Diagnosis and treatment of iron-deficiency anaemia in pregnancy and postpartum

Abstract

Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, iron-containing drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely are with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.

Treatment of iron deficiency and iron deficiency anemia with intravenous ferric carboxymaltose in pregnancy

“…Different levels of anemia, patients’ response, compliance, and tolerability to oral iron require individualized treatment. Oral iron replacement is often considered as the first-line treatment [17]. However, it can be ineffective, cause intolerable adverse events, or may not facilitate urgent rapid iron repletion [18, 19].…”

“…However, it can be ineffective, cause intolerable adverse events, or may not facilitate urgent rapid iron repletion [18, 19]. Intravenous iron administration is an alternative treatment option for IDA in pregnancy and has been recommended in various guidelines [17]. The uptake of this administration route has been hindered by perceived barriers and misconceptions, discussed elsewhere [20–22], and has led to the development of new, safer types of iron formulation.…”

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“…The use of oral iron supplementation for a few months is a standard treatment for anaemia in the postpartum period 11 . Therefore, iron deficiency anaemia during pregnancy and postpartum can lead to serious consequences for both mother and child 12 .…”

Principles of the diagnosis and treatment of iron deficiency anemia during pregnancy and the postnatal period

“…жизни ново-рожденного. Это в дальнейшем приводит к снижению у таких детей уровня интеллектуального развития, работо-способности и к нарушениям поведения [3,11,19,20]. Yusrawati et al показали, что дефицит железа у матери оказывает косвенное влияние на снижение концентрации нейротрофического фактора в гиппокампе новорожденно-го, который играет важную роль в развитии способностей к обучению, памяти и поведения [21].…”

“…Yusrawati et al показали, что дефицит железа у матери оказывает косвенное влияние на снижение концентрации нейротрофического фактора в гиппокампе новорожденно-го, который играет важную роль в развитии способностей к обучению, памяти и поведения [21]. В связи с этим своев-ременная диагностика и адекватная терапия ЖДА оказыва-ют положительное воздействие на исходы беременности как для матери, так и для плода [11,19].…”