Liposomal ferric pyrophosphate and ascorbic acid supplementation in pregnant women with iron deficiency anaemia: haematochemical, obstetric, neonatal and psychological outcomes in a prospective observational study

ObjectiveTo conduct a systematic review to investigate the safety of induction and/or augmentation of labour compared with spontaneous-onset normal labour among pregnant women with iron-deficiency anaemia.DesignSystematic review.SettingStudies from all countries, worldwide.PopulationPregnant women with iron-deficiency anaemia at labour and delivery.InterventionAny intervention related to induction and/or augmentation of labour.Outcome measuresPrimary: Postpartum haemorrhage (PPH), heart failure and maternal death. Secondary: Emergency caesarean section, hysterectomy, admission to intensive care unit.MethodWe searched 10 databases, including Medline and Embase, from database inception to 1 October 2018. We included all study designs except cross-sectional studies without a comparator group, case reports, case series, ecological studies, and expert opinion. The searches were conducted by a healthcare librarian and two authors independently screened and reviewed the studies. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approachto ascertain risk of bias and conducted a narrative synthesis.ResultsWe identified 3217 journal articles, 223 conference papers, 45 dissertations and 218 registered trials. Ten articles were included for full-text review and only one was found to fulfil the eligibility criteria. This was a retrospective cohort study from India, which showed that pregnant women with moderate and severe anaemia could have an increased risk of PPH if they underwent induction and/or augmentation of labour, but the evidence was weak (graded as ‘high risk of bias’).ConclusionThe best approach is to prevent anaemia, but a large number of women in low-to-middle-income countries present with severe anaemia during labour. In such women, appropriate peripartum management could prevent complications and death. Our review showed that at present we do not know if induction and augmentation of labour is safe in pregnant women with iron-deficiency anaemia and further research is required.PROSPERO registration numberCRD42015032421.

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Study of outcome of the treatment with intravenous iron sucrose in moderately anaemic pregnant women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193695 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3480

Author(s):

Kohila Kalimuthu ◽

Vanusha Avudaithangam

Keyword(s):

Standard Deviation ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Iron Sucrose ◽

P Value ◽

Deficiency Anaemia ◽

The Mean ◽

The Difference

Background: Moderate anaemia seen in about 15-20% of pregnant women. Iron sucrose complex which is used intravenously for the correction of Iron deficiency anaemia. The drug has been able to raise the haemoglobin to satisfactory level when used in moderately anaemic iron deficient pregnant women. The objective of this study was to study the improvement of Hb% after treatment with intravenous Iron sucrose complex in moderately anaemic pregnant women belonging to 24-32 weeks of gestational age.Methods: 50 antenatal patients between gestational age 24-32 weeks with hemoglobin between 8-9.5g/dl were selected and included in this study. They were subjected to blood hemoglobin estimation, hematocrit and peripheral smear study. In each infusion, the maximum total dose administered was 200 mg iron sucrose in 100 ml of normal saline, slow IV infused over 30 minutes. Monitoring was done throughout the infusion to observe for any side effects.Results: Mean hemoglobin among the 50 patients before starting the therapy was 8.172g/dl and the mean hemoglobin at the end of one month of completing the therapy was 11.066g/dl. The rise in mean hemoglobin i.e. the difference in the mean hemoglobin before and after treatment was 2.894g/dl. The p value is 0.0001 which is statistically significant. The mean hematocrit of the 50 patients studied before starting the treatment was 26.772% with a standard deviation of 1.914. The mean hematocrit after completing the therapy was 33.872% with a standard deviation of 1.321. The difference in the mean hematocrit was 7.100% with a p value of 0.0001 which is statistically significant.Conclusions: Intravenous iron sucrose complex is well tolerated and highly efficacious in improving hemoglobin, hematocrit in the treatment of iron deficiency anaemia in antenatal women.

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NIMO-CKD-UK: a real-world, observational study of iron isomaltoside in patients with iron deficiency anaemia and chronic kidney disease

BMC Nephrology ◽

10.1186/s12882-020-02180-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Philip A. Kalra ◽

Sunil Bhandari ◽

Michael Spyridon ◽

Rachel Davison ◽

Sarah Lawman ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Iron Deficiency ◽

