UK guidelines on the management of iron deficiency in pregnancy

Sue Pavord, Jan Daru, Nita Prasannan, Susan Robinson, Simon Stanworth, Joanna Girling, BSH Committee, Sue Pavord, Jan Daru, Nita Prasannan, Susan Robinson, Simon Stanworth, Joanna Girling, BSH Committee

No abstract available

Keywords: anaemia; iron; iron depletion; pregnancy.

References

    1. Auerbach, M., Abernathy, J., Juul, S., Short, V. & Derman, R. (2019) Prevalence of iron deficiency in first trimester, non-anaemic pregnant women. Maternal, Fetal and Neonatal Medicine, 3, 1-4.
    1. Balarajan, Y., Ramakrishnan, U., Özaltin, E., Shankar, A.H. & Subramanian, S.V. (2011) Anaemia in low-income and middle-income countries. The Lancet, 378, 2123-2135.
    1. Balesaria, S., Hanif, R., Salama, M.F., Raja, K., Bayele, H.K., McArdle, H. & Srai, S.K.S. (2012) Fetal iron levels are regulated by maternal and fetal Hfe genotype and dietary iron. Haematologica, 97, 661-669.
    1. Barroso, F., Allard, S., Kahan, B.C., Barroso, F., Allard, S., Kahan, B.C., Connolly, C., Smethurst, H., Choo, L., Khan, K. & Stanworth, S. (2011) Prevalence of maternal anaemia and its predictors: a multi-centre study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 159, 99-105.
    1. Bayoumeu, F., Subiran-Buisset, C., Baka, N.E., Legagneur, H., Monnier-Barbarino, P. & Laxenaire, M.C. (2005) Iron therapy in iron deficiency anemia in pregnancy: intravenous route versus oral route. European Journal of Obstetrics & Gynecology and Reproductive Biology, 123, S15-S19.
    1. Beard, J., Tobin, B. & Green, W. (1989) Evidence for thyroid hormone deficiency in iron-deficient anemic rats. Journal of Nutrition, 119, 772-778.
    1. Beard, J.L., Borel, M.J. & Derr, J. (1990) Impaired thermoregulation and thyroid function in iron-deficiency anemia. American Journal of Clinical Nutrition, 52, 813-819.
    1. Bothwell, T.H. (2000) Iron requirements in pregnancy and strategies to meet them. American Journal of Clinical Nutrition, 72, 257S-264S.
    1. Brabin, B.J., Hakimi, M. & Pelletier, D. (2001) An analysis of anemia and pregnancy-related maternal mortality. Journal of Nutrition, 131, 604S-614S.
    1. Breymann, C. (2002) Iron deficiency and anaemia in pregnancy: modern aspects of diagnosis and therapy. Blood Cells, Molecules and Diseases, 29, 506-516.
    1. Breymann, C., Milman, N., Mezzacasa, A., Bernard, R. & Dudenhausen, J.; FER-ASAP investigators. (2016) Ferric carboxymaltose vs. oral iron in the treatment of pregnant women with iron deficiency anemia: an international, open-label, randomized controlled trial (FER-ASAP). Journal of Perinatal Medicine, 45, 443-453.
    1. Briley, A., Seed, P.T., Tydeman, G., Ballard, H., Watersone, M., Sandall, J., Poston, L., Tribe, R.M. & Bewley, S. (2014) Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study. British Journal of Obstetrics and Gynaecology, 121, 876-888.
    1. Broche, D.E., Gay, C., Armand-Branger, S., Grangeasse, L. & Terzibachian, J.J. (2005) Severe anaemia in the immediate post-partum period. Clinical practice and value of intravenous iron. European Journal of Obstetrics & Gynecology and Reproductive Biology, 123, S21-S27.
    1. Chanarin, I., McFadyen, I.R. & Kyle, R. (1977) The Physiological macrocytosis of pregnancy. British Journal of Obstetrics & Gynaecology: An International Journal of Obstetrics & Gynaecology, 84, 504-508.
    1. Choi, J., Im, M. & Pai, S. (2000) Serum transferrin receptor concentrations during normal pregnancy. Clinical Chemistry, 46, 725-727.
    1. Corwin, E.J., Murray-Kolb, L.E. & Beard, J.L. (2003) Low hemoglobin level is a risk factor for postpartum depression. Journal of Nutrition, 133, 4139-4142.
    1. Costantine, M.M. (2014) Physiologic and pharmacokinetic changes in pregnancy. Frontiers in Pharmacology, 5, 65.
    1. Crispin, P., Stephens, B., McArthur, E. & Sethna, F. (2018) First trimester ferritin screening for pre-delivery anaemia as a patient blood management strategy. Transfusion and Apheresis Science, 58, 50-57.
