Treatments for iron deficiency anaemia in pregnancy

Cuervo, Luis Gabriel; Mahomed, Kassam

doi:10.1002/14651858.cd003094

Cited by 33 publications

(18 citation statements)

References 21 publications

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“…Spatone, and ferrous sulphate tablets had equivalent bioavailability in the in vitro model, which is consistent with previous absorption studies in human volunteers [16]. the UK were advised to take iron but this was found to be either ineffective [33], or to have no demonstrated benefit on maternal or foetal outcomes [34,35]. Recent research may challenge current UK guidelines [36]; two large systematic reviews with metaanalyses found that daily prenatal iron reduced maternal anaemia, IDA and risk of foetal low birth weight [37,38].…”

Section: Discussionsupporting

confidence: 84%

Iron bioavailability from commercially available iron supplements

et al. 2014

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PurposeIron deficiency anaemia (IDA) is a global public health problem. Treatment with the standard of care ferrous iron salts may be poorly tolerated leading to noncompliance and ineffective correction of IDA. Employing supplements with higher bioavailability might permit lower doses of iron to be used with fewer side effects, thus improving treatment efficacy. Here we compared the iron bioavailability of ferrous sulphate tablets with alternative commercial iron products, including three liquid based supplements. MethodsIron bioavailability was measured using Caco-2 cells with ferritin formation as a surrogate marker for iron uptake. Statistical analysis was performed using one-way ANOVA followed by either Dunnett's or Tukey's multiple comparisons tests. Results Spatone Apple® (a naturally iron-rich mineral water with added ascorbate) and IronVital F ® (a synthetic liquid iron supplement) had the highest iron bioavailability.There was no statistical difference between iron uptake from ferrous sulphate tablets, Spatone ® (naturally iron-rich mineral water alone) and Pregnacare Original ® (a multimineral/vitamin tablet). ConclusionIn our in vitro model naturally iron-rich mineral waters and synthetic liquid iron formulations have equivalent or better bioavailability compared with ferrous iron sulphate tablets. If these results are confirmed in vivo, this would mean that at risk groups for IDA could be offered a greater choice of more bioavailable and potentially better tolerated iron preparations.

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Section: Discussionsupporting

confidence: 84%

Iron bioavailability from commercially available iron supplements

et al. 2014

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“…14 The rise in MCV of 4 fL which occurs in pregnancy may have a role to play. 3 Thus the normal cut-off of MCV <78 fL to screen cases of iron deficiency anaemia may not hold true in pregnant women. By drawing ROC curves for various red cell indices for diagnosis of IDA, we found that the maximum area to be for Hb and a cut-off <9.7 g/dL had a sensitivity of 90.9% and a specificity of 79% in the diagnosis of Indian pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Furthermore, mothers given iron supplementation have decreased risk of preterm delivery. 5 Recently, there have been western studies which advocate the discontinuation of iron supplementation in pregnancy due to teratogenic effects.…”

Section: Introductionmentioning

confidence: 99%

“…As there is physiological macrocytosis with average increase of 4 fL at term, the normal cut-off of MCV <78 fL to screen cases of iron deficiency anaemia may not hold in pregnant women. 3 However, in India and most of the other developing countries the lower limit is often accepted as 10 gm per dL. Ferritin level of <12 ng/dL is considered as the gold standard for the diagnosis of iron deficiency anaemia in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of haemoglobin and red cell indices with serum ferritin in Indian women in second and third trimester of pregnancy

Tiwari¹,

Kotwal

et al. 2013

Medical Journal Armed Forces India

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a b s t r a c tBackground: Iron deficiency anaemia (IDA) is the most common cause of anaemia in pregnancy in Indians and is associated with increased risk of low birth-weight infants.Studies from developed countries recommend iron supplementation based on serum ferritin levels. However, screening by serum ferritin is not feasible in all cases in India. This study was undertaken to document haematological profile of pregnant Indian women. Methods:We studied the correlation between second and third trimester ferritin concentration and haemoglobin (Hb) and red cell indices in 100 consecutive ANC cases to select the best haematologic characteristic to identify women who needed iron therapy. Hb and red cell indices, RBC count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width were analysed and PBS studied to subtype anaemia if present.Results: Proportion of iron deficiency anaemia in pregnancy was 34% and significant correlation was found between serum ferritin and RDW-CV% and TRBC. No correlation was found between ferritin levels and Hb, MCV, MCH and MCHC. Serum ferritin levels were <12 ng/mL in 30 out of 52 non-anaemic cases suggesting prevalence of sub-clinical iron deficiency in 58% cases. None of the red cell indices correlated with ferritin level in this group. Only TRBC showed some correlation with ferritin (r ¼ À0.090, p > 0.05). Conclusion:All pregnant women in India should continue to get iron supplements unlike what is recommended in the developed countries where iron supplementation is based on serum ferritin levels. ª

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“…2,5,8) Thrombosis of the pulmonary vein and lower limb vein are known during pregnancy. 4) Half of a series of 42 pediatric CVST patients had anemia. 12) Iron deficiency anemia is more common than protein S or C deficiency, or cardiolipidosis.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis Associated With Iron Deficiency-Two Case Reports-

Kinoshita

Taniura²,

Shishido³

et al. 2006

Neurol. Med. Chir.(Tokyo)

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Two patients presented with cerebral venous sinus thrombosis (CVST) associated with iron deficiency. A 14-year-old man had thrombosis extending from the end of the superior sagittal sinus to the left transverse sinus. Severe dehydration after competitive sport had induced CVST. The laboratory findings showed severe iron deficiency anemia which persisted for 1 year. A 47-year-old man had thrombosis in the entire superior sagittal sinus. Dehydration caused by poor nutrition had induced CVST. The laboratory findings showed transient iron deficiency in the acute phase. Both patients received conservative treatment for dehydration and iron supplementation. These two cases indicate that iron deficiency is a risk factor for CVST.

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Treatments for iron deficiency anaemia in pregnancy

Cited by 33 publications

References 21 publications

Iron bioavailability from commercially available iron supplements

Iron bioavailability from commercially available iron supplements

Correlation of haemoglobin and red cell indices with serum ferritin in Indian women in second and third trimester of pregnancy

Cerebral Venous Sinus Thrombosis Associated With Iron Deficiency-Two Case Reports-

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