Treatment Of Anemia In Pregnancy Research Articles

Study of Iron Deficiency Anemia in First Three Trimesters of Pregnant Women During in RAMADAN: A Prospective Study

Background: Iron deficiency is defined as a condition in which Hemoglobin (Hb) level in the body is lower than normal, which results in decreased oxygen-carrying capacity of red blood cells to tissues, Pregnant women with Iron Deficiency Anemia are at a higher risk of postpartum hemorrhage. Methods: This study was a prospective analytical study conducted at the Sabratha Laboratory from RAMADAN 2021 to 2023. This study was conducted on all pregnant women with hemoglobin level less than 11 gm/dl in the first trimester and less than 10 gm/dl in the second and third trimesters. Data were 30 cases collected by studying from the Sabratha Laboratory in Libya. A self-designed questionnaire was used. The questionnaire was translated into the Arabic language for ease of understanding and administration to study the population. Conclusion: To improve maternal and fetal outcomes, it is recommended that primary health care has to be strengthened and high priority has to be given to aspects such as prevention, early diagnosis, and treatment of anemia in pregnancy before Fasting Ramadan.

Treatment of anaemia in pregnancy with oral iron, folic acid or iron, folic acid and vitamin B12 supplementation: A hospital-based open randomized study

: National iron plus initiative recommended that anaemic pregnant women should be treated with 200 mg of elemental iron and 1 mg folic acid. An increase in vitamin B12 deficiency has been reported in last two decades. An open randomised study was taken up in urban antenatal clinics to assess the impact of addition of vitamin B12 to the iron and folic acid supplementation.: Anaemic pregnant women willing to participate in the study were randomised into Group 1 (240 iron mg and 5 mg folic acid) or Group 2 (240 mg iron, 1.5 mg of folic acid and 15 µg vitamin B12); the impact of supplementation on Hb, ferritin, folic acid and vitamin B12 was assessed.: In both groups mean Hb improved by 1g/dL at 8 weeks and by 1.5g/dL by 38 weeks of pregnancy; at 38 weeks only 30% were anaemic. Mean ferritin and folic acid levels improved in both groups. There was a fall in the mean vitamin B12 levels in the group which received 5 mg of folic acid.: With assured supply and supportive supervision, the supplementation achieved substantial reduction in anaemia in both groups. Supplementation with folic acid 5 mg should not be done because it causes a fall in vitamin B12 levels. The reason why addition of vitamin B12 to iron folic acid supplementation did not result in improvement in mean Hb, or vitamin B12 levels has to be investigated.

Clinical outcome post treatment of anemia in pregnancy with intravenous versus oral iron therapy: a systematic review and meta-analysis

Oral iron therapy is often the most common way of treating anaemia; however intravenous iron is considered effective due to rapid iron replenishment. We have dearth of evidence on clinical outcomes post treatment of anaemia. We have searched studies published in English in PubMed, Cochrane, Scopus, ProQuest, and Google Scholar. Our study analysed the clinical outcomes amongst neonates and mother and the adverse events post treatment and assessed the mean change in maternal haemoglobin concentration in both the groups. Forest plots for the clinical outcomes are presented. From a total of 370 studies, 34 Randomized and quasi experimental studies comparing clinical outcomes post-treatment of anaemia in pregnancy were included for quantitative evidence synthesis. Pooled results of maternal clinical outcomes using random effect model [OR: 0.79 (95% CI 0.66; 0.95); 10 outcomes; 17 studies] showed statistically significant difference among both the groups [Moderate quality evidence]; however no significant difference [OR: 0.99 (95% CI 0.86; 1.14); 7 outcomes; 8 studies] have been observed for neonatal complications [Low quality evidence]. The study found that pregnant women receiving IV iron were significantly less likely to experience adverse events as compared with those receiving oral iron [OR 0.39; (95% CI 0.26–0.60)]; 34 studies; 13,909 women; [Low quality evidence]. Findings from meta-regression analysis showed that IV iron is more likely to reduce maternal complications by 21% compared to oral iron. Increase in odds of adverse maternal outcomes was observed due to increase in gestational age and publication year but no effect for the type of drug used. IV iron increases Hb more and at a higher pace than oral iron. Intravenous iron is more likely to avert adverse maternal outcomes and adverse reactions. However, there is no conclusive evidence on its effectiveness on individual maternal outcome or neonatal outcome/s. Protocol registered with PROSPERO CRD42022368346).

