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Desfechos obstétricos e perinatais em grávidas com ferropénia no 1º trimestre
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Introdução: A ferropénia é a deficiência mineral mais comum a nível mundial sendo particularmente frequente na grávida. Os desfechos obstétricos e neonatais associados à ferropénia durante a gestação não são conhecidos. Este estudo pretendeu verificar a influência da ferropénia no 1º trimestre de gestação nos desfechos obstétricos e perinatais. Material e Métodos: Estudo retrospectivo em que foi avaliado o valor de ferritina do 1º trimestre (<20semanas) em gestações de baixo risco/risco intermédio que não se encontravam a fazer suplementação com ferro. Foram colhidos dados referentes às características demográficas e obstétricas das grávidas e foram registados os valores de hemoglobina (1º e 3º trimestre) e os de ferritina sérica (1º trimestre). Da revisão dos processos clínicos registaram-se informações relativas ao parto, complicações obstétricas e complicações perinatais. Foi feita comparação destes desfechos entre o grupo sem ferropénia (FS≥30g/L) e o grupo com ferropénia (FS<30g/L) ou subgrupo com ferropénia grave (FS<15g/L). Resultados: Duzentas e cinquenta e nove (259) grávidas foram incluídas. A incidência de anemia no 1º trimestre foi de 4,3% e no 3º trimestre de 17%; a incidência de ferropénia foi de 37,5% e de ferropénia grave de 16,2%. A ferropénia no primeiro trimestre apenas se associou a existência de anemia no 1º e 3º trimestres. Conclusão: Não foi encontrada nenhuma associação estatisticamente significativa entre ferropénia do 1º trimestre e os desfechos estudados: tipo de parto, idade gestacional, prematuridade, peso ao nascer, índice de Apgar desfavorável ao 1º ou 5º minuto, necessidade de internamento em unidade de cuidados intensivos neonatais ou complicações obstétricas como diabetes gestacional, restrição de crescimento fetal ou pré-eclâmpsia.
Introduction: Globally, iron deficiency is the most common mineral deficiency and is particularly frequent among pregnant women. The obstetrics and neonatal outcomes associated with iron deficiency during pregnancy are not known. This study aims to verify the influence of iron deficiency during the first trimester in pregnancy outcomes. Material and Methods: A retrospective study was preformed where it was measured the level of serum ferritin in the 1st trimester (less than 20 weeks) of pregnancies of low/intermediate risk in women who were not taking iron supplements. Data was collected referring to demographic and obstetric characteristics of the pregnant women and levels of hemoglobin (1st and 3rd trimester) and serum ferritin (1st trimester) were registered. It was also collected information regarding to labor, obstetric complications and neonatal complications. The outcomes were compared between the group without iron deficiency (SF≥30g/L) and the group with iron deficiency (SF<30g/L) or the subgroup with severe iron deficiency (SF<15g/L). Results: Two hundred and fifty-nine pregnancies were included. The incidence of anemia in the 1st trimester was 4,3% and in the 3rd trimester it was 17%; the incidence of iron deficiency was 37,5% and the one of severe iron deficiency was 16,2%. Iron deficiency in the 1st trimester was associated only with de development of anemia in both 1st and 3rd trimesters. Conclusion: It was not found any statistically significant association between iron deficiency on the 1st trimester and the studied outcomes: labor type, gestacional age, prematurity, birthweight, unfavorable Apgar index (in the 1st and 5th minute), stay in neonatal intensive care unit or obstetric complications such as gestacional diabetes, fetal growth restriction or preeclampsia.
Introduction: Globally, iron deficiency is the most common mineral deficiency and is particularly frequent among pregnant women. The obstetrics and neonatal outcomes associated with iron deficiency during pregnancy are not known. This study aims to verify the influence of iron deficiency during the first trimester in pregnancy outcomes. Material and Methods: A retrospective study was preformed where it was measured the level of serum ferritin in the 1st trimester (less than 20 weeks) of pregnancies of low/intermediate risk in women who were not taking iron supplements. Data was collected referring to demographic and obstetric characteristics of the pregnant women and levels of hemoglobin (1st and 3rd trimester) and serum ferritin (1st trimester) were registered. It was also collected information regarding to labor, obstetric complications and neonatal complications. The outcomes were compared between the group without iron deficiency (SF≥30g/L) and the group with iron deficiency (SF<30g/L) or the subgroup with severe iron deficiency (SF<15g/L). Results: Two hundred and fifty-nine pregnancies were included. The incidence of anemia in the 1st trimester was 4,3% and in the 3rd trimester it was 17%; the incidence of iron deficiency was 37,5% and the one of severe iron deficiency was 16,2%. Iron deficiency in the 1st trimester was associated only with de development of anemia in both 1st and 3rd trimesters. Conclusion: It was not found any statistically significant association between iron deficiency on the 1st trimester and the studied outcomes: labor type, gestacional age, prematurity, birthweight, unfavorable Apgar index (in the 1st and 5th minute), stay in neonatal intensive care unit or obstetric complications such as gestacional diabetes, fetal growth restriction or preeclampsia.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Complicações obstétricas Desfechos neonatais Ferro Ferropénia Suplementação Obstetrícia