بررسي ارتباط غلظت هموگلوبين و شاخص تودة بدني ما در در سه ماهة اول نخستين بارداري با وزن هنگام تولد نوزاد

Relationship between Maternal Hemoglobin Concentration and BMI during the First Trimester in Primiparous Women and Her Neonatal's Birth Weight

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﺣﺪﻭﺩ 7/7 ﮐﻞ ﻧﻮﺯﺍﺩﺍﻥ ﻣﺘﻮﻟﺪ ﺷﺪﻩ ﺩﺭ ﺟﻬﺎﻥ ﺩﺍﺭﺍﻱ ﻭﺯﻥ ﭘﺎﻳﻴﻦ ﻫﻨﮕﺎﻡ ﺗﻮﻟﺪ ﻫﺴﺘﻨﺪ. ﻫﻤﭽﻨﻴﻦ 56 ﺯﻧﺎﻥ ﺑﺎﺭﺩﺍﺭ ﺩﺭ ﮐﺸﻮﺭﻫﺎﻱ ﺩﺭ ﺣﺎﻝ ﺗﻮﺳﻌﻪ، 18 ﺩﺭ ﮐﺸﻮﺭﻫﺎﻱ ﺗﻮﺳﻌﻪ ﻳﺎﻓﺘﻪ ﻭ 80 ﺩﺭ ﺟﻨﻮﺏ ﺁﺳﻴﺎ ﻣﺒﺘﻼ ﺑﻪ ﮐﻢ ﺧﻮﻧﻲ ﻣﻲ ﺑﺎﺷﻨﺪ. ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﺎﺕ ﺩﺭ ﻣﻮﺭﺩ ﺍﺭﺗﺒﺎﻁ ﻣﻴﺎﻥ ﻣﻴﺰﺍﻥ ﻏﻠﻈﺖ ﻫﻤﻮﮔﻠﻮﺑﻴﻦ ﻣﺎﺩﺭ ﻭ ﻭﺯﻥ ﻣﻮﻗﻊ ﺗﻮﻟﺪ ﻧﻮﺯﺍﺩ، ﺿﺪﻭﻧﻘﻴﺾ ﻣﻲ ﺑﺎﺷﺪ ﻭ ﺩﺭ ﮐﺘﺎﺏ ﻫﺎﻱ ﺭﻓﺮﻧﺲ ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﻤﺎﻥ ﻧﻴﺰ ﺩﺭ ﻣﻮﺭﺩ ﺍﻳﻦ ﺍﺭﺗﺒﺎﻁ ﻧﮑﺘﺔ ﺧﺎﺻﻲ ﺫﮐﺮ ﻧﺸﺪﻩ ﺍﺳﺖ. ﻫﺪﻑ ﺍﺯ ﺍﻧﺠﺎﻡ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮﺭﺳﻲ ﺍﺭﺗﺒﺎﻁ ﻏﻠﻈﻠﺖ ﻫﻤﻮﮔﻠﻮﺑﻴﻦ ﻭ ﺷﺎﺧﺺ ﺗﻮﺩﺓ ﺑﺪﻧﯽ ﻣﺎﺩﺭ ﺩﺭ ﺳﻪ ﻣﺎﻫﻪ ﺍﻭﻝ ﻧﺨﺴﺘﻴﻦ ﺑﺎﺭﺩﺍﺭﻱ ﺑﺎ ﻭﺯﻥ ﻣﻮﻗﻊ ﺗﻮﻟﺪ ﻣﻲ ﺑﺎﺷﺪ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺩﺭ ﻳﮏ ﻣﻄﺎﻟﻌﻪ ﺗﺤﻠﻴﻠﻲ ﻣﻘﻄﻌﻲ، ﭘﺮﻭﻧﺪﻩ 555 ﻣﺎﺩﺭ ﺑﺎﺭﺩﺍﺭ ﺍﻭﻝ ﺯﺍ ﻣﺮﺍﺟﻌﻪ ﮐﻨﻨﺪﻩ ﺑﻪ 5 ﻣﺮﮐﺰ ﺑﻬﺪﺍﺷﺘﻲ ﺩﺭﻣﺎﻧﻲ ﺷﻬﺮ ﺭﺷﺖ، ﺑﻴﻦ ﺷﻬﺮﻳﻮﺭ 83 ﺗﺎ ﺷﻬﺮﻳﻮﺭ 86، ﮐﻪ ﺣﺎﻭﻱ ﮐﻠﻴﻪ ﺍﻃﻼﻋﺎﺕ ﻣﻮﺭﺩ ﻧﻴﺎﺯ ﻣﻄﺎﻟﻌﻪ، ﺍﺯ ﺟﻤﻠﻪ ﺳﻦ، ﻗﺪ، ﻭﺯﻥ ﻭ ﻫﻤﻮﮔﻠﻮﺑﻴﻦ ﻣﺎﺩﺭ ﻭ ﻭﺯﻥ ﻫﻨﮕﺎﻡ ﺗﻮﻟﺪ ﺑﻮﺩﻧﺪ، ﺑﻪ ﻃﻮﺭ ﺗﺼﺎﺩﻓﻲ ﺍﻧﺘﺨﺎﺏ ﺷﺪﻩ ﻭ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﺍﻟﺒﺘﻪ ﻣﺎﺩﺭﺍﻧﻲ ﮐﻪ ﺩﺍﺭﺍﻱ ﻓﺎﮐﺘﻮﺭﻫﺎﻱ ﺩﺧﺎﻟﺖ ﮐﻨﻨﺪﻩ ﺑﺮ ﻭﺯﻥ ﻫﻨﮕﺎﻡ ﺗﻮﻟﺪ ﺑﻮﺩﻧﺪ، ﻣﺎﻧﻨﺪ ﺯﺍﻳﻤﺎﻥ ﭘﺮﻩ ﺗﺮﻡ، ﻧﺎﻫﻨﺠﺎﺭﻱ ﻫﺎﻱ ﺟﻔﺘﻲ ﻭ ﮊﻧﺘﻴﮑﻲ، ﺑﻴﻤﺎﺭﻱ ﻫﺎﻱ ﻣﺰﻣﻦ ﻭ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺩﺍﺭﻭﻫﺎﻱ ﺧﺎﺹ، ﺍﺯ ﻣﻄﺎﻟﻌﻪ ﻣﺎ ﺣﺬﻑ ﺷﺪﻧﺪ. ﺍﻃﻼﻋﺎﺕ ﺑﻪ ﺩﺳﺖ ﺁﻣﺪﻩ ﺗﻮﺳﻂ ﺁﺯﻣﻮﻥ ﻫﺎﻱ ﺁﻣﺎﺭﻱ ﻫﻤﺒﺴﺘﮕﻲ ﭘﻴﺮﺳﻮﻥ ﻭ ﺭﮔﺮﺳﻴﻮﻥ ﺧﻄﻲ ﻣﻮﺭﺩ ﺁﻧﺎﻟﻴﺰ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺍﺭﺗﺒﺎﻁ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﻣﻴﺎﻥ ﻏﻠﻈﺖ ﻫﻤﻮﮔﻮﺑﻴﻦ ﻣﺎﺩﺭ ﺩﺭ ﺳﻪ ﻣﺎﻫﻪ ﺍﻭﻝ ﻧﺨﺴﺘﻴﻦ ﺑﺎﺭﺩﺍﺭﻱ ﻭ ﻭﺯﻥ ﻣﻮﻗﻊ ﺗﻮﻟﺪ ﻧﻮﺯﺍﺩ ﻭﻱ ﺑﻪ ﺩﺳﺖ ﻧﻴﺎﻣﺪ. ﻫﻤﭽﻨﻴﻦ ﺍﻳﻦ ﺍﺭﺗﺒﺎﻁ ﺑﺮ ﺣﺴﺐ ﻋﺎﻣﻞ ﺩﺧﺎﻟﺖ ﮐﻨﻨﺪﻩ ﺳﻦ ﻣﺎﺩﺭ ﻧﻴﺰ ﻣﻌﻨﻲ ﺩﺍﺭ ﻧﺸﺪ، ﺍﻣﺎ ﺍﻳﻦ ﺍﺭﺗﺒﺎﻁ ﺩﺭ ﺷﺎﺧﺺ ﺗﻮﺩﺓ ﺑﺪﻧﯽ ﺑﻴﺸﺘﺮ ﺍﺯ30kg/m2 ﻣﻌﻨﻲ ﺩﺍﺭ ﺑﻮﺩ 0/041 =P ﻭ 0/225 =R(. ﺩﺭ ﻣﻄﺎﻟﻌﺔ ﻣﺎ ﻓﺮﺍﻭﺍﻧﻲ ﻧﺴﺒﻲ ﻭﺯﻥ ﮐﻢ ﻫﻨﮕﺎﻡ ﺗﻮﻟﺪ 4 ﻭ ﻣﺎﮐﺮﻭﺯﻭﻣﻲ 5 ﺑﻮﺩ. ﻫﻤﭽﻨﻴﻦ ﻣﻴﺰﺍﻥ ﻓﺮﺍﻭﺍﻧﻲ ﻧﺴﺒﻲ ﮐﻢ ﺧﻮﻧﻲ ﺩﺭ ﻣﺎﺩﺭﺍﻥ ﺑﺎﺭﺩﺍﺭ ﻣﻄﺎﻟﻌﻪ ﻣﺎ 21/3 ﺑﻮﺩ. ﻧﺘﻴﺠﻪ ﮔﻴـﺮﻱ: ﺑﺮ ﺍﺳﺎﺱ ﻳﺎﻓﺘﻪ ﻫﺎﻱ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻴﺎﻥ ﻏﻠﻈﺖ ﻫﻤﻮﮔﻠﻮﺑﻴﻦ ﺩﺭ ﺳﻪ ﻣﺎﻫﻪ ﺍﻭﻝ ﻧﺨﺴﺘﻴﻦ ﺑﺎﺭﺩﺍﺭﻱ ﻭ ﻭﺯﻥ ﻫﻨﮕﺎﻡ ﺗﻮﻟﺪ ﻧﻮﺯﺍﺩ ﺍﺭﺗﺒـﺎﻁ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﻭﺟﻮﺩ ﻧﺪﺍﺭﺩ. ﻣﻴﺰﺍﻥ ﻓﺮﺍﻭﺍﻧﻲ ﻧﺴﺒﻲ ﻭﺯﻥ ﮐﻢ ﻫﻨﮕﺎﻡ ﺗﻮﻟﺪ ﺩﺭ ﺟﺎﻣﻌﻪ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ ﻣﺎ ﺍﺯ ﻣﻴﺰﺍﻥ ﻣﺘﻮﺳﻂ ﺟﻬﺎﻧﻲ ﮐﻤﺘﺮ ﺍﺳﺖ. ﻫﻤﭽﻨﻴـﻦ ﻣﻴﺰﺍﻥ ﻓﺮﺍﻭﺍﻧﻲ ﻧﺴﺒﻲ ﮐﻢ ﺧﻮﻧﻲ ﺩﺭ ﻣﺎﺩﺭﺍﻥ ﺑﺎﺭﺩﺍﺭ ﻣﻄﺎﻟﻌﻪ ﻣﺎ ﺍﺯ ﮐﺸﻮﺭﻫﺎﻱ ﺩﺭ ﺣﺎﻝ ﺗﻮﺳﻌﻪ ﮐﻤﺘﺮ ﻭ ﺍﺯ ﮐﺸﻮﺭﻫﺎﻱ ﺗﻮﺳﻌﻪ ﻳﺎﻓﺘﻪ ﮐﻤﻲ ﺑﻴﺸﺘﺮ ﺍﺳﺖ.

Introduction & Objective: About 7.7% of all born neonates through at the world have low birth weight. Also 56% of pregnant women in under developed countries, 18% of pregnant women in developed countries and 80% of pregnant women in South Asia are anemic. The result of studies, which have been already done, about the relationship between mother's hemoglobin concentration and birth weight of her neonate are contravertial and also in reference books of obstetrics and genycology nothing is specifically mentioned about this issue. Our aim in this study is to evaluate the relationship between mother's hemoglobin concentration and BMI in the first