Observational Study ◽

Adverse Drug Reactions ◽

Real World ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Drug Reactions ◽

Deficiency Anaemia

Abstract Background Intravenous iron is often used to treat iron deficiency anaemia in non-dialysis chronic kidney disease (ND-CKD), but the optimal dosing regimen remains unclear. We evaluated the impact of high- versus low-dose intravenous iron isomaltoside on the probability of retreatment with intravenous iron in iron-deficient ND-CKD patients. Methods This real-world, prospective, observational study collected data from 256 ND-CKD patients treated for anaemia in the UK. Following an initial course of iron isomaltoside, patients were followed for ≥12 months. Iron dose and the need for retreatment were determined at the investigators’ discretion. The primary study outcome was the need for retreatment at 52 weeks compared between patients who received >1000 mg of iron during Course 1 and those who received ≤1000 mg. Safety was evaluated through adverse drug reactions. Results The probability of retreatment at Week 52 was significantly lower in the >1000 mg iron group (n = 58) versus the ≤1000 mg group (n = 198); hazard ratio (95% confidence interval [CI]): 0.46 (0.20, 0.91); p = 0.012. Mean (95% CI) haemoglobin increased by 6.58 (4.94, 8.21) g/L in the ≤1000 mg group and by 10.59 (7.52, 13.66) g/L in the >1000 mg group (p = 0.024). Changes in other blood and iron parameters were not significantly different between the two groups. Administering >1000 mg of iron isomaltoside saved 8.6 appointments per 100 patients compared to ≤1000 mg. No serious adverse drug reactions were reported. Of the patients who received ≤1000 mg of iron in this study, 82.3% were eligible for a dose >1000 mg. Conclusions The >1000 mg iron isomaltoside regimen reduced the probability of retreatment, achieved a greater haemoglobin response irrespective of erythropoiesis-stimulating agent treatment, and reduced the total number of appointments required, compared to the ≤1000 mg regimen. Many of the patients who received ≤1000 mg of iron were eligible for >1000 mg, indicating that there was considerable underdosing in this study. Trial registration ClinicalTrials.gov NCT02546154, 10 September 2015.

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Iron stores in pregnant women with sickle cell disease: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026497 ◽

2019 ◽

Vol 9 (9) ◽

pp. e026497 ◽

Cited By ~ 2

Author(s):

Desmond Aroke ◽

Benjamin Momo Kadia ◽

Tsi Njim

Keyword(s):

Systematic Review ◽

Sickle Cell Disease ◽

Iron Deficiency ◽

Pregnant Women ◽

Sickle Cell ◽

Iron Deficiency Anaemia ◽

Meta Analysis ◽

Cochrane Library ◽

Cell Disease ◽

Deficiency Anaemia

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD have led to an increase in the number of women with SCD reaching the reproductive age. Iron deficiency anaemia remains the most common cause of anaemia in pregnancy, affecting 51%–63% of pregnancies in Africa. However, the unavailability of guidelines on supplementation of iron in this pregnant subpopulation often leaves clinicians in a fix. We propose to conduct the first systematic review and possibly a meta-analysis on the prevalence, associated factors and maternal/fetal outcomes of iron deficiency anaemia among pregnant women with SCD.Methods and analysisWe will search the following electronic databases for studies on the iron status of pregnant women with SCD: PubMed, MEDLINE, EMBASE, Google Scholar, African Journals Online, African Index Medicus, Popline and the Cochrane Library. After the selection of eligible studies from the search output, review of full text, data extraction and data synthesis will be performed. Studies obtained from the review shall be evaluated for quality, risk of bias and heterogeneity. Appropriate statistical methods shall be used to pool prevalence estimates for matching studies globally and in subpopulations. This protocol has been reported as per the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationThere is no requirement for ethical approval as the proposed study will use published data. The findings of this study will be published in a peer-reviewed journal and will be presented at conferences.Trial registration numberCRD42018109803.

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Iron-Supplementation Programmes: Compliance of Target Groups and Frequency of Tablet Intake

Food and Nutrition Bulletin ◽

10.1177/156482659601700105 ◽

1996 ◽

Vol 17 (1) ◽

pp. 1-5 ◽

Cited By ~ 24

Author(s):

Werner Schultink

Keyword(s):

Developing Countries ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Large Scale ◽

Iron Supplementation ◽

Daily Basis ◽

Original Research ◽

Target Groups ◽

Deficiency Anaemia

The prevalence of iron-deficiency anaemia remains especially high in developing countries, despite large-scale iron-supplementation programmes. The reasons for the lack of success of these programmes are discussed based on the results of original research conducted in Indonesia. Studies among pregnant women in rural Sulawesi and urban Jakarta demonstrated that besides insufficient coverage of the target group, women's compliance with tablet intake was a serious problem. Compliance may be improved when it is not necessary to take tablets on a daily basis. Studies among pre-school children and non-pregnant women proved the effectiveness of once-weekly and twice-weekly supplementation. These supplementation schedules should also be investigated in pregnant women.

