Iron deficiency anaemia in pregnancy: The role of parenteral iron

Esen, Umo I

doi:10.1080/01443615.2016.1180505

Cited by 17 publications

(21 citation statements)

References 27 publications

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“…Values were calculated for a 162‐cm tall woman weighing between 60 and 100 kg. (), Ganzoni formula using ideal bodyweight ( IBW ); (), Ganzoni formula using total bodyweight ( TBW ); (), Ganzoni formula using adjusted bodyweight ( ABW ); (), Simplified Method – dosing weight ≥ 70 kg; (), Simplified Method – dosing weight < 70 kg.…”

Section: Resultsmentioning

confidence: 99%

“…While a number of different intravenous formulations of iron has been studied in pregnancy, dosing strategies are often inconsistent, and there has been no examination of the optimal dosing weight to use when calculating body iron deficit and subsequent iron dose. This is of particular concern given the increasing prevalence of overweight and obesity in pregnancy, leading to confusion in what dosing weight to use.…”

Section: Introductionmentioning

confidence: 99%

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Approaches for optimising intravenous iron dosing in pregnancy: a retrospective cohort study

Grzeskowiak

Qassim

Jeffries

et al. 2017

Internal Medicine Journal

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Background Intravenous iron is commonly utilised in pregnancy when treatment with oral is not tolerated or where rapid replenishment of iron stores is required. Aims To examine the relationship between doses of intravenous iron administered during pregnancy according to different maternal bodyweight measures and subsequent treatment response. Methods Retrospective cohort study of pregnant women with confirmed iron deficiency anaemia who received intravenous iron polymaltose at a tertiary teaching hospital in Australia from 1 January 2014 to 31 January 2016. Diagnosis of anaemia and/or iron deficiency, infusion dosage characteristics and haematological parameters were collected from paper‐based case notes and electronic records. The dose of intravenous iron administered was examined relative to maternal total bodyweight (TBW), ideal bodyweight (IBW) (equation = 45.5 kg + 0.9 kg/cm for each cm over 152 cm) and adjusted bodyweight (equation = IBW + [0.4 × (TBW – IBW)]). Results A total of 122 pregnancies was identified where women had confirmed iron deficiency anaemia and received a single infusion of intravenous iron polymaltose. Dose–response relationships were evident between change in haemoglobin from treatment until delivery and intravenous iron dose according to adjusted bodyweight (adjusted beta coefficient 0.70 (95% CI 0.24–1.15)) and pre‐pregnancy total bodyweight (adjusted beta coefficient 0.83 (95% CI 0.36–1.29)), but not ideal bodyweight (adjusted beta coefficient 0.37 (95% CI −0.04–0.78)). Calculating iron deficit using adjusted bodyweight most closely matched that based on a physiological estimate of iron deficit according to weight‐based total blood volume. Conclusion Optimal treatment outcomes in pregnant women requiring intravenous iron may be reached by dosing according to adjusted pre‐pregnancy bodyweight rather than ideal bodyweight.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Approaches for optimising intravenous iron dosing in pregnancy: a retrospective cohort study

Grzeskowiak

Qassim

Jeffries

et al. 2017

Internal Medicine Journal

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“…The risk factors related to IDA among women include low socio-economic status, social deprivation, teenage pregnancy, high parity, multiple pregnancies, and short inter-pregnancy intervals. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy and safety of intravenous ferric carboxymaltose and iron sucrose for iron deficiency anemia in obstetric and gynecologic patients

