Adam K Lewkowitz1, Anjlie Gupta2, Laura Simon3, Bethany A Sabol4, Carrie Stoll2, Emily Cooke5, Roxanne A Rampersad4, Methodius G Tuuli6. 1. Department of Obstetrics and Gynecology, Washington University in St. Louis, 4566 Scott Avenue, Campus Box 8064, St. Louis, MO, 63110, USA. lewkowitza@wustl.edu. 2. Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO, 63110, USA. 3. Becker Medical Library, Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO, 63110, USA. 4. Department of Obstetrics and Gynecology, Washington University in St. Louis, 4566 Scott Avenue, Campus Box 8064, St. Louis, MO, 63110, USA. 5. Department of Pharmacy, Barnes-Jewish Hospital, One Barnes-Jewish Hospital Plaza, St. Louis, MO, 63110, USA. 6. Department of Obstetrics & Gynecology, Indiana University School of Medicine, 550N. University Boulevard, UH 2440, Indianapolis, IN, 46202, USA.
Abstract
OBJECTIVE: To assess the effect of intravenous versus oral iron on hematologic indices and clinical outcomes for iron-deficiency anemia (IDA) in pregnancy. STUDY DESIGN: Searches in Ovid Medline, Embase, SCOPUS, Cochrane Database, and ClinicalTrials.gov identified randomized-controlled trials comparing intravenous to oral iron for treating IDA in pregnancy. Primary outcomes were maternal hematologic indices at delivery. Secondary outcomes were blood transfusion, cesarean delivery, neonatal outcomes, and medication reactions. RESULTS: Of 15,637 studies, 20 randomized trials met inclusion criteria and were analyzed. Mean hemoglobin at delivery (9 studies: WMD 0.66 g/dL (95% confidence Interval 0.31 -1.02 g/dL)) was significantly higher after intravenous iron therapy. Intravenous iron was associated with higher birthweight (8 studies: WMD 58.25 g (95% CI: 5.57-110.94 g)) but no significant differences in blood transfusion, cesarean delivery, or neonatal hemoglobin. There were fewer medication reactions with intravenous iron (21 studies: RR 0.34% (95% CI: 0.20-0.57)). CONCLUSION: Intravenous iron therapy is associated with higher maternal hemoglobin at delivery with no difference in blood transfusion and fewer mild medication reactions.
OBJECTIVE: To assess the effect of intravenous versus oral iron on hematologic indices and clinical outcomes for iron-deficiency anemia (IDA) in pregnancy. STUDY DESIGN: Searches in Ovid Medline, Embase, SCOPUS, Cochrane Database, and ClinicalTrials.gov identified randomized-controlled trials comparing intravenous to oral iron for treating IDA in pregnancy. Primary outcomes were maternal hematologic indices at delivery. Secondary outcomes were blood transfusion, cesarean delivery, neonatal outcomes, and medication reactions. RESULTS: Of 15,637 studies, 20 randomized trials met inclusion criteria and were analyzed. Mean hemoglobin at delivery (9 studies: WMD 0.66 g/dL (95% confidence Interval 0.31 -1.02 g/dL)) was significantly higher after intravenous iron therapy. Intravenous iron was associated with higher birthweight (8 studies: WMD 58.25 g (95% CI: 5.57-110.94 g)) but no significant differences in blood transfusion, cesarean delivery, or neonatal hemoglobin. There were fewer medication reactions with intravenous iron (21 studies: RR 0.34% (95% CI: 0.20-0.57)). CONCLUSION: Intravenous iron therapy is associated with higher maternal hemoglobin at delivery with no difference in blood transfusion and fewer mild medication reactions.
Authors: Toby Richards; Ravishankar Rao Baikady; Ben Clevenger; Anna Butcher; Sandy Abeysiri; Marisa Chau; Rebecca Swinson; Tim Collier; Matthew Dodd; Laura Van Dyck; Iain Macdougall; Gavin Murphy; John Browne; Andrew Bradbury; Andrew Klein Journal: Health Technol Assess Date: 2021-02 Impact factor: 4.014
Authors: Toby Richards; Christian Breymann; Matthew J Brookes; Stefan Lindgren; Iain C Macdougall; Lawrence P McMahon; Malcolm G Munro; Elizabeta Nemeth; Giuseppe M C Rosano; Ingolf Schiefke; Günter Weiss Journal: Ann Med Date: 2021-12 Impact factor: 4.709