scholarly journals Systematic review to investigate the safety of induction and augmentation of labour among pregnant women with iron-deficiency anaemia

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021793 ◽  
Author(s):  
Kathryn Bunch ◽  
Nia Roberts ◽  
Marian Knight ◽  
Manisha Nair

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.

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026497 ◽  
Author(s):  
Desmond Aroke ◽  
Benjamin Momo Kadia ◽  
Tsi Njim

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.


2021 ◽  
Vol 14 ◽  
pp. 117863882110394
Author(s):  
Nhyira Yaw Adjei-Banuah ◽  
Victor Abugah Aduah ◽  
Shamsu-Deen Ziblim ◽  
Martin Amogre Ayanore ◽  
Anthony Amalba ◽  
...  

Introduction: Iron deficiency anaemia is an international public health concern and pregnant women are at an increased risk. We investigated the consumption of iron rich foods and associated factors among pregnant women in a rural district from Ghana. Methods: Following a cross-sectional design, dietary intake of iron rich foods was obtained from 252 pregnant women using a 24-hour recall food check list. Nutrition knowledge, attitudes and socio-demographic characteristics were also assessed. Findings: Participants had a mean (SD) knowledge score of 54.66 (22.74)%. About 73% of the participants had heard about iron-deficiency anaemia. Only 16.3% of the participants knew foods that help the body to absorb and use iron while 9.1% knew beverages that decrease iron absorption. About 71% of the participants ate fish and/or seafood while 67.1% of them ate green leafy vegetables. Only 4.4% of the participants ate organ meat, and 29% took flesh meat. Only 22.4% of the study participants usually drank coffee or tea while 78.2% ate vitamin C-rich foods. With regards to attitudes, 88.5% of the participants perceived anaemia to be a serious disease. Nutrition knowledge was significantly associated with the consumption of iron rich foods (β = .02; 95% CI = 0.01-0.02). Conclusion: Nutrition knowledge may be an important determinant of the consumption of iron rich foods among pregnant women making it necessary for healthcare providers to continue to provide nutrition education to pregnant women during routine antenatal care.


2006 ◽  
Vol 9 (4) ◽  
pp. 443-448 ◽  
Author(s):  
Ritsuko Aikawa ◽  
Ngyen C Khan ◽  
Satoshi Sasaki ◽  
Colin W Binns

AbstractObjectiveTo assess the prevalence of anaemia in rural Vietnam and to determine its risk factors.DesignA cross-sectional survey.SettingVietnam, Nghe An Province.Study populationThe total number of participants was 439. Of these participants, one was excluded from the study due to a mental disorder. Forty-seven did not participate in the test for parasites and 68 did not complete at least one of the questions.ResultsThe prevalence of anaemia (haemoglobin (Hb) < 11.0 g dl−1) was 43.2% and of severe anaemia (Hb < 8.0 g dl−1) was 0.5%. Taking iron tablets, the consumption of eggs and the preference for Western medicine significantly and positively correlated with Hb concentration in the pregnant women in a multiple regression analysis. Pregnancy duration and hookworm infestation significantly and negatively correlated with Hb concentration in the pregnant women.ConclusionThe prevalence of anaemia in rural Vietnam has remained as high as that found in the national anaemia survey in 2000. The results of the present study could aid in the development of an iron-deficiency anaemia programme among pregnant women in rural Vietnam that emphasises iron supplementation, parasite control and improved diet, including the consumption of eggs. The programme's focus should be on women who prefer traditional medicine to Western medicine.


2021 ◽  
Author(s):  
Annette Pluddemann ◽  
Elizabeth A Spencer ◽  
Carl Heneghan ◽  
Jon Brassey ◽  
Igho J Onakpoya ◽  
...  

