scholarly journals IRON DEFICIENCY ANEMIA

2016 ◽  
Vol 23 (06) ◽  
pp. 673-679
Author(s):  
Malahat Mansoor ◽  
Hammad Raza

Around 65% of pregnant women in South Asia suffer from IDA & in Indiansub-continent alone, the rate of developing IDA during pregnancy is 88%. Moreover anemicpregnant patients are more likely to give birth to low birth weight babies which itself is anotherfactor adding to socio-economic burden on the whole family. The food has not been fortified forIron, Zinc & Vitamin D & hence the prevention of anemia has not yet been achieved Objectives:To study Awareness of women about food fortification & prevention of IDA Vs cost for treatinganemia. Period: August 2015-Dec 2015. Study Design: Observational Study. Settings: At BhattiInternational Hospital, Kasur Results: Among the selected anemic women, almost half (55%)had mild anemia, while rest had moderate to severe anemia indicting that the prevalence is verycommon. The treatment offered was oral &/or IV Iron with blood transfusions. The cost of iv Irontherapy & blood transfusions estimates in thousands with added risks of Transfusion Reactions,allergic reactions& transmission of blood-borne diseases like HCV,HBV,HIV(AIDS)&others. Theawareness level was found to be poor among these women .Only 8/60 i.e 13% had someidea about iron deficiency anemia & almost none knew about food fortifications. The insightabout their own disease of IDA was also 35% (21/60) indicating that most of the women incommunity live with IDA without any understanding of a preventable condition. Conclusion:The cost & time spend to treat IDA can be minimizes creating awareness about food fortification& supplementation.

2021 ◽  
pp. 1-6
Author(s):  
Nighat Aftab ◽  
Saima Faraz ◽  
Komal Hazari ◽  
Asma Fahad ◽  
Nadia AlSawalhee ◽  
...  

<b><i>Introduction:</i></b> Iron deficiency anemia (IDA) is endemic among pregnant females worldwide. Liposomal iron preparation is a novel therapy for treating IDA in pregnant females. There is a lack of research on cost-effect and comparison between various new iron preparations as liposomal and intravenous (IV) iron supplements in the international literature. <b><i>Objective:</i></b> The objective of this study was to evaluate the cost-effect and maternal-fetal outcome of IDA during pregnancy in Latifa Women and Children Hospital, Dubai, UAE. <b><i>Design:</i></b> The study was a quasi-experimental study. <b><i>Settings:</i></b> Settings include tertiary-care hospital settings affiliated with academic center in UAE. <b><i>Patients and Methods:</i></b> A total of 226 pregnant women were inducted in the study who were controlled in terms of age, BMI, baseline hemoglobin (Hb), severity of anemia, and ferritin levels. There were 116 patients who received oral liposomal iron pyrophosphate and 110 patients received IV iron saccharate complex for 4 weeks. The overall cost-effect and maternal-fetal outcomes were compared in 2 groups. <b><i>Main Outcomes Measured:</i></b> The main outcomes measured the cost-effect of liposomal and IV iron therapy, and the 2 treatments were compared in terms of maternal and fetal outcomes. <b><i>Result:</i></b> The subjects were matched for age and body mass index and showed that the patients in the IV group were more symptomatic than those in the oral group (18.1 vs. 31.9% <i>p</i> value &#x3c;0.01). There was no statistically significant difference among women from different nationalities living in UAE (<i>p</i> value 0.079). There were 98 (84.4%) patients in the oral group and 99 (90%) patients in the IV group who achieved the desired Hb levels after 1 month of treatment (<i>p</i> value = 0.878). Moreover, the side effects were also comparable in both groups (1.72 vs. 1.82% <i>p</i> value = 0.56). The incremental cost-effect ratio for IV iron was USD 108,633/rise to desired Hb. <b><i>Conclusion:</i></b> Liposomal iron preparations may be cost-effective and have fewer side effects than IV iron. In terms of outcome, the maternal and fetal variables are comparable in liposomal and IV groups.


Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points


2021 ◽  
Vol 9 (3) ◽  
pp. 127-130
Author(s):  
Swapana John ◽  

Anemia during pregnancy is a major world health concern especially in developing countries affecting the life of the women and the future of the child thereby influencing the present as well the future of the nation and the world at large. Nutritional deficiency still emerges out the main cause of iron deficiency anemia affecting the life of the pregnant women. The iron deficiency anemia has a major say in adverse pregnancy outcomes like pre term delivery, IUGR, morbidity even leading to mortality, however it is noted that severe anemia has a significant effect than moderate and mild anemia. A well balanced diet can avert this condition, nonetheless iron supplementations as per the government guidelines and various treatment available also help to tackle the situation. Education of the women and more awareness programmes on health, pregnancy and nutrition by the stakeholders can further reduce the incidence of anemia in pregnancy.


2004 ◽  
Vol 74 (6) ◽  
pp. 435-443 ◽  
Author(s):  
Hertrampf ◽  
Olivares

Iron amino acid chelates, such as iron glycinate chelates, have been developed to be used as food fortificants and therapeutic agents in the prevention and treatment of iron deficiency anemia. Ferrous bis-glycine chelate (FeBC), ferric tris-glycine chelate, ferric glycinate, and ferrous bis-glycinate hydrochloride are available commercially. FeBC is the most studied and used form. Iron absorption from FeBC is affected by enhancers and inhibitors of iron absorption, but to a lesser extent than ferrous sulfate. Its absorption is regulated by iron stores. FeBC is better absorbed from milk, wheat, whole maize flour, and precooked corn flour than is ferrous sulfate. Supplementation trials have demonstrated that FeBC is efficacious in treating iron deficiency anemia. Consumption of FeBC-fortified liquid milk, dairy products, wheat rolls, and multi-nutrient beverages is associated with an improvement of iron status. The main limitations to the widespread use of FeBC in national fortification programs are the cost and the potential for promoting organoleptic changes in some food matrices. Additional research is required to establish the bioavailability of FeBC in different food matrices. Other amino acid chelates should also be evaluated. Finally there is an urgent need for more rigorous efficacy trials designed to define the relative merits of amino acid chelates when compared with bioavailable iron salts such as ferrous sulfate and ferrous fumarate and to determine appropriate fortification levels


Author(s):  
Mohamed Saber ◽  
Mohamed Khalaf ◽  
Ahmed M. Abbas ◽  
Sayed A. Abdullah

Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Ilknur Col Madendag ◽  
Mefkure Eraslan Sahin ◽  
Yusuf Madendag ◽  
Erdem Sahin ◽  
Mustafa Bertan Demir ◽  
...  

Aim. The aim of the present study was to evaluate the relationship between iron deficiency anemia and small for gestational age (SGA) in early third trimester pregnancies. Methods. A total of 4800 pregnant women who met the inclusion criteria were analyzed retrospectively. We included pregnant women who had iron deficiency anemia between 26+0 and 30+0 weeks of gestation and delivered singletons between 37+0 and 41+6 weeks of gestation. Patients were divided into four groups according to anemia level: (1) hemoglobin (Hb) < 7 mg/dl (n = 80), (2) Hb 7–9.9 mg/dl (n = 320), (3) Hb 10–10.9 mg/dl (n = 1300), and (4) Hb > 11 mg/dl (n = 3100, control group). The primary outcome of this study was the presence of SGA. Results. The demographic and obstetric characteristics were similar among all the groups. Maternal age, BMI <30 kg/m2, nulliparity rates, and previous cesarean delivery rates were similar among groups. Ethnicity was significantly different in the severe and moderate anemia groups (<0.001). Mean fetal weight was 2900 ± 80 g in the severe anemia group, 3050 ± 100 g in the moderate anemia group, 3350 ± 310 g in the mild anemia group, and 3400 ± 310 g in the control group. Fetal weight was significantly lower in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). The SGA rate was 18.7% in the severe anemia group, 12.1% in the moderate anemia group, 5.3% in the mild anemia group, and 4.9% in the control group. SGA was significantly higher in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). Conclusion. The results of this study indicated that early third trimester severe and moderate iron deficiency anemia was associated with SGA. Iron deficiency anemia in pregnant women may lead to low birth weight.


2020 ◽  
Vol 99 ◽  
pp. 58-75 ◽  
Author(s):  
Kumar Shubham ◽  
T. Anukiruthika ◽  
Sayantani Dutta ◽  
A.V. Kashyap ◽  
Jeyan A. Moses ◽  
...  

