Is every other day iron supplementation effective for the treatment of the iron deficiency anemia in pregnancy?

Karakoç, Gökhan; Örgül, Gökçen; Şahın, Dilek; Yücel, Aykan

doi:10.1080/14767058.2021.1910666

Cited by 12 publications

(9 citation statements)

References 8 publications

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“…These encompass dietary diversification, food fortification and individual oral iron supplementation, as the first line method [12]. Considering the gastrointestinal upset caused by iron supplementation, this can be administered every other day with similar efficiency [13].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection

et al. 2022

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Anemia is a very common occurrence during pregnancy, with important variations during each trimester. Anemia was also considered as a risk factor for severity and negative outcomes in patients with SARS-CoV-2 infection. As the COVID-19 pandemic poses a significant threat for pregnant women in terms of infection risk and access to care, we developed a study to determine the impact of nutritional supplementation for iron deficiency anemia in correlation with the status of SARS-CoV-2 infection. In a case-control design, we identified 446 pregnancies that matched our inclusion criteria from the hospital database. The cases and controls were stratified by SARS-CoV-2 infection history to observe the association between exposure and outcomes in both the mother and the newborn. A total of 95 pregnant women were diagnosed with COVID-19, having a significantly higher proportion of iron deficiency anemia. Low birth weight, prematurity, and lower APGAR scores were statistically more often occurring in the COVID-19 group. Birth weight showed a wide variation by nutritional supplementation during pregnancy. A daily combination of iron and folate was the optimal choice to normalize the weight at birth. The complete blood count and laboratory studies for iron deficiency showed significantly decreased levels in association with SARS-CoV-2 exposure. Puerperal infection, emergency c-section, and small for gestational age were strongly associated with anemia in patients with COVID-19. It is imperative to screen for iron and folate deficiency in pregnancies at risk for complications, and it is recommended to supplement the nutritional intake of these two to promote the normal development and growth of the newborn and avoid multiple complications during pregnancy in the COVID-19 pandemic setting.

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Section: Introductionmentioning

confidence: 99%

The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection

et al. 2022

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“…Multiple studies comparing the effects of PO iron versus placebo in the outpatient setting have found a change in Hb level of 1-2 g/dL over approximately 20 weeks, which is unrealistic in this patient population [ 19 - 25 ] (see appendix). In several studies, there was little to no benefit in giving more than 30-65 mg of elemental iron per day to pregnant women, and it may be as beneficial to give every other day dosing [ 20 - 21 , 24 , 26 - 27 ]. The iron group in our study achieved close to 85 mg/day of elemental iron, yet no rise in Hb level was detected, likely related to the unanticipated short duration of therapy.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Oral Iron Therapy in Anemic Inpatient Pregnant Women: A Single Center Retrospective Cohort Study

