Iron Deficiency Anaemia in Pregnancy and Postpartum: Pathophysiology and Effect of Oral versus Intravenous Iron Therapy

Abstract

<jats:p>Nutritional iron-deficiency anaemia (IDA) is the most common disorder in the world, affecting more than two billion people. The World Health Organization’s global database on anaemia has estimated a prevalence of 14% based on a regression-based analysis. Recent data show that the prevalence of IDA in pregnant women in industrialized countries is 17.4% while the incidence of IDA in developing countries increases significantly up to 56%. Although oral iron supplementation is widely used for the treatment of IDA, not all patients respond adequately to oral iron therapy. This is due to several factors including the side effects of oral iron which lead to poor compliance and lack of efficacy. The side effects, predominantly gastrointestinal discomfort, occur in a large cohort of patients taking oral iron preparations. Previously, the use of intravenous iron had been associated with undesirable and sometimes serious side effects and therefore was underutilised. However, in recent years, new type II and III iron complexes have been developed, which offer better compliance and toleration as well as high efficacy with a good safety profile. In summary, intravenous iron can be used safely for a rapid repletion of iron stores and correction of anaemia during and after pregnancy.</jats:p>

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

“…Recent reports demonstrate the feasibility of rapid iron polymaltose infusion over 90 minutes [33,34]. However, a test-dose of iron polymaltose (100 mg) should be first administered over 30 minutes.…”

“…However, a test-dose of iron polymaltose (100 mg) should be first administered over 30 minutes. Moreover, the new intravenous iron preparations represent a medical revolution in the effective, rapid and safe repletion of iron stores in the management of IDA and therefore should be considered in the new guidelines of management of IDA in different clinical scenarios [24,34]. This will create an effective and attractive solution in the management of IDA in different populations.…”

Position of the Academy of Nutrition and Dietetics: Nutrition and Lifestyle for a Healthy Pregnancy Outcome

“…Iron deficiency with resultant anemia is the most prevalent micronutrient deficiency worldwide, affecting primarily pregnant or lactating women and young children. 19 Iron deficiency anemia in pregnant women in industrialized countries is 17.4%, 20 with approximately 9% of adolescent girls and women of childbearing age in the United States having inadequate stores of body iron. 19 The high incidence of iron deficiency underscores the need for iron supplementation in pregnancy.…”

“…19 Iron deficiency anemia in pregnant women in industrialized countries is 17.4%, 20 with approximately 9% of adolescent girls and women of childbearing age in the United States having inadequate stores of body iron. 19 The high incidence of iron deficiency underscores the need for iron supplementation in pregnancy. During the first two trimesters of pregnancy, iron deficiency anemia increases the risk for preterm labor, LBW, and infant mortality.…”

“…21 Maternal and fetal demand for iron increases during pregnancy; this increase cannot be met without iron supplementation. 19 Folic acid. Folic acid is recognized as important prior to and during pregnancy because of its preventive properties against neural tube defects.…”