Foods ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1871
Author(s):  
Ângela Liberal ◽  
José Pinela ◽  
Ana Maria Vívar-Quintana ◽  
Isabel C. F. R. Ferreira ◽  
Lillian Barros

Iron deficiency remains one of the main nutritional disorders worldwide and low iron intake and/or bioavailability are currently the major causes of anemia. To fight this public health problem, the scientific challenge is to find an iron form with sufficient bioavailability to increase its levels in humans through food fortification. In turn, biofortification appears as a comparatively advantageous and bearable strategy for the delivery of vitamins and other micronutrients for people without access to a healthy and diverse diet. This approach relies on plant breeding, transgenic techniques, or agronomic practices to obtain a final food product with a higher iron content. It is also known that certain food constituents are able to favor or inhibit iron absorption. The management of these compounds can thus successfully improve the absorption of dietary iron and, ultimately, contribute to fight this disorder present all over the world. This review describes the main causes/manifestations of iron-deficiency anemia, forms of disease prevention and treatment, and the importance of a balanced and preventive diet. A special focus was given to innovative food fortification and biofortification procedures used to improve the iron content in staple food crops.


2018 ◽  
Vol 36 (04) ◽  
pp. 366-376 ◽  
Author(s):  
Richard Burwick ◽  
Shravya Govindappagari

Objective To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the benefits of intravenous (IV) iron in pregnancy. Study Design Systematic review was registered with PROSPERO and performed using PRISMA guidelines. PubMed, MEDLINE, Web of Science, ClinicalTrials.gov, Cochrane Library, and Google Scholar were searched. Eleven RCTs, comparing IV to oral iron for treatment of iron-deficiency anemia in pregnancy, were included. Meta-analyses were performed with Stata software (College Station, TX), utilizing random effects model and method of DerSimonian and Laird. Outcomes were assessed by pooled odds ratios (OR) or pooled weighted mean difference (WMD). Sensitivity analyses were performed for heterogeneity. Results We found that pregnant women receiving IV iron, compared with oral iron, had the following benefits: (1) Achieved target hemoglobin more often, pooled OR 2.66 (95% confidence interval [CI]: 1.71–4.15), p < 0.001; (2) Increased hemoglobin level after 4 weeks, pooled WMD 0.84 g/dL (95% CI: 0.59–1.09), p < 0.001; (3) Decreased adverse reactions, pooled OR 0.35 (95% CI: 0.18–0.67), p = 0.001. Results were unchanged following sensitivity analyses. Conclusion In this meta-analysis, IV iron is superior to oral iron for treatment of iron-deficiency anemia in pregnancy. Women receiving IV iron more often achieve desired hemoglobin targets, faster and with fewer side effects.


2012 ◽  
Vol 08 (02) ◽  
pp. 74
Author(s):  
Mark Janis ◽  

Anemia is highly prevalent, affecting approximately 40 % of cancer patients, and results in a significant decrease in health-related quality of life while also being associated with shorter cancer survival times. A recent survey of 15,000 cancer patients in Europe found that 39 % were anemic at the time of enrolment. In addition, anemia is a recognized complication of myelosuppressive chemotherapy, and it has been estimated that, in the US, around 1.3 million cancer patients who are not anemic at the time of diagnosis will develop anemia during the course of their disease. The etiology of anemia in cancer patients is variable and often multifactorial, and may be the result of an absolute or a functional iron deficiency. Cancer produces an enhanced inflammatory state within the body—causing hepcidin levels to increase and erythropoietin production to decrease—and results in a reduction in erythropoiesis due to impaired iron transport. This type of anemia is known as functional iron deficiency, where the body has adequate iron stores but there are problems with mobilization and transport of the iron. Absolute iron deficiency is when both iron stores and iron transport are low. The National Comprehensive Cancer Network (NCCN) treatment guidelines for cancer-related anemia recommend intravenous (IV) iron products alone for iron repletion in cancer patients with absolute iron deficiency, and erythropoiesis-stimulating agents (ESAs) in combination with IV iron in cancer patients (currently undergoing palliative chemotherapy) with functional iron deficiency. Although IV iron has been demonstrated to enhance the hematopoietic response to ESA therapy, the use of supplemental iron has not yet been optimized in oncology. Here we discuss the significance of iron deficiency anemia in cancer patients and the need to implement tools to properly diagnose this condition, and we provide an overview of the management strategies and recommendations for patients with iron deficiency anemia as outlined in the NCCN guidelines.


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