    1. Daru, J., Zamora, J., Fernández-Félix, B.M., Vogel, J., Oladapo, O.T., Morisaki, N., Tuncalp, O., Torloni, M.R., Mittal, S. & Jayaratne, K. (2018) Risk of maternal mortality in women with severe anaemia during pregnancy and postpartum: a multilevel analysis. The Lancet Global Health, 6, e548-e554.
    1. Daru, J., Allotey, J., Peña-Rosas, J.P. & Khan, K.S. (2017) Serum ferritin thresholds for the diagnosis of iron deficiency in pregnancy: a systematic review. Transfusion Medicine, 27, 167-174.
    1. Davidsson, L., Kastenmayer, P., Szajewska, H., Hurrell, R.F. & Barclay, D. (2000) Iron bioavailability in infants from an infant cereal fortified with ferric pyrophosphate or ferrous fumarate. American Journal of Clinical Nutrition, 71, 1597-1602.
    1. Dignass, A., Gasche, C., Bettenworth, D., Birgegård, G., Danese, S., Gisbert, J., Gomollon, F., Iqbal, T., Katsanos, K., Koutroubakis, I., Magro, F., Savoye, G., Stein, J. & Vavricka, S.; The European Crohn's and Colitis Organisation [ECCO]. (2015) European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. Journal of Crohn's and Colitis, 9, 211-222.
    1. EMA. (2013) Assessment Report For: Iron Containing Intravenous (IV) Medicinal Products. EMA/549569/2013. European Medicines Agency, London, UK.
    1. Fisher, A.L. & Nemeth, E. (1567S) Iron homeostasis during pregnancy. The American Journal of Clinical Nutrition, 106, 1567S-74S.
    1. Gambling, L., Lang, C. & McArdle, H.J. (2011) Fetal regulation of iron transport during pregnancy. American Journal of Clinical Nutrition, 94, 1903S-1907S.
    1. Ganzoni, A.M. (1970) Intravenous iron-dextran: therapeutic and experimental possibilities. Schweizerische Medizinische Wochenschrift, 100, 301-303.
    1. Garcia-Casal, M.N., Peña-Rosas, J.P. & Pasricha, S.R. (2014) Rethinking ferritin cutoffs for iron deficiency and overload. The Lancet Haematology, 1, e92-e94.
    1. Georgieff, M.K., Brunette, K.E. & Tran, P.V. (2015) Early life nutrition and neural plasticity. Development and Psychopathology, 27, 411-23.
    1. Gluckman, P.D. & Hanson, M.A. (2004) Living with the past: evolution, development and patterns of disease. Science, 305, 1733-1736.
    1. Govindappagari, S. & Burwick, R.M. (2018) Treatment of iron deficiency anemia in pregnancy with intravenous versus oral iron: a meta-analysis of RCTs [10OP]. Obstetrics & Gynecology, 131, 3S-4S.
    1. Govindappagari, S. & Burwick, R.M. (2019) Treatment of iron deficiency anemia in pregnancy with intravenous versus oral iron: systematic review and meta-analysis. American Journal of Perinatology, 36, 366-376.
    1. Gozzard, D. (2011) When is high-dose intravenous iron repletion needed? Assessing new treatment options. Drug Design, Development and Therapy, 5, 51-60.
    1. Güven, Z., Holm, C., Rosthoej, S. & Langhoff-Roos, J. (2018) Association between blood loss at delivery and fatigue in the puerperium: a prospective longitudinal study. The Journal of Maternal-Fetal & Neonatal Medicine, 27, 1-6.
    1. Haider, B.A., Olofin, I., Wang, M., Spiegelman, D., Ezzati, M. & Fawzi, W.W. (2013) Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. British Medical Journal, 346, f3443.
    1. Hallberg, L., Bengtsson, C., Lapidus, L., Lindstedt, G., Lundberg, P.-A. & Hultén, L. (1993) Screening for iron deficiency: an analysis based on bone-marrow examinations and serum ferritin determinations in a population sample of women. British Journal of Haematology, 85, 787-798.
    1. Huang, L., Lee, D., Troster, S.M., Kent, A.B., Roberts, M.A., Macdougall, I.C. & McMahon, L.P. (2018) A controlled study of the effects of ferric carboxymaltose on bone and haematinic biomarkers in chronic kidney disease and pregnancy. Nephrology Dialysis Transplantation, 33, 1628-1635.