Intravenous infusions of ferumoxytol compared to oral ferrous sulfate for the treatment of anemia in pregnancy: a randomized controlled trial

Iron-deficiency anemia in pregnancy is highly prevalent and presents significant risk to patients. Initial treatment is often with oral medication. We hypothesized that intravenous ferumoxytol would result in superior treatment of anemia as compared to oral ferrous sulfate. This study aimed to investigate whether 2 infusions of intravenous ferumoxytol are superior to the use of twice-daily oral ferrous sulfate for the treatment of iron-deficiency anemia in pregnancy. A randomized controlled trial was performed in which participants with anemic (hemoglobin <11 g/dL and hematocrit <33%) were allocated to receive either 2 infusions of 510 mg of intravenous ferumoxytol approximately 7 days apart, or 325 mg oral ferrous sulfate twice daily from enrollment to the end of their pregnancy. Participants were randomized in a 1:1 ratio to each treatment. Our primary outcome was the change in maternal hemoglobin. Secondary outcomes included maternal iron indices, maternal safety, and maternal tolerability. There were 124 participants (N=62 per group). In the intravenous iron group, the mean change in hemoglobin was 1.86 g/dL (95% confidence interval, 1.57 g/dL-2.14 g/dL) and in the oral group was 0.79 g/dL (95% confidence interval, 0.42 g/dL-1.17 g/dL) (P<.0001). The median change in ferritin between groups was 64.5 (range, 31-364) vs 8 (range, -436 to +167) (P=.0001). The median change in iron between groups was also statistically significant with 47.5 ug/dL (range, -133 ug/dL to +664 ug/dL) in the intravenous group vs 8.5 ug/dL (range, -313 ug/dL to +437 ug/dL) in the oral iron group (P=.001). Intravenous ferumoxytol was well tolerated, and it was associated with statistically significant increases in maternal hemoglobin, hematocrit, iron, and ferritin compared to oral ferrous sulfate.

Efficacy and Safety of Shengxuening Combined with Conventional Iron Supplementation in the Treatment of Anemia during Pregnancy: A Systematic Review and Meta-analysis.

To evaluate the efficacy and safety of Shengxuening combined with conventional iron supplementation in the treatment of anemia during pregnancy. Electronic searches of Embase, Web of Science, Cochrane Library, China Biomedical Literature Database (CBM), China Knowledge Network (CNKI), Wanfang database (Wanfang), and China Science and Technology Journal Database (VIP) were conducted. A randomized controlled trial of Shengxuening combined with conventional iron supplements for the treatment of anemia in pregnancy was included. The quality of the included trials was assessed using the Cochrane Handbook's Risk of Bias Assessment Tool (version 5.1.0), and data analysis was performed using RevMan 5.4 software and Stata 15.0 statistical software. A total of 150 studies were detected and 17 studies with a total of 1741 cases were finally included. Meta-analysis results showed that the effectiveness of Shengxuening combined with conventional iron supplementation was significantly better than that of conventional iron supplementation alone, and the adverse effects were significantly reduced compared with that of iron supplementation alone, and various anemia indicators such as Hb, RBC, MCV, and MCHC and iron metabolism indicators such as SI and TSAT were also significantly increased. The efficacy of the combination of Shengxuening and conventional iron supplementation in the treatment of anemia in pregnancy is better than that of conventional iron supplementation alone, and the adverse effects in the experimental group are much less than those in the control group, but the quality of the included studies is not high, and more high-quality randomized controlled trials are needed for further validation.

