约旦中部孕妇妊娠期贫血的患病率及危险因素

摘要(中文译文)

孕产妇贫血仍然是最重要的公共卫生问题之一，尤其是在中低收入国家。世界卫生组织报告称，育龄妇女的孕产妇贫血患病率为37%；发展中国家这一比率进一步升高。这项横断面分析研究旨在估计约旦中部接受孕产服务的孕妇中孕产妇贫血的患病率，并评估其相关危险因素。数据收集采用经过验证的自填式问卷，对2023年8月至11月期间在三家医疗机构接受医疗服务的297名孕妇进行调查。问卷考察了与孕产妇贫血相关的多个领域，包括社会人口学特征、妊娠概况、生育史、营养习惯、血红蛋白水平，并评估了孕妇对贫血的知识水平。统计分析使用社会科学统计软件包（SPSS）进行，以多变量逻辑回归作为主要推断模型，并辅以多层感知器神经网络以验证预测因子的一致性。两个模型的准确率分别为73.0%和71.1%。结果显示，约半数参与者（52.5%）患有贫血。采用多变量逻辑回归识别孕产妇贫血的相关危险因素。妊娠晚期更容易发生贫血（比值比[OR]=1.69，95%置信区间[CI] 1.036-2.771），流产次数较多的女性也更易发生贫血（OR=6.33，95%[CI] 1.314-13.515），而使用营养补充剂则是一个保护因素（OR=0.104，95%[CI] 0.013-0.858）。这些结果凸显了加强产前筛查方案和实施针对性营养干预的迫切需求，尤其是对于妊娠晚期女性和有流产史的女性。

Abstract

Maternal anemia remains one of the most significant public health issues, particularly in low-to-middle-income countries. The World Health Organization reported a maternal anemia prevalence of 37% among women of reproductive age; this rate is further inflated in developing countries. This cross-sectional analytical study aimed to estimate the prevalence of maternal anemia and assess its associated risk factors among pregnant women receiving maternity services in central Jordan. Data collection was conducted using validated self-administered questionnaires administered to 297 pregnant women receiving medical care at three medical facilities during the period between August and November of 2023. The questionnaire examined several domains related to maternal anemia, including sociodemographic characteristics, pregnancy profile, reproductive history, nutritional habits, hemoglobin levels, and evaluated the knowledge level of anemia among pregnant women. Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS), with multivariable logistic regression as the primary inferential model, supplemented by a multilayer perceptron neural network to validate predictor consistency. The models achieved an accuracy of 73.0% and 71.1%, respectively. The results revealed that approximately half of the participants (52.5%) were anemic. A multivariable logistic regression was used to identify the associated risk factors for maternal anemia. Anemia is more likely to develop in later stages of pregnancy (odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.036-2.771) and among women with a high number of abortions (OR = 6.33, 95% [CI] 1.314-13.515), whereas the use of nutritional supplements was a protective factor (OR = 0.104, 95% [CI] 0.013-0.858). These results highlight the urgent need for strengthened antenatal screening protocols and targeted nutritional interventions, particularly for women in later stages of pregnancy and those with a history of abortions.

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