    1. Holm, C., Thomsen, L.L., Norgaard, A., Markova, V., Michaelsen, K.F. & Langhoff-Roos, J. (2017a) Iron concentration in breast milk normalised within one week of a single high-dose infusion of iron isomaltoside in randomised controlled trial. Acta Paediatrica, 106, 256-260.
    1. Holm, C., Thomsen, L.L., Norgaard, A. & Langhoff-Roos, J. (2017b) Single-dose intravenous iron infusion or oral iron for treatment of fatigue after postpartum haemorrhage: a randomized controlled trial. Vox Sanguinis, 112, 219-228.
    1. Holm, C., Thomsen, L.L., Norgaard, A. & Langhoff-Roos, J. (2017c) Single-dose intravenous iron infusion versus red blood cell transfusion for the treatment of severe postpartum anaemia: a randomized controlled pilot study. Vox Sanguinis, 112, 122-131.
    1. Holm, C., Thomsen, L.L. & Langhoff-Roos, J. (2018) Intravenous iron isomaltoside treatment of women suffering from severe fatigue after postpartum hemorrhage. The Journal of Maternal-Fetal & Neonatal Medicine, 19, 1-8.
    1. Joint Formulary Committee. (2017) BNF 74: September 2017. Pharmaceutical Press, London.
    1. Kaestel, P., Aaby, P., Ritz, C. & Friis, H. (2015) Markers of iron status are associated with stage of pregnancy and acute-phase response, but not with parity among pregnant women in Guinea-Bissau. British Journal of Nutrition, 11, 1072-1079.
    1. Khalafallah, A.A., Hyppa, A., Chuang, A., Hanna, F., Wilson, E., Kwok, C., Yan, C., Gray, Z., Mathew, R., Falloon, P., Dennis, A., Pavlov, T. & Allen, J.C. (2018) A prospective randomised controlled trial of a single intravenous infusion of ferric carboxymaltose vs single intravenous iron polymaltose or daily oral ferrous sulphate in the treatment of iron deficiency anaemia in pregnancy. Seminars in Hematology, 55, 223-234.
    1. Koenig, M.D., Tussing-Humphreys, L., Day, J., Cadwell, B. & Nemeth, E. (2014) Hepcidin and iron homeostasis during pregnancy. Nutrients, 6, 3062-3083.
    1. Lee, K.A. & Zaffke, M. (1999) Longitudinal changes in fatigue and energy during pregnancy and the postpartum period. Journal of Obstetric, Gynecologic & Neonatal Nursing, 28, 183-191.
    1. Lone, F.W., Qureshi, R.N. & Emanuel, F. (2004) Maternal anaemia and its impact on perinatal outcome. Tropical Medicine and International Health, 9, 486-490.
    1. Lumish, R.A., Young, S.L., Lee, S., Cooper, E., Pressman, E., Guillet, R. & O'Brien, K.O. (2014) Gestational iron deficiency is associated with pica behaviors in adolescents-3. The Journal of Nutrition, 144, 1533-1539.
    1. Lynch, S.R. (1997) Interaction of iron with other nutrients. Nutritional Reviews, 55, 102-110.
    1. Lyseng-Williamson, K.A. & Keating, G.M. (2009) Ferric carboxymaltose. Drugs, 69, 739-756.
    1. McLean, E., Cogswell, M., Egli, I., Wojdyla, D. & de Benoist, B. (2009) Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993-2005. Public Health Nutrition, 12, 444-454.
    1. McSorley, S.T., Tham, A., Jones, I., Talwar, D. & McMillan, D.C. (2019) Regression correction equation to adjust serum iron and ferritin concentrations based on C-reactive protein and albumin in patients receiving primary and secondary care. Journal of Nutrition, 149, 877-883.
    1. Mireku, M.O., Davidson, L.L., Boivin, M.J., Zoumenou, R., Massougbodji, A. & Cot, M. (2016) Prenatal iron deficiency, neonatal ferritin, and infant cognitive function. Pediatrics, 138, pii, e20161319.
    1. Moretti, D., Goede, J.S., Zeder, C., Jiskra, M., Chatzinakou, V., Tjalsma, H., Melse-Boonstra, A., Brittenham, G., Swinkels, D.W. & Zimmermann, M.B. (2015) Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women. Blood, 126, 1981-1989.
    1. Nagpal, J. & Choudhury, P. (2004) Iron formulations in pediatric practice. Indian Pediatrics, 41, 807-815. PMID 15347868
    1. Nair, M., Churchill, D., Robinson, S., Nelson-Piercy, C., Stanworth, S.J. & Knight, M. (2017) Association between maternal haemoglobin and stillbirth: a cohort study among a multi-ethnic population in England. British Journal of Haematology, 179, 829-837.
