Iron deficiency during pregnancy: effectiveness of therapy and key points for clinical practice

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Resumo

Iron deficiency of varying degrees of severity remains one of the most common complications of pregnancy.

Objective: To present our own experience of using a preparation containing ferrous fumarate and folic acid for the treatment and prevention of iron deficiency in pregnant women during various stages of gestation.

Materials and methods: The study included 90 pregnant women with varying degrees of iron deficiency. Group 1 included 30 first trimester pregnant women, group 2 consisted of 30 second trimester pregnant women, and group 3 included 30 third trimester pregnant women. All patients took ferrous fumarate in combination with folic acid for 21 days.

Results: The examination revealed a high incidence of diseases of the gastrointestinal tract. The lowest initial indicators of iron concentration were revealed in patients whose gravidity and parity were ≥ 2 (16.6% in group 1, 20% in group 2 and 20% in group 3). Iron deficiency was found most frequently in pregnant women in their third trimester. The most remarkable effect was noted in patients of the 1st and 2nd groups who started therapy at earlier stages of pregnancy in comparison with the patients of the 3rd group. The analysis of hematological and ferrokinetic indicators showed that hemoglobin, serum iron, TIBC, hematocrit increased significantly, and the level of ferritin increased slowly.

Conclusion: The preparation containing ferrous fumarate and folic acid can be effectively used for the prevention and treatment of various stages of iron deficiency during pregnancy starting from the first trimester. Quick and marked positive effect can be obtained by early iron supplementation (including preventive supplementation, pre-latent iron deficiency and latent iron deficiency).

Sobre autores

Eliso Dzhobava

Crede Experto Clinic LLC

Autor responsável pela correspondência
Email: super.lis9@yandex.ru

Dr. Med. Sci., Medical Director of the Clinic, Obstetrician-Gynecologist

Rússia, Moscow

Inessa Knysheva

Crede Experto Clinic LLC

Email: super.lis9@yandex.ru

PhD, General Director of the Clinic, Obstetrician-Gynecologist

Rússia, Moscow

Darya Artizanova

Crede Experto Clinic LLC

Email: super.lis9@yandex.ru

Obstetrician-Gynecologist

Rússia, Moscow

Bibliografia

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  2. Peace J.M., Banayan J.M. Anemia in pregnancy: pathophysiology, diagnosis, and treatment. Int. Anesthesiol. Clin. 2021; 59(3): 15-21. https://dx.doi.org/ 10.1097/AIA.0000000000000320
  3. Elmore C., Ellis J. Screening, treatment, and monitoring of iron deficiency anemia in pregnancy and postpartum. J. Midwifery Womens Health. 2022; 67(3): 321-31. https://dx.doi.org/10.1111/ jmwh.13370
  4. Kumar A., Sharma E., Marley A., Samaan M.A., Brookes M.J. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol. 2022; 9(1): e000759. https://dx.doi.org/10.1136/bmjgast-2021-000759
  5. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Нормальная беременность. М.; 2020. [Ministry of Health of the Russian Federation. Clinical guidelines. Normal pregnancy. Moscow; 2020. (in Russian)].
  6. Коноводова Е.Н., Бурлев В.А., Серов В.Н., Кан Н.Е., Тютюнник В.Л. Федеральные клинические рекомендации «Диагностика, профилактика и лечение железодефицитных состояний у беременных и родильниц». 2013. 80с. [Konovodova E.N., Burlev V.A., Serov V.N., Kan N.E., Tyutyunnik V.L. Federal clinical guidelines "Diagnosis, prevention and treatment of iron deficiency conditions in pregnant and postpartum women. 2013. 80p. (in Russian)].

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