Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections

Abstract

ObjectivesGestational IDA has been linked to adverse maternal and neonatal outcomes, but the impact of iron supplementation on outcome measures remains unclear. Our objective was to assess the effects of gestational IDA on pregnancy outcomes and compare outcomes in pregnancies treated with either oral or intravenous iron supplementation.MethodsWe evaluated maternal and neonatal outcomes in 215 pregnancies complicated with gestational IDA (Hb<100 g/L) and delivered in our tertiary unit between January 2016 and October 2018. All pregnancies from the same period served as a reference group (n=11,545). 163 anemic mothers received oral iron supplementation, and 52 mothers received intravenous iron supplementation.ResultsGestational IDA was associated with an increased risk of preterm birth (10.2% vs. 6.1%, p=0.009) and fetal growth restriction (FGR) (1.9% vs. 0.3%, p=0.006). The gestational IDA group that received intravenous iron supplementation had a greater increase in Hb levels compared to those who received oral medication (18.0 g/L vs. 10.0 g/L, p<0.001), but no statistically significant differences in maternal and neonatal outcomes were detected.ConclusionsCompared to the reference group, prematurity, FGR, postpartum infections, and extended hospital stays were more common among mothers with gestational IDA, causing an additional burden on the families and the healthcare system.

High burden of anemia among pregnant women in Tanzania: a call to address its determinants

“…The authors declare that they have no competing interests. 3 Key Laboratory of Health Technology Assessment, National Health Commission, Shanghai, China. 4 Implementation Science Tanzania, Dar es Salaam, Tanzania.…”

“…Within the Sub-Saharan Africa, anemia among pregnant women is the highest in West Africa, with the prevalence of 56% [1]. Anemia during pregnancy is associated with a number of adverse events for both the mother and her offspring [3,4]. Chiefly, it has been an important cause of maternal and perinatal mortality globally [5,6].…”

High Burden of Anemia Among Pregnant Women in Tanzania: A Call to Address Its Determinants

“…Within the Sub-Saharan Africa, anemia among pregnant women is the highest in West Africa, with the prevalence of 56% (25). Anemia during pregnancy is associated with a number of adverse events for both the mother and her offspring (12,21). Chie y, it has been an important cause of maternal and perinatal mortality globally (1,22).…”

Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación

“…Resultados: La proporción de mujeres con depósitos de hierro inadecuados fue de 32%, promedio geométrico de ferritina de 39,2 μg/L (rango 38,4 -40,0 μg/L) Las gestantes que no deseaban el embarazo, tuvieron 1,1 veces más posibilidad de tener inadecuados depósitos de hierro comparado con las que si lo deseaban (OR= 2,10 IC95% 1, 74). La inseguridad alimentaria incrementó en un 47% la probabilidad de tener inadecuados depósitos de hierro (OR= 1,47 IC95% 1,13). El apoyo familiar redujo en un 61% la probabilidad de inadecuados depósitos de hierro (OR= 0,39 IC95% 0, 78).…”

“…Los resultados de una reciente revisión de metaanálisis indicaron que la anemia materna por deficiencia de hierro aumentaba el riesgo de bajo peso al nacer, parto prematuro, mortalidad neonatal y perinatal 12 . La evidencia también sugiere que los recién nacidos con deficiencia de hierro presentan un retraso en el crecimiento y anomalías del desarrollo con efectos adversos sobre la mielinización, los neurotransmisores y la programación cerebral que persisten incluso después de la repleción de hierro 10,13 .…”