    1. Nair, M., Choudhury, M.K., Choudhury, S.S., Kakoty, S.D., Sarma, U.C., Webster, P. & Knight, M.; the IndOSS-Assam Steering Committee. (2016) Association between maternal anaemia and pregnancy outcomes: a cohort study in Assam, India. British Medical Journal Global Health, 1, e000026.
    1. Nemeth, E. & Ganz, T. (2006) Regulation of iron metabolism by hepcidin. Annual Review of Nutrition, 26, 323-342.
    1. NICE. (2014) Intrapartum care for healthy women and babies. Clinical Guideline [CG190]. National Institute for Health and Care Excellence, London, UK.
    1. NICE. (2016) Antenatal care for uncomplicated pregnancies. Clincial Cuideline [CG62]. National Institute for Health and Care Excellence, London, UK.
    1. Parker, J.A., Barroso, F., Stanworth, S.J., Spiby, H., Hopewell, S., Doree, C.J., Renfrew, M.J. & Allard, S. (2012) Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews. BMC Pregnancy and Childbirth, 12, 56.
    1. Pasricha, S.R., Colman, K., Centeno-Tablante, E., Garcia-Casal, M.N. & Peña-Rosas, J.P. (2018) Revisiting WHO haemoglobin thresholds to define anaemia in clinical medicine and public health. The Lancet Haematology, 5, e60-e62.
    1. Pavord, S., Myers, B., Robinson, S., Allard, S., Strong, J. & Oppenheimer, C.; British Committee for Standards in Haematology. (2012) UK guidelines on the management of iron deficiency in pregnancy. British Journal of Haematology, 156, 588-600.
    1. Peña-Rosas, J.P., De-Regil, L.M., Dowswell, T. & Viteri, F.E. (2012) Daily oral iron supplementation during pregnancy. Cochrane Database of Systematic Reviews, Issue 12, Art. No. CD004736.
    1. Pena-Rosas, J.P., De-Regil, L.M., Malave, H.G., Flores-Urrutia, M.C. & Dowswell, T. (2015) Intermittent oral iron supplementation during pregnancy. Cochrane Database of Systematic Reviews, Issue 10, Art. No. CD009997.
    1. Pereira, D.I., Couto Irving, S.S., Lomer, M.C. & Powell, J.J. (2014) A rapid, simple questionnaire to assess gastrointestinal symptoms after oral ferrous sulphate supplementation. BMC Gastroenterology, 14, 103.
    1. Pratt, J.J. & Khan, K.S. (2016) Non-anaemic iron deficiency - a disease looking for recognition of diagnosis: a systematic review. European Journal of Haematology, 96, 618-628.
    1. Qassim, A., Mol, B.W., Grivell, R.M. & Grzeskowiak, L.E. (2018) Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: a systematic review. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58, 22-39.
    1. Rabindrakumar, M.S.K., Pujitha Wickramasinghe, V., Gooneratne, L., Arambepola, C., Senanayake, H. & Thoradeniya, T. (2018) The role of haematological indices in predicting early iron deficiency among pregnant women in an urban area of Sri Lanka. BMC Hematology, 18, 37.
    1. Rahman, M., Abe, S.K., Rahman, M.S., Kanda, M., Narita, S., Bilano, V., Ota, E., Gilmour, S. & Shibuya, K. (2016) Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. American Journal of Clinical Nutrition, 103, 495-504.
    1. Rogers, J., Wood, J., McCandlish, R., Ayers, S., Truesdale, A. & Elbourne, D. (1998) Active versus expectant management of third stage of labour: the Hinchingbrooke randomised controlled trial. Lancet, 351, 693-699.
    1. Roy, N.B.A. & Pavord, S. (2018) The management of anaemia and haematinic deficiencies in pregnancy and post-partum. Transfusion Medicine, 28, 107-116.
    1. Royal College of Obstetricians and Gynaecologists. (2015) Blood transfusion in Obstetrics. Greentop Guideline 47.
    1. Rukini, R., Knight, M., Murphy, M.F., Roberts, D. & Stansworth, S.J. (2015) Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria. BMC Pregnancy Childbirth, 15, 269.
    1. Schaap, C.C., Hendriks, J.C., Kortman, G.A., Klaver, S.M., Kroot, J.J., Laarakkers, C.M., Wiegerinck, E.T., Tjalsma, H., Janssen, M.C. & Swinkels, D.W. (2013) Diurnal rhythm rather than dietary iron mediates daily hepcidin variations. Clinical Chemistry, 59, 527-535.
