저자들은 산모빈혈의 유병율을 파악하고 산모빈혈이 조산 및 산모와 태아의 주산기이환에 미치는 영향을 살펴보고자 1994년 12월부터 1995년 10월까지 단국대학교병원 산부인과에 입원하여 분만한 재태기간 21주~44주의 산모에 대한 환자-대조군 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 분만당시 산모 빈혈의 유병율은 25.6%였다. 2. 분만산모의 재태기간별 헤모글로빈의 평균농도는 21주~27주에서 10.8g/dl, 28주~36주에서 10.9g/dl, 37주~44주에서 10.9g/dl이었다. 3. 산전과 산후의 헤모글로빈의 농도는 통계적으로 유의한 선형 상관관계를 보여 서로 비례하여 증가하는 양상을 보였다. 4. 산모빈혈과 조산과의 관련성은 발견되지 않았다. 또한 산모빈혈과 신생아이환(neonatal morbidity), 즉 7점미만의 1분 및 5분 Apgar score, 태아가사, 선천성기형, 분만외상, 신생아 집중치료실 입원여부 및 입원기간, 신생아소생술 시행여부 및 패혈증의 합병증 여부 등과의 관련성도 발견되지 않았다. 5. 산모빈혈이 있을 경우 재태기간에 비해 저체중아(SGA)와 저체중아(LBW)의 발생이 각각 40% 및 60%감소한 반면, 재태기간에 비해 과체중아(LGA)의 발생은 70% 더 증가하였다. 6. 산모빈혈이 있을 경우 산후출혈이 6.5배이상, 산후수혈을 한 경우가 8.5배이상 더 발생하였으며, 산욕열이 80%이상 더 발생하였다. 이사의 결과로 보아 산모빈혈과 조산 및 신생아이환과의 관련성은 보이지 않았으나 산후출혈과 산후수혈 및 산욕열의 발생이 증가하는 것으로 보아 산전진찰 중 빈혈에 대한 철저한 예방과 관리가 필요하다고 하겠다.

Objective: Maternal anemia is one of the most common hematologic disorders of the child-bearing mothers. However the role of maternal anemia in the etiology of preterm delivery and adverse pregnancy outcomes remains a source of controversy. The aim of this study was to determine the effects of maternal anemia on the preterm birth and the adverse pregnancy outcomes. Study Design: A total of 1,010 women aged 19~44 years, who admitted to our hospital for the delivery between December 1994 and October 1995, were recruited into a hospital baed case-control study design. 259 women complicated by maternal anemia(cases) were compared with 751 women without maternal anemia(controls). Multiple logistic regression analyses were performed to control for the effects of other potentially confounding factors, including maternal age, body mass index, previous term delivery, previous preterm delivery and previous abortion. In all logistic regression analyses odds ratio and 95% confidence intervals were calculated. Results: The prevalence of maternal anemia(hemoglobin<10g/dl) was 25.6%. There was a positive linear relationship between the prepartum hemoglobin concentration and the postpartum concentration. There was no significant differences of the incidence of preterm birth and the neonatal morbidity, such as poor Apgar scores, fetal distress, congenital anomaly, birth trauma, admission to neonatal intensive care unit, resuscitation and sepsis between case and control groups. Small for gestational age and low birth weight were associated with an somewhat decreased risk of maternal anemia and large for gestational age, not macrosomia, was associated with an 70% increased risk of maternal anemia at the time of delivery. Maternal anemia was associated with 6.5 fold increases in the risks of postpartum bleeding, 8.5 fold increases in the postpartum transfusion and 80% increases in the puerperal fever respectively. Conclusions: Maternal anemia was not associated with increased risks of preterm birth and the neonatal morbidty. However there was a significant relationship between maternal anemia and postpartum maternal morbidity, such as postpartum bleeding, postpartum transfusion and puerperal fever.