth weight in the control group(10.83%)were sigtificantly lower than that in the control group(p<0.05).There were no obvious adverse reactions during iron treatment.Conclusion:1.Iron deficiency and iron deficiency anemia were serious in the group,which were obvious after the middle pregnancy;2.Early detection of iron deficiency,reasonable iron treatment,can significantly reduce the oecurrenee of iron deficiency and anemia in the following pregnancy trimesters,and also help reduce postpartum bleeding and postpartum anemia,reduce the incidence of low birth weight children.3.It is safe and effective to start reasonable iron treatment according to serum iron detection in early pregnancy.