    1. Scholl, T.O. (2005) Iron status during pregnancy: setting the stage for mother and infant. American Journal of Clinical Nutrition, 81, S1218-S1222.
    1. Seid, M.H., Derman, R.J., Baker, J.B., Banach, W., Goldberg, C. & Rogers, R. (2008) Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia: a randomized controlled clinical trial. American Journal of Obstetrics and Gynecology, 199, 435.
    1. Shao, J., Lou, J., Rao, R., Georgieff, M.K., Kaciroti, N., Felt, B.T., Zhao, Z.Y. & Lozoff, B. (2012) Maternal serum ferritin concentration is positively associated with newborn iron stores in women with low ferritin status in late pregnancy. Journal of Nutrition, 142, 2004-2009.
    1. Shinar, S., Skornick-Rapaport, A. & Maslovitz, S. (2017) Iron supplementation in singleton pregnancy: is there a benefit to doubling the dose of elemental iron in iron-deficient pregnant women? A randomized controlled trial. Journal of Perinatology, 37, 782-786.
    1. Skikne, B. & Baynes, R.D. (1994) Iron absorption. In: Iron Metabolism in Health and Disease (eds. by Brock, J.H., Halliday, J.W., Pippard, M.J. & Powell, L.W.), pp. 151-187. Saunders, London.
    1. Smith, G.A., Fisher, S.A., Doree, C., Di Angelantonio, E. & Roberts, D.J. (2014) Oral or parenteral iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors. Cochrane Database Systematic Reviews, 7, CD009532.
    1. Stevens, G.A., Finucane, M.M., de-Regil, L.M., Paciorek, C.J., Flaxman, S.R., Branca, F., Peña-Rosas, J.P., Bhutta, Z.A. & Ezzati, M.; Nutrition Impact Model Study Group (Anaemia). (2013) Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. The Lancet Global Health, 1, e16-e25.
    1. Stoffel, N.U., Cercamondi, C.I., Brittenham, G., Zeder, C., Geurts-Moespot, A.J., Swinkels, D.W., Moretti, D. & Zimmermann, M.B. (2017) Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. The Lancet Haematology, 4, e524-e533.
    1. Tapiero, H., Gaté, L. & Tew, K.D. (2001) Iron: deficiencies and requirements. Biomedicine and Pharmacotherapy, 55, 324-332.
    1. Thompson, J., Pavord, S. & Lim, K. (2014) Severe hemosiderin pigmentation after intravenous iron infusion. Journal of Internal Medicine, 44, 706-708.
    1. US Preventive Services Task Force. (2015). Final Recommendation Statement: Iron Deficiency Anemia in Pregnant Women: Screening and Supplementation.
    1. van den Broek, N.R., Letsky, E.A., White, S.A. & Shenkin, A. (1998) Iron status in pregnant women: which measurements are valid? British Journal of Haematology, 103, 817-824.
    1. Van Wyk, D.B. & Martens, M.G. (2007) Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anaemia: a randomized controlled trial. Obstetrics & Gynecology, 110, 267-278.
    1. Veena, S.R., Gale, C.R., Krishnaveni, G.V., Kehoe, S.H., Srinivasan, K. & Fall, C.H. (2016) Association between maternal nutritional status in pregnancy and offspring cognitive function during childhood and adolescence; a systematic review [internet]. BMC Pregnancy Childbirth, 16, 220.
    1. Vora, S., Messina, G. & Pavord, S. (2019) Utility of erythrocyte indices in identifying iron depletion in pregnancy. Obstetric Medicine, in press.
    1. White, J., Qureshi, H., Massey, E., Needs, M., Byrne, G., Daniels, G. & Allard, S.; on behalf of the British Committee for Standards in Haematology. (2016) Guideline for blood grouping and red cell antibody testing in pregnancy. Transfusion Med, 26, 246-263.
    1. WHO. (2017) Nutritional Anaemias: Tools for Effective Prevention and Control. World Health Organization, Geneva. Page 7 Licence: CC BY-NC-SA 3.0 IGO.
    1. WHO. (2011) Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System. World Health Organization, Geneva. (WHO/NMH/NHD/MNM/11.1)
    1. Zoller, H., Schaefer, B. & Glodny, B. (2017) Iron-induced hypophosphatemia: an emerging complication. Current Opinion in Nephrology and Hypertension, 26, 266-275.

Source: PubMed

3
Předplatit