trimester of pregnancy and birth weight of her neonate. Materials & Methods: This was a cross sectional study in which the files of 555 nulipar women, which related during August 2004 - August 2007 to 5 health center in Rasht city, during August 2004-August 2007, were selected randomly and referred to the data needed for this study, such as age, height, weight, mother's hemoglobin and birth weight of her neonate were collected. Other confounding factor such as prematurity, genetic disorders, placental insufficiency, chronic disease and administration of some special drugs were eliminated. The data were analyzed by pearson and linear regression Analysis. Results: There was not significant relationship between mother's hemoglobin concentration during the first terimestr of pregnancy and her neonate's birth weight. Also the relationship between mother's hemoglobin concentration and her neonate's birth weight with interfering factor of age, was not significant, but the relationship with the interfering factor of BMI, in BMI higher than 30 kg/m2 was found to be significant (P=0.041). The ratio of LBW in our study was 4% and the ratio of macrosomy was 5%. Also ratio of anemic pregnant women in our study was 21.3%. Conclusions: According to our study there is no significant relationship between mother's hemoglobin concentration during the first terimestr of pregnancy and her neonate's birth weight. The ratio of LBW in our study was lower than world-wide average. Also the ratio of anemic pregnant women in our study was lower than under developed countries and a little higher than developed countries.