Background Vertical transmission of SARS-CoV-2 has been reported but does not appear to be common. This study aims to systematically review the evidence for vertical transmission of SARS-CoV-2. Methods This review is part of an Open Evidence Review on the transmission dynamics of SARS-CoV-2 and the role of intrauterine mother to fetus transmission. Literature searches were performed in the WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, search date up to 20 December 2020, no language restrictions. Results We included 106 studies assessing vertical transmission of SARS-CoV-2 from pregnant women to their neonates: these studies comprised 40 reviews (21 fulfilled systematic review methodology, including risk of bias assessment of included studies) and 66 primary studies including 32 case reports (of up to two cases) and 34 prospective and retrospective cohort studies, prospective and retrospective case series, observational studies (including asymptomatic screening), database studies and a quality improvement project. Almost all were conducted in a hospital setting. The 32 case reports were considered to be at high risk of bias, due to the study design; across the 34 remaining primary studies, risk of bias was low to moderate. Sixteen case reports examined vertical transmission, which was not related to maternal symptomatology. For the cohort and case series studies, the percentage of positive neonates ranged from 0% to 22% across the studies. Twenty studies reported no positive vertical transmission. Three studies that reported the highest positivity rates of 11%, 15% and 22% had specifically selected neonates with a positive test (within up to 35 days) within the study population and were therefore more selective populations. Across the cohort and case series studies there were 65/2391 (2.7%) neonates born to mothers with a diagnosis of COVID-19 tested positive for SARS-CoV-2 within 24 hours of birth. No evidence correlated maternal symptomatology to vertical transmission. Mode of delivery did not correlate with rates of vertical transmission. Of 25 studies, 7 identified SARS-CoV-2 in placental tissue; some of these did not demonstrate vertical transmission to the neonate. No study reported the results of viral culture to detect SARS-CoV-2. Conclusions The results of these studies indicate that vertical transmission is possible, but is not frequent, and factors that influence when vertical transmission occurs are unknown. Further studies using standardised methods to establish viral infection are needed to establish vertical transmission rates and to assess clinical and other conditions affecting transmission.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042350
Author(s):  
Maximilian Sohn ◽  
Ayman Agha ◽  
Igors Iesalnieks ◽  
Anna Tiefes ◽  
Alfred Hochrein ◽  
...  

IntroductionAcute diverticulitis of the sigmoid colon is increasingly treated by a non-operative approach. The need for colectomy after recovery from a flare of acute diverticulitis of the left colon, complicated diverticular abscess is still controversial. The primary aim of this study is to assess the risk of interval emergency surgery by systematic review and meta-analysis.Methods and analysisThe systematic review and meta-analysis will be conducted in accordance to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE will be screened for the predefined searching term: (Diverticulitis OR Diverticulum) AND (Abscess OR pelvic abscess OR pericolic abscess OR intraabdominal abscess) AND (surgery OR operation OR sigmoidectomy OR drainage OR percutaneous drainage OR conservative therapy OR watchful waiting). All studies published in an English or German-speaking peer-reviewed journal will be suitable for this analysis. Case reports, case series of less than five patients, studies without follow-up information, systematic and non-systematic reviews and meta-analyses will be excluded. Primary endpoint is the rate of interval emergency surgery. Using the Review Manager Software (Review Manager/RevMan, V.5.3, Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration, 2012) meta-analysis will be pooled using the Mantel-Haenszel method for random effects. The Risk of Bias in Non-randomized Studies of Interventions tool will be used to assess methodological quality of non-randomised studies. Risk of bias in randomised studies will be assessed using the Cochrane developed RoB 2-tool.Ethics and disseminationAs no new data are being collected, ethical approval is exempt for this study. This systematic review is to provide a new insight on the need for surgical treatment after a first attack of acute diverticulitis, complicated by intra-abdominal or pelvic abscesses. The results of this study will be presented at national and international meetings and published in a peer-reviewed journal.PROSPERO registration numberCRD42020164813.


Author(s):  
Kohila Kalimuthu ◽  
Vanusha Avudaithangam

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.


1996 ◽  
Vol 17 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Werner Schultink

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.


2019 ◽  
Vol 211 (8) ◽  
pp. 367-373 ◽  
Author(s):  
Alaa Qassim ◽  
Rosalie M Grivell ◽  
Amanda Henry ◽  
Giselle Kidson‐Gerber ◽  
Antonia Shand ◽  
...  

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