Prevalence of Anaemia and its Socio-Demographic Characteristics among Pregnant Women Attending the Antenatal Booking Clinic in Esut Teaching Hospital (Esuth), Enugu

Background: Anaemia is the commonest haematological abnormality diagnosed in pregnancy and continues to be a major public health problem in the developing, poor resource countries. It is associated with increased rates of maternal and perinatal morbidity and mortality. The prevalence of anaemia among pregnant women is estimated to be very high in Nigeria and other developing countries. Knowledge of the current situation in our environment will help antenatal care-givers in prevention, early detection and prompt management of anaemia so as to mitigate its attendant complications in pregnancy. Aim: To determine the prevalence and socio-demographic characteristics of anaemia among pregnant women in ESUTH. Specific objectives The objectives of this study were to determine: • the prevalence of anaemia • the prevalence of the different grades of anaemia • the distribution of anaemia based on socio-demographic characteristics among pregnant women at the antenatal booking clinic of ESUTH. Method: This was a cross-sectional study of 370 women who booked for antenatal care at the ESUTH from august 1, to December 31, 2020. Women who came for antenatal booking were counseled on the study and informed consent obtained. A proforma was used to collect their bio-data and other relevant obstetric and medical information. A sample of venous blood was collected and the haemoglobin concentration determined using haemoglobinometer. Data analysis: Data was analyzed using Statistical Package for Social Sciences, SPSS version 20.0 for Windows. Frequencies and percentages were calculated and represented in tables and charts. Result: The result showed that out of the 370 women recruited into the study 295 (65.1%) had anaemia of which 155 (41.9%) were mild, 69 (18.6%) were moderate and 17 (4.6%) were severe. Conclusion and recommendation: Anaemia in pregnancy has an unacceptably high prevalence among our pregnant women. Efforts should be made to increase community health education/awareness on child spacing, consumption of balanced diet and early antenatal booking so as to prevent, enhance early detection and adequate treatment of anaemia in pregnancy.

A Cross Sectional Study on Prevalence of Anaemia and its Determinant Factors among Pregnant Mothers in a Rural Community

Anemia is the greatest common nutritional deficiency disorders affecting the pregnant women in the developing countries and determine the prevalence of anaemia among pregnant women in a rural community and determine the socio demographic factors and obstetric factors associated with anaemia. The objective of the study was to evaluation the prevalence of anemia between pregnant women and to regulate its association with maternal and fetal consequences. The care given by the health care provider to a pregnant woman during her pregnancy period (a period of 280 days) is known as antenatal care. This research was carried out in rural field practicing area, Sripuram Kanchepuram district of Tamilnadu. The pregnant mothers residing in this area were taken as the study subject. This study was conducted for a period of four month from June 2014 to September 2014. Anaemia is considered a severe public health problem by World Health Organization when anaemia prevalence is equal to or greater than 40% in the population. Iron deficiency is highest population subgroups that are at peak growth rates that is infant, children and pregnant mothers. Anaemia in pregnancy, the most common micro nutritional deficiency (disorder). It is estimated that more than 50% of pregnant women are anaemic and majority (90%) belongs to iron deficiency. The great incidence of anemia in pregnant women speciously increases the maternal and fetal risks. To increase maternal and fetal effect, it is suggested that the primary health care has to be strengthened, prevention, initial diagnosis, and treatment of anemia in pregnancy to be given priority.

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

Aim To understand if every other day iron supplementation may be as effective as daily iron intake in anemic pregnant women. Methods This case-control study was conducted at a tertiary hospital in Turkey. The study randomly categorized women into two groups as daily intake (n = 124) vs every other day intake (n = 140) of 100 mg daily oral ferrous fumarate. The numbers of women recruited from the study were 13 and 34 in two groups. Thus, for analysis, there were 111 women in the daily group and 106 women in the other group. The current study obtained hemoglobin (Hb) and ferritin levels two times to evaluate the effects of treatment, noting initial levels before drug administration, and a second blood sample was obtained after two months. Two groups were compared according to the increase in Hb and ferritin levels. The study asked the women whether they experienced gastrointestinal side effects. Results The ferritin levels increased 4.9 ± 4.2 ng/mL in the daily intake group and 3.9 ± 2.9 ng/mL in every other day group (p = .215). The Hb increased 1.4 ± 0.7 g/dL in the daily intake group and 1.6 ± 0.6 g/dL in the other group (p = .021). Gastrointestinal side effects appeared in 47 (17.8%) out of 264 women. The rate of gastrointestinal side effect was lower in every other day group (41.4% vs 15.1%, p = .0057). Conclusion Every other day iron supplementation is as effective as daily intake for treating iron deficiency anemia with lesser gastrointestinal side effects during pregnancy.

