儿童缺铁状况的预测与预防

L. Ilyenko, S. Bogdanova, Aleksey N. Gureev, S. I. Lazareva, Galina A. Semashina, Elena V. Obelchak, Dmitry A. Ponomarev, Julia Y. Chepurnaya
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Pregnant, lactating women: the main group-women who received iron preparations during registration-106 persons, the comparison group-those who did not receive iron preparations-142. Inclusion criteria: absence of exacerbation of chronic pathology, allergic reactions, gastrointestinal pathology, infectious diseases. The women were examined at the end of the 3rd trimester and the postpartum period. Catamnestic observation was carried out for 248 children born to pregnant women. All children were observed with the informed consent of their parents. The duration of observation was up to a year. The children of the main group (106) and the comparison group (142) were singled out. Children of the main group on natural feeding (98) were divided into two subgroups. The first subgroup - 47 children whose mothers received iron preparations during lactation, the second subgroup - 51 children whose mothers did not receive iron subsidies. 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引用次数: 0

摘要

缺铁问题的相关性是由于高频率和稳定增长的趋势,影响了人口的生活质量。孕妇、哺乳期妇女和幼儿患缺铁性疾病的风险很高。在孕妇中,发现妊娠早期缺铁与妊娠和分娩的病理过程、儿童身体和心理运动发育指标较低之间存在直接相关性。材料和方法。对248对母子进行了前瞻性队列研究。孕妇、哺乳期妇女:主要组妇女在登记期间接受了铁制剂-106人,对照组妇女未接受铁制剂-142人。纳入标准:无慢性病理恶化、过敏反应、胃肠道病理、传染病。这些妇女在妊娠晚期和产后接受检查。对248名孕妇所生儿童进行了回顾性观察。所有儿童均在征得其父母知情同意的情况下接受观察。观察时间长达一年。主要组(106名)和对照组(142名)的儿童被挑选出来。自然喂养的主要组(98)的儿童被分为两个亚组。第一个亚组——47名母亲在哺乳期接受了铁制剂的儿童,第二个亚组是51名母亲没有接受铁补贴的儿童。对身体状况进行了评估,并进行了一般临床检查。结果和讨论。根据使用统计分析方法获得的数据,发现产前缺铁显著增加了早产的频率,导致出生体重不足、心脏病,并导致孕妇感染病毒的频率很高。在未接受铁制剂的母亲的新生儿中,发现潜伏性缺铁(LID)和缺铁性贫血(IDA)的频率很高。根据实验室诊断结果,对照组的新生儿接受了LID和IDA治疗,但由于身体发育指标较低,NPR一直持续到6个月。在产后,哺乳期母亲预防性摄入铁制剂与儿童潜在缺铁和IDA的发生之间存在直接相关性。结论所获得的数据使我们能够谈论孕妇和哺乳期妇女预防性补铁的高效性,以降低病理性妊娠和分娩的风险,从而影响新生儿和婴儿的身体和神经心理发育(NPD)指标。即使新生儿及时消除了缺铁,身体和NPR的延迟也会长达6个月。对孕妇和哺乳期母亲缺铁对产前、分娩和儿童健康状况的影响的分析表明,有必要从个性化的角度进行预防。
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Iron deficiency conditions prediction and prevention in children
The relevance of iron deficiency issues is due to the high frequency and tendency to steady growth, affecting the quality of life of the population. Pregnant, lactating women and young children are at high risk of developing iron deficiency conditions. Among pregnant women, a direct correlation was found between iron deficiency in the early stages of gestation and the pathological course of pregnancy and childbirth, lower indicators of physical, psychomotor development of children. Materials and methods. A prospective cohort study of 248 mother-child pairs was conducted. Pregnant, lactating women: the main group-women who received iron preparations during registration-106 persons, the comparison group-those who did not receive iron preparations-142. Inclusion criteria: absence of exacerbation of chronic pathology, allergic reactions, gastrointestinal pathology, infectious diseases. The women were examined at the end of the 3rd trimester and the postpartum period. Catamnestic observation was carried out for 248 children born to pregnant women. All children were observed with the informed consent of their parents. The duration of observation was up to a year. The children of the main group (106) and the comparison group (142) were singled out. Children of the main group on natural feeding (98) were divided into two subgroups. The first subgroup - 47 children whose mothers received iron preparations during lactation, the second subgroup - 51 children whose mothers did not receive iron subsidies. An assessment of the somatic status, a general clinical examination was carried out. Results and Discussion.Based on the data obtained using the statistical method of analysis, it was found that iron deficiency in the antenatal period significantly increased the frequency of premature birth, caused a deficiency of birth weight, heart disease, and led to a high frequency of viral infections in pregnant women. In newborns, from mothers who did not receive the iron preparation, a high frequency of latent iron deficiency (LID) and iron deficiency anemia (IDA) was noted. Newborns from the comparison group, according to the results of laboratory diagnostics, were treated with LID and IDA, however, lower indicators of physical development, NPR remained until 6 months. In the postnatal period, there was a direct correlation between the prophylactic intake of iron preparations by a nursing mother and the occurrence of latent iron deficiency and IDA in a child. Conclusion. The data obtained allow us to speak about the high effectiveness of preventive iron supplementation by a pregnant and lactating woman, to reduce the risk of pathological pregnancy and childbirth, affecting the indicators of physical and neuropsychic development (NPD) of a newborn and an infant. Even with the timely elimination of iron deficiency in a newborn, the delay in physical and NPR is noted up to 6 months. The analysis of the effect of iron deficiency in pregnant and nursing mothers on the course of the antenatal period, childbirth and the state of the child’s health dictates the need for prevention from the standpoint of a personalized approach.
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