Iron deficiency anemia in pregnancy: evaluation and management.

Abstract

Anemia is a condition in which the number of red blood cells (RBC) is insufficient to meet the body's physiological needs for oxygen transport. A limiting factor for the erythrocyte mass increase is iron deficiency, which can also have a negative impact on the pregnancy's prognosis. The most frequent pathogenic cause of anemia in pregnancy is iron deficiency anemia (IDA). Biochemical tests such as serum iron concentration, total iron binding capacity (TIBC), transferrin concentration, and ferritin concentration are decreased in iron deficiency anemia. In clinical practice, iron deficiency is defined as low serum ferritin or a decreased percentage of transferrin saturation by iron. Usually, the diagnosis begins with the determination of serum ferritin. Although iron supplementation for iron deficiency is advised as soon as the condition has been diagnosed, prophylactic iron delivery is still under discussion. In patients for whom oral iron is ineffective or contraindicated, intravenous iron can be used to restore lost iron.

Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia

“… 71 Maternal consequences of ID/IDA also include abnormal thyroid function, placental abruption, pre‐eclampsia, and eclampsia. 72 , 73 , 74 Studies have also identified anemia as a significant risk factor for postpartum hemorrhage. 75 , 76 , 77 In fact, one study showed that the risk of death for women who experience a postpartum hemorrhage is almost seven‐fold higher if they are anemic at the onset of pregnancy.…”

“…Maternal or prepartum IDA and excessive blood loss at delivery are the leading causes of postpartum anemia. 73 , 84 , 85 Reduced milk production and resultant shortening of lactation periods are also characteristic of ID/IDA during the postpartum period. The emotional well‐being of postpartum women with IDA can also be seriously affected, with an increased risk of postpartum anxiety and depression and a decreased quality of life.…”

“…In a recent systematic review, maternal IDA was associated with a significantly increased risk of cesarean delivery, postpartum anemia, and blood transfusion 71 . Maternal consequences of ID/IDA also include abnormal thyroid function, placental abruption, pre‐eclampsia, and eclampsia 72‐74 . Studies have also identified anemia as a significant risk factor for postpartum hemorrhage 75‐77 .…”

“…Maternal or prepartum IDA and excessive blood loss at delivery are the leading causes of postpartum anemia 73,84,85 . Reduced milk production and resultant shortening of lactation periods are also characteristic of ID/IDA during the postpartum period.…”