Is IV iron sucrose a cost-effective option for treatment of severe anaemia in pregnancy as compared with oral iron?

Anaemia in pregnancy is a public health concern because it is strongly associated with maternal and perinatal morbidity and mortality. An open label randomized controlled trial (RCT) was conducted in India across four government medical colleges, comparing intravenous (IV) iron sucrose and oral iron for the treatment of anaemia in pregnancy. This RCT failed to demonstrate superiority of IV iron sucrose compared with oral iron therapy in reducing adverse clinical (maternal and foetal/neonatal) outcomes in moderate-to-severe anaemia in pregnancy. However, IV iron sucrose seemed to reduce the need for blood transfusion among women with severe anaemia. The study objective was to conduct a cost-effectiveness analysis of IV iron sucrose over oral therapy for treatment of severe anaemia in pregnancy, alongside the RCT, to inform policy. The outcome of interest in our study was a 'safe delivery' defined by the absence of composite maternal and foetal/neonatal adverse clinical outcomes. Incremental cost-effectiveness ratio (ICER) was calculated from a limited societal perspective. IV iron sucrose was found to be more costly but more effective than the oral therapy for treatment of severe anaemia. The ICER was calculated at INR 31951 (USD 445.2) per safe delivery. We considered a threshold of half the gross national income for decision-making. Considering this threshold of India (INR 57230, USD 797.4), IV iron-sucrose remained cost-effective in 67% of the iterations in the model. At the current ICER, for every 32 severely anaemic pregnant woman treated with IV iron sucrose one additional pregnant woman will have a safe delivery. Such analyses can complement the national strategy to support evidence-based action.

A comparative study to evaluate oral iron and intravenous iron sucrose for treatment of anemia in pregnancy in a poor socioeconomic region of Northeast India.

Objective:The prevalence of anemia during pregnancy is as high as 80% in some sections of the Indian population. Iron therapy in different forms has been found to alleviate anemia and yield good fetomaternal outcome. This study aims to evaluate the efficacy of intravenous iron sucrose (IVIS) versus oral iron in treating anemia among the antenatal mothers attending a tertiary care center of Northeast India.Materials and Methods:One hundred women between 18 and 28 weeks of gestation with diagnosed iron-deficiency anemia and hemoglobin (Hb) of 7–10.9 g/dL were enrolled to be administered either oral ferrous sulfate 200 mg twice daily or requisite dose of IVIS 100 mg in 100 ml normal saline on alternate days. Hb and hematocrit were measured at the time of enrollment, 4th week, and 8th week of therapy. Acceptability of both the drugs based on like and dislike after interviewing the study participants was recorded. Adverse drug reactions, gestational age at delivery, and neonatal birth weight were also noted in both the groups. The results were analyzed by Student's t-test and Chi-square test.Results:Hb and hematocrit values were found to be increased in both the groups at 4th and 8th weeks. When both the groups were compared, the rise in the values was higher in the iron sucrose group (at 4th week P = 0.01 and at 8th week P = 0.00). The number of participants who reached target Hb levels at 4 weeks was 41 (82%) with oral iron and 48 (96%) with iron sucrose. In the iron sucrose group, no adverse effects were observed, suggesting its safety, and the acceptability and newborn birth weight were noted to be higher.Conclusion:IVIS was found to be more effective than oral iron therapy in treating antenatal anemia with no serious adverse drug reactions.

The Jehovah's Witness obstetric patient - a literature review.

The patient's right to refuse blood transfusion must be honoured in case of its clear expression. Some special pharmacologic and/or surgical procedures can be useful in a Jehovah Witness (JW) parturient. In case of excess blood loss the maintenance of peripheral tissue oxygenation is crucial. Only a few hospitals have equipment for blood salvage, and alternative oxygen carriers have potentially lethal side effects. Findings suggest that obstetric facilities should develop special algo-rithms of management in the case of the JW obstetric patient, with written declaration of which elements of blood are not acceptable for the patient, early diagnosis and intensive treatment of anaemia in pregnancy, administration of antifibrinolytic agents before surgery, use of electric surgical tools to restore haemostasis, early detection and aggressive treatment of excessive blood loss and, last but not least, close cooperation between obstetricians and anaesthesiologists, including sharing the information about the patient's refusal of blood transfusion.