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Status of Ascorbic Acid in Iron Deficiency Anaemia and Thalassaemia

Acta Haematologica ◽

10.1159/000207283 ◽

1980 ◽

Vol 64 (5) ◽

pp. 271-275 ◽

Cited By ~ 4

Author(s):

Bharati Chatterjea ◽

Arati Maitra ◽

D.K. Banerjee ◽

A.K. Basu

Keyword(s):

Ascorbic Acid ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Deficiency Anaemia

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The impacts of maternal iron deficiency and being overweight during pregnancy on neurodevelopment of the offspring

British Journal Of Nutrition ◽

10.1017/s0007114517002410 ◽

2017 ◽

Vol 118 (7) ◽

pp. 533-540 ◽

Cited By ~ 15

Author(s):

Staffan K. Berglund ◽

Francisco J. Torres-Espínola ◽

Luz García-Valdés ◽

Mª Teresa Segura ◽

Cristina Martínez-Zaldívar ◽

...

Keyword(s):

Risk Factors ◽

Iron Deficiency ◽

Gestational Diabetes ◽

Observational Study ◽

Pregnant Women ◽

Prospective Observational Study ◽

Infant Neurodevelopment ◽

Spanish Women ◽

Independent Effects ◽

Maternal Iron

AbstractBoth maternal Fe deficiency (ID) and being overweight or obese (Ow/Ob, BMI≥25 kg/m2) may negatively affect offspring brain development. However, the two risk factors correlate and their independent effects on infant neurodevelopment are unclear. PREOBE is a prospective observational study that included 331 pregnant Spanish women, of whom 166 had pre-gestational Ow/Ob. Fe status was analysed at 34 weeks and at delivery, and babies were assessed using Bayley III scales of neurodevelopment at 18 months. In confounder-adjusted analyses, maternal ID at 34 weeks was associated with lower composite motor scores at 18 months (mean 113·3 (sd 9·9) v. 117·1 (sd 9·2), P=0·039). Further, the offspring of mothers with ID at delivery had lower cognitive scores (114·0 (sd 9·7) v. 121·5 (sd 10·9), P=0·039) and lower receptive, expressive and composite (99·5 (sd 8·6) v. 107·6 (sd 8·3), P=0·004) language scores. The negative associations between maternal ID at delivery and Bayley scores remained even when adjusting for maternal Ow/Ob and gestational diabetes. Similarly, maternal Ow/Ob correlated with lower gross motor scores in the offspring (12·3 (sd 2·0) v. 13·0 (sd 2·1), P=0·037), a correlation that remained when adjusting for maternal ID. In conclusion, maternal ID and pre-gestational Ow/Ob are both negatively associated with Bayley scores at 18 months, but independently and on different subscales. These results should be taken into account when considering Fe supplementation for pregnant women.

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Prevalence of Iron Deficiency Anaemia among the Reproductive Age Group Women Attending the Unani Hospital, Bangalore, Karnataka, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44851.14340 ◽

2020 ◽

Author(s):

Mazharul Islam ◽

Atiya Khan ◽

Arish Mohammad Khan Sherwani

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Economic Status ◽

Cross Sectional Study ◽

Reproductive Age ◽

Age Group ◽

Cross Sectional ◽

Deficiency Anaemia ◽

Reproductive Age Group

Introduction: Iron Deficiency Anaemia (IDA) is the most widespread micronutrient deficiency. Globally, nearly two billion people are affected by anaemia. This disease most often affects children, women of child-bearing age, and pregnant women. Nearly half of the pregnant women in the world are estimated to be anaemic. Its prevalence varies according to region and socio-economic conditions. The majority of those who are anaemic live in developing countries where the problem is exacerbated by limited access to inadequate resources and appropriate treatment. Aim: To find out the prevalence of IDA in the reproductive age group women and its associated factors. Materials and Methods: This hospital based, cross-sectional study was conducted among 400 females, of age group 15-49 years. After obtaining the written informed consent, eligible subjects were inquired about socio-demographic variables, socio-economic status, anthropometric measurements and risk factors. Required investigations were done. All the information was recorded on the semi-structured schedule form. Chi-square/Fisher’s-exact test was used to find the significance of study parameters on categorical scale between two or more groups. Results: Prevalence of IDA was found to be 42% (168/400). Prevalence of IDA was significant with habitat (p=0.0180), exercise (p=0.0004), amount of blood loss during menstruation (p<0.0001), duration of flow during menstruation, (p=0.0020), consumption of fish (p=0.0002), consumption of legumes (p=0.002), consumption of green leafy vegetable (p<0.0001). Conclusion: Results confirmed an increased prevalence of IDA in women of reproductive age group.

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