Effect Of Oral Iron Therapy Research Articles

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

Background and aim Oral iron therapy is effective in treating iron deficiency anemia in outpatient pregnant womenbut 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 hospitalizedfor 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.

Study of Coagulation Profile in Iron Deficiency Anaemia in Antenatal Patients and Effect of Oral Iron Therapy

Background: Iron deficiency anaemia (IDA) is a quite common factor during pregnancy in under developedcountries. It impairs the coagulation factors of the blood and leads to frequency of pre-term labour and low birthweight infantsMethod: 150 pregnant women having Hb% (gm/dl) less than 10% were compared with 100 normal (controlled)groups. The haematological and coagulation profile in both patients were studied and compared.Results: The haematological parameters Hb%, TLC, DLC, MCV,(fl)MCH (pg) MCHC had significant p value(p<0.001) in both groups comparison. In the study of coagulation profile of both groups comparison except BT(bleeding time) all values were highly significant.Conclusion: The present study will be a tool for physician, gynaecologist to treat such patient efficiently to presentmorbidity and mortality of mother and infant as well.

Effect of Oral Iron Therapy in Moderately Affected Anemianic Pregnant Women

In India, Iron deficiency anemia is one of the major causes of maternal deaths, over the past years, various oral and intra muscular & intravenous preparations of iron have been used for correction of iron muscular are associated with significant side effects; Intramuscular (Iron dextran) was used as an alternative to oral iron therapy for those who were not compliant to oral therapy. Iron dextran has a lot of side effects such as fever, arthralgia, even anaphylactic reactions extending to pulmonary edema and even death. Further it is not possible to achieve the target rise in Hemoglobin level in a limited time period, when the patient is approaching term. Whereas Intravenous (Iron sucrose complex) is a relatively new drug which is a BOON to medical therapy and is the BEST OPTION of iron therapy when used as an alternative to oral therapy as it restores iron stores more promptly and is able to raise the hemoglobin to satisfactory level .

Effect of iron therapy on red cell indices and hemoglobin subtypes on patients with beta-thalassemia trait who developed iron-deficiency anemia: a tertiary center experience

BackgroundThe combination of beta-thalassemia trait (BTT) and iron-deficiency anemia (IDA) is an interesting common issue in our country. However, treatment of this condition is challenging.ObjectivesThis prospective observational study was designed to evaluate the effect of oral iron therapy on red cell indices, iron status, and hemoglobin A2 levels in patients with BTT who developed IDA.Patients and methodsA total of 50 patients with BTT who developed IDA were included. A complete blood count, iron status, and follow-up hemoglobin electrophoresis by high-performance liquid chromatography were done. The patients with BTT received oral iron therapy of 60mg elemental iron three times/day for a period of 5 months, and the investigations were repeated after 3 and 5 months of treatment.ResultsThere was a statistically significant increase in hemoglobin level (P<0.001 each), mean corpuscular volume (P<0.001 each), mean corpuscular hemoglobin (P=0.004 and P<0.001, respectively), mean corpuscular hemoglobin concentration (P=0.007 and P=0.001, respectively), serum iron (P<0.001 each), serum ferritin (P<0.001 each), and hemoglobin A2 levels (P=0.001 and P=0.005, respectively), whereas significant decrease in the total iron-binding capacity (P=0.001, and P=0.005, respectively) after the third and fifth month of oral iron therapy.ConclusionIt is important to suspect, recognize, and correct IDA in patients with BTT and to repeat hemoglobin electrophoresis after iron therapy.

Iron supplementation should be given in breath-holding spells regardless of anemia

Background/aim The purpose of this retrospective study was to determine the effectiveness of oral iron therapy in breath-holding spells and evaluation of electrocardiographical changes.Materials and methods Three hundred twelve children aged 1–48 months and diagnosed with breath-holding spells between January 2017 and April 2018 were included. Patients’ laboratory findings were compared with 100 patients who had one simple febrile seizure.Results Cyanotic breath-holding spells were diagnosed in 85.3% (n = 266) of patients, pallid spells in 5.1% (n = 16), and mixed-type spells in 9.6% (n = 30). Sleep electroencephalograms were applied for all patients, 98.2% (n = 306) of which were normal, while slow background rhythm was determined in 1.2% (n = 4). Epileptic activity was observed in only 2 patients (0.6%). The mean hemoglobin (Hb) value in the breath-holding spell group was 10.1 mg/dL. Patients’ mean corpuscular volume (MCV) was 73 fL. Patients’ Hb and MCV values were statistically significantly lower than those of the control group (P < 0.001). The difference between spell burden was not statistically significant (P = 0.691). Spell burden decreased equally in both groups.Conclusion Oral iron therapy can be administered in breath-holding seizures irrespective of whether or not the patient is anemic.

Targeting, Monitoring and Effect of Oral Iron Therapy on Haemoglobin Levels in Older Patients Discharged to Primary Care from Inpatient Rehabilitation: A Cohort Study Using Routinely Collected Data.