Intravenous Iron Sucrose versus Packed Cell Volume for Treatment of Severe Iron Deficiency Anaemia in Pregnancy

Intravenous Iron Sucrose versus Packed Cell Volume for Treatment of Severe Iron Deficiency Anaemia in Pregnancy

Heme iron polypeptide in treatment of anemia inpregnancy

Introduction: Treatment of iron deficiency anemia with non-heme iron salts still remains a challenge. The negative influence of various dietary elements and medications slows the absorption of iron from iron salts which makes it less bio-available, the side effects associated with iron salts, results in poor compliance. But Heme Iron Polypeptide claims to overcome the short comings of the non – heme oral iron. Materials and Methods: This prospective clinical study was done on patients of SSG Hospital, Baroda; 100 mild to moderate anemia pregnant patients between 16 to 28 weeks were included. The primary outcome of interest was mean maternal hemoglobin and serum ferritin levels at the end of treatment. Secondary outcomes were treatment related side effects and compliance. Results: There was significant rise in hemoglobin [mean difference (MD), 1.05841; p< 0.001] and serum ferritin [mean difference (MD) 7.3715, p, 0.001]. No side effects and good compliance with Heme Iron Polypeptide. Conclusion: Heme Iron Polypeptide is promising supplementary treatment for iron deficiency anemia in pregnancy as there was significant rise in hemoglobin and other iron indices which are comparable to oral iron salts. Heme Iron Polypeptide is a better source of iron for iron deficiency anemia in pregnancy, as it has less side effects especially gastrointestinal side effects, because of which it has better compliance.

Outcome of intravenous iron sucrose in treatment of anemia in pregnancy

Outcome of intravenous iron sucrose in treatment of anemia in pregnancy

Comparative Study of Efficacy and Safety of Intravenous Iron Sucrose Versus Oral Iron in the Treatment of Iron Deficiency Anaemia in Pregnancy

Comparative Study of Efficacy and Safety of Intravenous Iron Sucrose Versus Oral Iron in the Treatment of Iron Deficiency Anaemia in Pregnancy

Intravenous iron sucrose v/s oral ferrous fumarate for treatment of anemia in pregnancy. A randomized controlled trial

BackgroundThe objective of this study was to compare the efficacy, safety and tolerability of intravenous iron sucrose with that of oral ferrous fumarate in iron deficiency anemia during 14 to 34 weeks of pregnancy.MethodsA randomized controlled trial was performed involving 112 patients attending the antenatal clinic at Shri B.M.Patil Medical college Hospital, Bijapur from October 2011 to August 2012,with hemoglobin levels between 70-110 g/L and serum ferritin of < 15 ng/ml.In the intravenous group,200 mg of iron sucrose was administered in 100 ml 0.9% sodium chloride per day. Participants in the oral group were given 200 mg of ferrous fumarate per day. The primary outcome measures for the trial, haemoglobin and serum ferritin levels were measured after 4 weeks. Statistical significance was assessed using Student’s t-test.ResultsThe change in haemoglobin in women receiving intravenous iron was higher than with oral ferrous fumarate 22 ± 11.5 g/L vs 12 ± 9 g/L (p < 0.0001).Similarly the change of serum ferritin was significantly higher in women receiving intravenous iron compared to oral iron.55% participants in the intravenous group had an improvement in haemoglobin more than 20 g/L compared to only 11% of the oral therapy group.48% of patients in I.V group showed increase in ferritin level between 51 to 100 ng/ml in comparison to only 3.5% in oral group.Intravenous iron sucrose is an effective in correction of anemia in pregnancy or iron store depletion.ConclusionIntravenous iron sucrose is more effective than 200 mg a day ferrous fumarate in increasing maternal iron stores.Trial registrationThe trial registration number is CTRI/2016/12/007552 registered in Clinical Trial Registry India on 8/12/2016. It is a retrospectively registered trial.