Shin¹,

Go²,

Lee³

et al. 2021

Medicine

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Introduction: Iron deficiency anemia (IDA) is common among obstetric and gynecologic patients. This systematic review aimed to assess the comparative efficacy and safety of commonly used intravenous (IV) iron formulations, ferric carboxymaltose (FCM), and iron sucrose (IS) in the treatment of IDA in obstetric and gynecologic patients. Methods: We systematically searched PubMed, EMBASE, Cochrane CENTRAL, and Google Scholar for eligible randomized controlled trials (RCTs) comparing IV iron replacement using FCM and IS up to October 2019. The primary outcome was to compare the efficacy of FCM and IS, assessed by measuring serum hemoglobin (Hb) and ferritin levels before and after iron replacement. The secondary outcome was to compare the safety of FCM and IS, assessed by the incidence of adverse events during iron replacement. The meta-analysis was performed using RevMan 5.3. Results: We identified 9 RCTs with 910 patients (FCM group, n = 456; IS group, n = 454). Before iron replacement, FCM and IS group patients had similar baseline Hb (mean difference [MD], 0.04 g/dL; 95% confidence interval [CI], −0.07 to 015; I 2 = 0%; P = 0.48) and ferritin levels (MD, −0.42 ng/mL; 95% CI, −1.61 to 0.78; I 2 = 45%; P = 0.49). Following iron replacement, patients who received FCM had higher Hb (MD, 0.67; 95% CI, 0.25–1.08; I 2 = 92%; P = 0.002) and ferritin levels (MD, 24.41; 95% CI, 12.06–36.76; I 2 = 75%; P = 0.0001) than patients who received IS. FCM group showed a lower incidence of adverse events following iron replacement than IS group (risk ratio, 0.53; 95% CI, 0.35–0.80; I 2 = 0%; P = 0.003). Serious adverse events were not reported in any group. Conclusion: FCM group showed better efficacy in increasing Hb and ferritin levels and a favorable safety profile with fewer adverse events compared with IS group for IDA treatment among obstetric and gynecologic patients. However, this meta-analysis was limited by the small number of RCTs and high heterogeneity. Trial registration: The review was prospectively registered with the International Prospective Registry of Systematic Reviews ( https://www.crd.york.ac.uk/prospero/ , registration number CRD42019148905).

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“…In fact, ID is the major cause of anemia in pregnancy and can increase the perinatal maternal morbidity and mortality. (3,4) Iron is also an essential micronutrient for fetal and infant brain development. Iron deficiency in early life is associated with worse cognitive, motor, social emotional as well as neurophysiological development.…”

Section: Introductionmentioning

confidence: 99%

Iron status of full-term infants in early infancy is not associated with maternal ferritin levels nor infant feeding practice

Chan

Tsun

et al. 2021

Br J Nutr

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Iron deficiency (ID) in early life is associated with morbidities. Most fetal iron required for infant growth is acquired in the third trimester from maternal iron store. However, how prenatal iron level affects ferritin level in early infancy remains controversial. This study aimed to examine the associations between maternal ferritin levels and cord blood serum ferritin (CBSF) and to compare the ferritin levels between different feeding practices in early infancy. Healthy Chinese mothers with uncomplicated pregnancy and their infants were followed up at 3 months post-delivery for questionnaire completion and infant blood collection. Infants who were predominantly breastfed and those who were predominantly formula fed were included in this analysis. Serum ferritin levels were measured in maternal blood samples collected upon delivery, cord blood and infant blood samples at 3 months of age. Ninety-seven mother-baby dyads were included. Maternal ID is common (56%) while the CBSF levels were significantly higher than maternal ferritin levels. Only 3 infants (3%) had ID at 3 months of age. There were no significant correlations between maternal ferritin levels with CBSF (r=0.168, p=0.108) nor with infant ferritin levels at 3 months of age (r=0.023, p=0.828). Infant ferritin levels at 3 months were significantly and independently associated with CBSF (p=0.007) and birth weight (p<0.001) after adjusting for maternal age, parity, maternal education, infant sex and feeding practice. In conclusion, maternal ID was common upon delivery. However, maternal ferritin levels were not significantly associated with CBSF concentrations nor infant ferritin concentrations at 3 months of age.

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Iron deficiency anaemia in pregnancy: The role of parenteral iron

Cited by 17 publications

References 27 publications

Approaches for optimising intravenous iron dosing in pregnancy: a retrospective cohort study

Approaches for optimising intravenous iron dosing in pregnancy: a retrospective cohort study

Comparative efficacy and safety of intravenous ferric carboxymaltose and iron sucrose for iron deficiency anemia in obstetric and gynecologic patients

Iron status of full-term infants in early infancy is not associated with maternal ferritin levels nor infant feeding practice

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