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雑誌文献

臨床婦人科産科78巻7号

2024年07月発行

文献概要

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

貧血と産科合併症の関連性

著者: 植木典和1 牧野真太郎1

所属機関: 1順天堂大学医学部附属浦安病院産婦人科

ページ範囲:P.604 - P.609

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●妊娠中の貧血は,慢性的な低酸素状態に対する代償反応に関連して,産科合併症が生じている.

●妊娠に伴う母体の循環血漿量増加による希釈性貧血は,母児の有害事象の低下と関連している.

●妊娠中の貧血は分娩転帰だけでなく,児の心奇形や将来的な発育・発達にも影響を及ぼす可能性がある.

参考文献

1)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
2)Shi H, et al : Severity of anemia during pregnancy and adverse maternal and fetal outcomes. JAMA Netw Open 5 : e2147046, 2022
3)Rath G, et al : HIF-1 alpha and placental growth factor in pregnancies complicated with preeclampsia : a qualitative and quantitative analysis. J Clin Lab Anal 30 : 75-83, 2016
4)Kadyrov M, et al : Increased fetoplacental angiogenesis during first trimester in anaemic women. Lancet 352 : 1747-1749, 1998
5)Watkins VY, et al : The relationship between maternal anemia and umbilical cord oxygen content at delivery. Am J Obstet Gynecol MFM 3 : 100270, 2021
6)Venkata Surekha M, et al : Study on the effect of severity of maternal iron deficiency anemia on regulators of angiogenesis in placenta. Fetal Pediatr Pathol 38 : 361-375, 2019
7)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
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9)Georgieff MK : Maternal gestational iron status and infant haematological and neurodevelopmental outcomes. BJOG 130(Suppl 3) : 92-98, 2023
10)Yang J, et al : Iron intake and iron status during pregnancy and risk of congenital heart defects : a case-control study. Int J Cardiol 301 : 74-79, 2020
11)Kalisch-Smith JI, et al : Maternal iron deficiency perturbs embryonic cardiovascular development in mice. Nat Commun 12 : 3447, 2021
12)Chang YH, et al : Maternal iron deficiency programs rat offspring hypertension in relation to renin-angiotensin system and oxidative stress. Int J Mol Sci 23 : 8294, 2022
13)Barker DJ, et al : Fetal and placental size and risk of hypertension in adult life. BMJ 301 : 259-262, 1990
14)Pandey AK, et al : Clinical outcome post treatment of anemia in pregnancy with intravenous versus oral iron therapy : a systematic review and meta-analysis. Sci Rep 14 : 179, 2024

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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