Prospective study on prevalence of anemia of pregnant women and its outcome: A community based study.

Background:Anemia is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. Anemia during pregnancy is commonly associated with poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus.Objective:The objective of the study was to estimate the prevalence of anemia among pregnant women and to determine its association with maternal and fetal outcomes.Settings and Design:This study design was a prospective, observational, community-based study.Subjects and Methods:Four hundred and forty-six pregnant women were included in the study from three primary health centers in Kolar district by multistage sampling technique and were followed up till 1 week after delivery.Statistical Analysis:The data were analyzed using SPSS version 22; correlation coefficient, Chi-square test, and logistic regression were used.Results:There was a significant overall improvement in the hemoglobin levels of pregnant during the follow-up (10.3–10.72 gm%). About 35.6% of the women had maternal or fetal morbidity. Anemia was one of the main pregnancy-related complications (62.3%), other complications include difficult labor (3%), postpartum hemorrhage, and preeclampsia 1.6% each abortions/stillbirths (3.5%). The fetal complications include low birth weight (25.5%) followed by premature delivery (0.2%) and birth asphyxia (0.5%).Conclusions:A high prevalence of anemia in pregnant women apparently increases the maternal and fetal risks. To improve maternal and fetal outcome, it is recommended that the primary health care has to be strengthened, prevention, early diagnosis, and treatment of anemia in pregnancy to be given priority.

Iron deficiency anaemia in pregnancy: The role of parenteral iron

Maternal and perinatal morbidity and mortality remain major challenges in the delivery of safe maternity care worldwide. Anaemia in pregnancy is an important contributor to this dismal picture, especially where blood transfusion services are poorly developed. An early diagnosis and treatment of iron deficiency anaemia in pregnancy using the new generation dextran-free parenteral iron preparations can save lives and reduce morbidity in selected pregnancies. It is time to cast aside the fears associated with the use of the old parenteral iron preparations which were associated a high incidence of anaphylaxis, and embrace the use of new parenteral iron products which have better side effect profiles and can deliver total dose infusions without the need for test dosing. In selected women, the benefits of this treatment far outweigh any disadvantages.

Current approaches to the prevention and treatment of iron deficiency anemia in pregnancy in the XXI century

Pregnantare in particular risk of developing iron-deficiency anemia as a result of the increasing need in trace elements during gestation. According to WHO recommendations for the prevention of iron deficiency anemia, pregnant as early as possible, no later than the I trimester and during hole pregnancy appointed iron supplements in a dose of 60 mg iron in a day. Among the oral medication for the treatment of iron deficiency anemia should be preferred non-ionic iron preparations on the basis of the hydroxide polymaltose complex of ferric iron.

Use of Iron Sucrose Complex in Treatment of Anemia in Pregnancy

Objective: To demonstrate the value of iron sucrose complex in the treatment of anemia in pregnancy.Methods: It is a prospective clinical study, of 35 consecutive pregnant women suffering from anemia in pregnancy. The study was conducted over a period of twelve months. Hemoglobin concentration was measured three times during pregnancy. All women consumed timed release iron from 17 weeks onward up to birth of the baby. If hemoglobin level is (8.5 - 9) gm/dl, parentral Iron sucrose complex 2 doses (400gm of iron) were given intravenously and hemoglobin level was checked after 15 days.Results: There were 35 women who completed the treatment and data was available for analysis. Their mean age was 27.5(range21-35) years. Fifty six percent were 2nd gravid. Twenty eight (28%) percent women in 1st half of pregnancy, 53% in 2nd trimester and 16% in 3rd trimester suffering from moderate anemia and treated with iron sucrose complex (ISC). The average Hemoglobin concentration before treatment was 8.47gm/dl and after treatment was 9.67gm/dl. There was a statistically significant improvement in hemoglobin concentration. Three women developed side effects and did not get 2nd dose.Conclusion: Intravenous iron therapy is safe, convenient and effective in treatment of iron deficiency anemia during pregnancy. The intravenous iron therapy can replace blood transfusion in antenatal period in many patients. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13728 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 20-23