Oral iron is commonly prescribed to older patients with suspected or confirmed iron-deficiency anaemia; however, few studies have examined the effectiveness of oral iron therapy in the real world in this population. We therefore determined the prevalence of iron deficiency in older people prescribed oral iron, examined the response mounted to therapy and ascertained predictors of response to oral iron. We analysed a routinely collected, linked dataset from older patients who had undergone inpatient rehabilitation between 1999 and 2011. An initial analysis examined patients within this cohort who were prescribed iron after rehabilitation and derived three groups based upon their ferritin and transferrin indices: probably, possibly and not iron deficient. A second analysis compared pre- and post-treatment haemoglobin to determine the degree of response to iron therapy across each category of deficiency. Finally, patient demographics, linked biochemistry data and comorbid disease based on International Classification of Disease (ICD-10) codes from previous hospital admissions were used in regression modelling to evaluate factors affecting response to therapy. A total of 490 patients were prescribed oral iron within 90 days of rehabilitation discharge. Of these, 413 (84%) had iron indices performed; 94 (23%) were possibly deficient, 224 (54%) were probably deficient, and 95 (23%) were not deficient. Of the 490 patients, 360 had both pre- and post-treatment haemoglobin data and iron indices; probably deficient patients mounted a slightly greater response to oral iron (17 vs. 12g/L for not deficient; p<0.05). Only pre-treatment haemoglobin, mean cell volume and lower gastrointestinal pathology were significant predictors of a response to oral iron therapy. Notably, acid-suppressant use was not a predictor of response. We conclude that many older patients are exposed to oral iron without good evidence of either iron deficiency or a significant response to therapy.

A study of correlation between iron deficiency anaemia and serum lipid profile in Indian adults in BRIMS, Bidar

Background: Both iron deficiency anemia and dyslipidaemia are widely prevalent public health problems, especially in the Indian population. Some link has been suggested between the two potentially morbid conditions but a sufficient Indian study could not be found in this regard. Methods: This study was planned to find the changes in serum lipid profile in adult Indian patients with iron deficiency anemia and the effect of oral iron therapy on them. 100 iron deficiency anemia and 70 age and sex matched healthy controls, in the age group 18-35 years were investigated for any possible changes in serum lipid profile i.e., triglycerides, total cholesterol, high density lipoprotein cholesterol, very low density lipoprotein cholesterol. The patients were followed up after 3 months of oral iron therapy. Results: The results are shown as mean± standard deviation. Triglycerides and very low density lipoprotein cholesterol levels were found to be significantly (P <0.001) elevated in the iron deficiency anemia group (151.87 ± 48.06 mg/dl and 30.40 ± 9.71 mg/dl) as compared to controls (109.99 ± 30.81 mg/dl and 21.96 ± 6.69 mg/dl), whereas level of low density lipoprotein cholesterol were found to be significantly (P = 0.02) lower in patients (90.96 ± 41.55 mg/dl) as compared to controls (105.24 ± 26.45 mg/dl). However, after treatment (in 43 patients) there was significant (P <0.001) reduction in the levels of triglycerides and very low density lipoprotein cholesterol (111.56 ± 26.87 mg/dl and 22.30 ± 5.36 mg/dl) when compared to their pretreatment level (154.70 ± 53.89 mg/dl and 30.93 ± 10.84 mg/dl), whereas low density lipoprotein cholesterol levels did not show any significant change. Conclusion: These findings indicate that iron deficiency anemia in Indian adults is attended by abnormal serum lipid profile, which responds significantly to iron therapy.

Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial

The true benefit of iron supplementation for nonanemic menstruating women with fatigue is unknown. We studied the effect of oral iron therapy on fatigue and quality of life, as well as on hemoglobin, ferritin and soluble transferrin receptor levels, in nonanemic iron-deficient women with unexplained fatigue. We performed a multicentre, parallel, randomized controlled, closed-label, observer-blinded trial. We recruited from the practices of 44 primary care physicians in France from March to July 2006. We randomly assigned 198 women aged 18-53 years who complained of fatigue and who had a ferritin level of less than 50 ug/L and hemoglobin greater than 12.0 g/dL to receive either oral ferrous sulfate (80 mg of elemental iron daily; n=102) or placebo (n=96) for 12 weeks. The primary outcome was fatigue as measured on the Current and Past Psychological Scale. Biological markers were measured at 6 and 12 weeks. The mean score on the Current and Past Psychological Scale for fatigue decreased by 47.7% in the iron group and by 28.8% in the placebo group (difference -18.9%, 95% CI -34.5 to -3.2; p=0.02), but there were no significant effects on quality of life (p=0.2), depression (p=0.97) or anxiety (p=0.5). Compared with placebo, iron supplementation increased hemoglobin (0.32 g/dL; p=0.002) and ferritin (11.4 μg/L; p<0.001) and decreased soluble transferrin receptor (-0.54 mg/L; p<0.001) at 12 weeks. Iron supplementation should be considered for women with unexplained fatigue who have ferritin levels below 50 μg/L. We suggest assessing the efficiency using blood markers after six weeks of treatment. Trial registration no. EudraCT 2006-000478-56.

