臨床婦人科産科78巻7号

2024年07月発行

今月の臨床 臨床力をグッとUPさせる「貧血」の知識―鉄代謝の基礎から管理・治療の具体策まで 産科領域の貧血

妊婦のヘモグロビン値の基準

著者： 利光正岳¹

所属機関： ¹東京大学医学部附属病院女性診療科・産科

ページ範囲：P.600 - P.603

●日本人妊婦の正常なヘモグロビン（Hb）値の推移は，妊娠第1三半期から第3三半期の初期にかけて徐々に低下し，第3三半期の後期にわずかに上昇する特徴がある．

●妊婦のHb値の解釈では，妊娠時期に応じた基準範囲を考慮する．

●妊婦の低Hb値のみならず，高Hb値にも留意することが重要である．

参考文献

1）de Haas S, et al : Physiological adaptation of maternal plasma volume during pregnancy : a systematic review and meta-analysis. Ultrasound Obstet Gynecol 49 : 177-187, 2017

2）Pasricha SR, et al : Revisiting WHO haemoglobin thresholds to define anaemia in clinical medicine and public health. Lancet Haematol 5 : e60-e62, 2018

3）Shi H, et al : Severity of anemia during pregnancy and adverse maternal and fetal outcomes. JAMA Netw Open 5 : e2147046, 2022

4）Young MF, et al : Maternal low and high hemoglobin concentrations and associations with adverse maternal and infant health outcomes : an updated global systematic review and meta-analysis. BMC Pregnancy Childbirth 23 : 264, 2023

5）Toshimitsu M, et al : Gestational stage-specific association of hemoglobin concentration with the risk of preterm birth and small for gestational age. Hypertens Res Pregnancy 11 : 25-35, 2023

6）Simpong NL, et al : Establishing pregnancy-specific haematological reference intervals in Ghana ; a three-center cross-sectional study. PLoS One 18 : e0274422, 2023

7）Sun M, et al : Variation patterns of hemoglobin levels by gestational age during pregnancy : a cross-sectional analysis of a multi-center retrospective cohort study in China. Nutrients 15 : 1383, 2023

8）Chiossi G, et al : Reference intervals for hemoglobin and hematocrit in a low-risk pregnancy cohort : implications of racial differences. J Matern Fetal Neonatal Med 32 : 2897-2904, 2019

9）Ohuma EO, et al : International values for haemoglobin distributions in healthy pregnant women. EClinicalMedicine 29-30 : 100660, 2020