Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis

Rogozińska, Ewelina; Daru, Jahnavi; Nicolaides, Marios; Amezcua‐Prieto, Carmen; Robinson, Susan E.; Wang, Rui; Godolphin, Peter J.; Saborido, C Martin; Zamora, Javier; Khan, Khalid S.; Thangaratinam, Shakila

doi:10.1016/s2352-3026(21)00137-x

Cited by 32 publications

(29 citation statements)

References 79 publications

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“…As history serves, when the menstruation cycle initiates, the endometrial lining begins to shed its layers of the columnar epithelium; in retrospect to pregnancy, the glands and angiogenesis begin to enlarge [ 110 ]. A paper published in the Journal of Obstetrics and Gynaecology, 2016 has outlined significant resources relating to the iron supplementation and infusion of dextran-free preparations, while also producing better hematological responses compared to oral therapy alone [ 111 , 112 , 113 , 114 , 115 , 116 ]. Therefore, it has been an important tool in aiding the prevention of the iron-deficiency in pregnant women and hemorrhage-related maternal and perinatal mortality and morbidity.…”

Section: Trace Elements and Female Reproductive Organsmentioning

confidence: 99%

Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers—A State-of-the-Art Review

et al. 2021

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Gynecological neoplasms pose a serious threat to women’s health. It is estimated that in 2020, there were nearly 1.3 million new cases worldwide, from which almost 50% ended in death. The most commonly diagnosed are cervical and endometrial cancers; when it comes to infertility, it affects ~48.5 million couples worldwide and the number is continually rising. Ageing of the population, environmental factors such as dietary habits, environmental pollutants and increasing prevalence of risk factors may affect the reproductive potential in women. Therefore, in order to identify potential risk factors for these issues, attention has been drawn to trace elements. Trace mineral imbalances can be caused by a variety of causes, starting with hereditary diseases, finishing with an incorrect diet or exposure to polluted air or water. In this review, we aimed to summarize the current knowledge regarding trace elements imbalances in the case of gynecologic cancers as well as female fertility and during pregnancy.

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Section: Trace Elements and Female Reproductive Organsmentioning

confidence: 99%

Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers—A State-of-the-Art Review

et al. 2021

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“…In a recent editorial, the Australian Research Fellow Antonia Shand 42 clearly stated that there is still no optimal established management strategy for the prevention, screening and treatment of pregnancy-associated iron deficiency anemia. In Shandʼs view, it is still not clear, based on the existing data, whether improvements in therapy-associated hematology results 35 actually lead to better clinical outcomes. The recommendation of the U. S. Preventive Services Task Force 43 bears out this critical view by highlighting the contradictory results reported by often poorly designed studies.…”

Section: Discussionmentioning

confidence: 99%

“…The number of publications and the marketing of intravenously administered iron preparations has increased in recent years. High concentrations of intravenous iron (e.g., Ferinject 1000 mg iron) are effective within 4 weeks of starting treatment 35 and the product characteristics state that treatment is safe for fetuses from the 2nd trimester of pregnancy 36 .…”

Section: Iron Supplementationmentioning

confidence: 99%

“…Intravenöses Eisen in hohen Konzentrationen (z. B. Ferinject 1000 mg Eisen) ist grundsätzlich innerhalb von 4 Wochen effektiv 35 und ab dem 2. Trimenon laut Fachinformation 36 auch für die Feten sicher.…”

Section: Intravenöse Eisensubstitutionunclassified

“…In einem rezenten Editorial hat die Australierin Antonia Shand 42 klar formuliert, dass es bis heute kein optimales und etabliertes Management für Prävention, Screening und Behandlung einer schwangerschaftsassoziierten Eisenmangelanämie gäbe. Aus ihrer Sicht ist es aufgrund der bestehenden Datenlage unklar, ob verbesserte therapieassoziierte hämatologische Ergebnisse 35 auch tatsächlich zu einem verbesserten klinischen Ergebnis führen. Auch in der amerikanischen Empfehlung der U. S. Preventive Services Task Force 43 wird diese kritische Sichtweise bestätigt, in der die widersprüchlichen Ergebnisse der häufig schlecht designten Studien hervorgehoben werden.…”

Section: Schlussfolgerungunclassified

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Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG)

Fischer

Helmer

Klaritsch

et al. 2022

Geburtshilfe Frauenheilkd

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This overview analyzes the data on the controversial therapy of iron substitution during pregnancy, the diagnosis of iron deficiency anemia and the indication-related therapy, and is the first recommendation issued by the OEGGG on the appropriate therapy. The effects of anemia during pregnancy on postnatal outcomes have been intensively investigated with heterogeneous results. A final scientific conclusion with regards to the “optimal” maternal hemoglobin level is limited by the heterogeneous results of various studies, many of which were conducted in emerging nations (with different dietary habits and structural differences in the respective healthcare systems). The current literature even suggests that there may be a connection between both decreased and increased maternal serum hemoglobin concentrations and unfavorable short-term and long-term neonatal outcomes. In Austria, 67 percent of pregnant women take pharmacological supplements or use a variety of dietary supplements. Clinically, the prevalence of maternal anemia is often overestimated, leading to overtreatment of pregnant women (iron substitution without a medical indication). To obtain a differential diagnosis, a workup of the indications for treatment should be carried out prior to initiating any form of iron substitution during pregnancy. If treatment is medically indicated, oral iron substitution is usually sufficient. Because of the restricted approval and potential side effects, medical indications for intravenous iron substitution should be limited. Intravenous iron substitution without a prior detailed diagnostic workup is an off-label use and should only be used in very limited cases, and women should be advised accordingly.

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Mammary Leukocyte‐Assisted Nanoparticle Transport Enhances Targeted Milk Trace Mineral Delivery

et al. 2022

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Nanoparticles are applied as versatile platforms for drug/gene delivery in many applications owing to their long‐retention and specific targeting properties in living bodies. However, the delivery mechanism and the beneficial effect of nanoparticle‐retention in many organisms remain largely uncertain. Here, the transport and metabolism of mineral nanoparticles in mammary gland during lactation are explored. It is shown that maternal intravenous administration of iron oxide nanoparticles (IONPs; diameter: ≈11.0 nm, surface charge: −29.1 mV, surface area: 1.05 m2 g−1) provides elevated iron delivery to mammary gland and increased iron secretion into breast milk, which is inaccessible by classical iron‐ion transport approaches such as the transferrin receptor‐mediated endocytic pathway. Mammary macrophages and neutrophils are found to play dominant roles in uptake and delivery of IONPs through an unconventional leukocyte‐assisted iron secretion pathway. This pathway bypasses the tight iron concentration regulation of liver hepcidin‐ferroportin axis and mammary epithelial cells to increase milk iron‐ion content derived from IONPs. This work provides keen insight into the metabolic pathway of nanoparticles in mammary gland while offering a new scheme of nutrient delivery for neonate metabolism regulation by using nanosized nutrients.

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Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis

Cited by 32 publications

References 79 publications

Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers—A State-of-the-Art Review

Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers—A State-of-the-Art Review

Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG)

Mammary Leukocyte‐Assisted Nanoparticle Transport Enhances Targeted Milk Trace Mineral Delivery

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