Intérêt du fer intraveineux dans les anémies induites par l'hémodilution en chirurgie cardiaque pédiatrique

Objective. – Anaemia is the main complication following haemodilution in paediatric cardiac surgery. Iron oral therapy is ineffective to improve anaemia. The aim of this study is to assess the effect of a single dose of intravenous iron saccharate Venofer ®. Study design. – Open, randomized. Patients and methods. – 93 patients were randomized in two groups. The first one is the control group without iron supplementation and the second one received a 5 mg/kg injection of Venofer ® administered at day 1. Three biological factors were studied on day 1 and day 5 following surgery: haemoglobin, ferrritin and reticulocyte rate. Student test was used for statistical analysis of results. Results. – Age, weight, haemoglobin, ferritine and reticulocyte on day 1 were similar in both group (no significant difference). On day 5 ferritin was higher in the treated group 215 ± 87 vs 101 ± 55 μg/l in the non treated group ( P < 0.001). Reticulocyte rate was also higher in the treated group 3.25 ± 1.16 vs 2.65 ± 0.97% ( P < 0.005) in the untreated group. Conclusion. – Postoperative systemic inflammation is probably the factor which impaired the effect of oral iron therapy. Parenteral iron may act by treating a functional iron deficiency and/or by increasing endogenous erythropoietin synthesis. Faster reversibility of anaemia following iron injection improves quality of the postoperative recovery.

Iron status in exercising women: the effect of oral iron therapy vs increased consumption of muscle foods

Forty-seven previously sedentary women participating in a 12-wk moderate aerobic-exercise program were randomly assigned to one of four dietary groups: 50-mg/d iron supplement and a low food-iron diet (50 FE + EX), 10-mg/d iron supplement and a low food-iron diet (10 FE + EX), placebo and unrestricted diet (P + EX), and meat supplement and high food-iron diet (M + EX). A sedentary control group (n = 13) received no dietary interventions. Hematocrit, total iron-binding capacity, and hemoglobin, serum iron, serum ferritin, and serum albumin concentrations were measured every 4 wk. Hemoglobin values decreased at the end of 4 wk in all exercising groups compared with the control group. Iron status in the 50 FE + EX and M + EX groups improved after week 4 as indicated by an increase in serum ferritin, serum iron, and hemoglobin concentrations, and a decline in total iron-binding capacity. Thus, short-term, moderate aerobic exercise resulted in compromised iron status that was offset to varying degrees by ingesting iron or meat supplements. However, meat supplements were more effective in protecting hemoglobin and ferritin status than were iron supplements.

Effect of oral iron therapy on the upper gastrointestinal tract. A prospective evaluation.

This study assesses the effect of oral iron therapy on the upper gastrointestinal tract and fecal occult blood testing. Fourteen healthy volunteers completed a checklist of gastrointestinal symptoms, underwent endoscopy and biopsy of the stomach and duodenum, and supplied a fresh stool sample for Hemoccult and HemoQuant testing. They then took ferrous sulfate 325 mg per os tid for two weeks and had the same evaluation repeated. Gastrointestinal symptoms were rated by the patients on a scale of 0-3, endoscopic findings were numerically scored (0-4), and the biopsies were graded blindly. Thirteen other healthy volunteers took ferrous sulfate 325 mg per os tid for one week and had Hemoccult testing of stool at days 0 and 7. All subjects developed dark stools, and significant nausea and diarrhea were noted (0.1 +/- 0.1 to 0.9 +/- 0.3, P less than 0.05 for both symptoms). Only 1/27 had a questionably trace-positive Hemoccult test (two observers disagreed) and no significant difference was seen in HemoQuant testing (1.4 +/- 0.5 to 1.8 +/- 0.7 mg Hb/g). A significant increase was seen in endoscopic abnormalities in the stomach (0.1 +/- 0.1 to 1.5 +/- 0.3, P = 0.003), consisting of erythema, small areas of subepithelial hemorrhage, and, in two subjects, erosions. Biopsies showed no significant change after iron therapy. We conclude that (1) oral ferrous sulfate rarely causes Hemoccult-positive stools, and patients with positive Hemoccult tests on iron therapy require further evaluation; and (2) oral iron may cause mild endoscopic abnormalities in the stomach which are of uncertain clinical significance.

THE EFFECT OF ORAL IRON THERAPY ON THE STOOL GUAIAC AND ORTHOTOLIDINE REACTIONS.

Article1 August 1963The Effect of Oral Iron Therapy on the Stool Guaiac and Orthotolidine ReactionsJAMES R. BRAYSHAW, M.D., FORREST HARRIS, M.D., PAUL R. MCCURDY, M.D.JAMES R. BRAYSHAW, M.D.Search for more papers by this author, FORREST HARRIS, M.D.Search for more papers by this author, PAUL R. MCCURDY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-59-2-172 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince occult gastrointestinal bleeding is of paramount importance in the genesis of iron deficiency in the adult, the physician must know how oral therapy with iron salts affects the results of the commonly used tests for occult blood in the stool. Some investigators have suggested that oral iron can produce a weakly positive guaiac reaction (1, 2), but others have been unable to confirm these findings (3-6). Interpretation of these studies is difficult because there were relatively few determinations, the types and doses of oral iron varied, and the tests were not performed by one individual in standard fashion.The...