Sutter,

Freundlich,

Raymond

et al. 2024

Cureus

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Background and aim Oral iron therapy is effective in treating iron deficiency anemia in outpatient pregnant women but has not been studied in inpatient pregnant women. We aimed to evaluate the effect of oral iron therapy versus no therapy during hospitalization on maternal and neonatal outcomes in women with anemia who are hospitalized for pregnancy-related morbidities (i.e., preterm premature rupture of membranes, preterm labor, pre-eclampsia, abnormal placentation, or fetal monitoring). Methods A retrospective, single-center study was conducted in hospitalized pregnant women (2018 to 2020) with inpatient stays of more than three days. The primary outcome was a change in hemoglobin level from admission to delivery in women treated with oral iron compared with those left untreated. Secondary outcomes included the total amount of iron administered before delivery, the time interval from admission to delivery, and neonatal effects. Results Two hundred sixty-three women were admitted, 79 women had anemia, and 29 (36.7%) received at least one dose of oral iron. Baseline patient characteristics were similar between groups. The median (interquartile range) dose of iron in the oral iron group was 1185.0 (477.0, 1874.0) mg. Neither absolute hemoglobin before delivery (control group: 10.0±1.2 g/dL; iron group: 10.1±1.1 g/dL; p=0.774) nor change in hemoglobin from admission to delivery (control group: -0.1±1.1 g/dL vs. iron group: 0.4±1.1 g/dL; p=0.232) differed between groups. Women in the control group had shorter length of stay (LOS) median (IQR) than women in the iron group (control group: 7.1 (5.0, 13.7) days; iron group: 11.4 (7.4, 25.9) days; p=0.03). There were no differences in maternal mode of delivery, though each group had high rates of cesarean delivery (control group: 53.7%; iron group: 72.4%; p=0.181). There were no differences in estimated blood loss at delivery (control group: 559±401; iron group: 662.1±337.4;p=0.264) in either group. Neonatal birthweight (control group: 1.9±0.7 kg; iron group: 1.9±0.7 kg; p=0.901), birth hemoglobin (control group: 16.3±2.2 g/dL; iron group: 16±2.2 g/dL; p=0.569), neonatal intensive care unit (NICU) admission (control group: 93.3%; iron group: 84.8%;p=0.272 ), or neonatal death (control group: 8.9%; iron group: 3%; p=0.394) were not different between groups. Conclusions Oral iron administered to anemic inpatient pregnant women was not associated with higher hemoglobin concentrations before delivery. Lack of standardized iron regimens and short hospital stays may contribute to the inefficacy of oral iron for this inpatient pregnant population. The small sample size and retrospective nature of this study are limiting factors in drawing conclusive evidence from this study.

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“…The issue of patient adherence remains a pressing barrier. One of the simplest and most effective ways of improving adherence is using alternate day (every other day) dosing protocols, which have been shown to result in effective iron replenishment with fewer adverse effects 54 . Future studies aimed at improving compliance and access to iron supplementation (both oral and parenteral) in the populations identified at highest risk will help to address this gap.…”

Section: Discussionmentioning

confidence: 99%

Identification and treatment of iron‐deficiency anemia in pregnancy and postpartum: A systematic review and quality appraisal of guidelines using AGREE II

Mintsopoulos

Tannenbaum

Malinowski

et al. 2023

Intl J Gynecology & Obste

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BackgroundSeveral international guidelines provide recommendations for the optimal management of iron‐deficiency anemia (IDA) in the pregnant and postpartum populations.ObjectivesTo review the quality of guidelines containing recommendations for the identification and treatment of IDA in pregnancy and postpartum using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and to summarize their recommendations.Search StrategyPubMed, Medline, and Embase databases were searched from inception to August 2, 2021. A web engine search was also performed.Selection CriteriaClinical practice guidelines that focused on the management of IDA in pregnancy and/or postpartum populations were included.Data Collection and AnalysisIncluded guidelines were appraised using AGREE II independently by two reviewers. Domain scores greater than 70% were considered high‐quality. Overall scores of six or seven (out of a possible seven) were considered high‐quality guidelines. Recommendations on IDA management were extracted and summarized.Main ResultsOf 2887 citations, 16 guidelines were included. Only six (37.5%) guidelines were deemed high‐quality and were recommended by the reviewers. All 16 (100%) guidelines discussed the management of IDA in pregnancy, and 10 (62.5%) also included information on the management of IDA in the postpartum period.ConclusionsThe complex interplay of racial, ethnic, and socioeconomic disparities was rarely addressed, which limits the generalizability of the recommendations. In addition, many guidelines failed to identify barriers to implementation, strategies to improve uptake or iron treatment, and resource and cost implications of clinical recommendations. These findings highlight important areas to target future work.

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Is every other day iron supplementation effective for the treatment of the iron deficiency anemia in pregnancy?

Cited by 12 publications

References 8 publications

The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection

The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with SARS-CoV-2 Infection

Effectiveness of Oral Iron Therapy in Anemic Inpatient Pregnant Women: A Single Center Retrospective Cohort Study

Identification and treatment of iron‐deficiency anemia in pregnancy and postpartum: A systematic review and quality appraisal of guidelines using AGREE II

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