Rukuni Ruramayi, Knight Marian, Murphy Michael F, Roberts David, Stanworth Simon J
National Perinatal Epidemiology Unit, University of Oxford, Old Road, Campus, Oxford, OX3 7LF, UK.
Department of Haematology, John Radcliffe Hospital, NHS Blood & Transplant/Oxford University Hospital Trust, University of Oxford, Oxford, UK.
BMC Pregnancy Childbirth. 2015 Oct 20;15:269. doi: 10.1186/s12884-015-0679-9.
Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes.
Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness.
Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy.
Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.
尽管有国家治疗建议和指南，但缺铁性贫血仍是孕期常见问题。本研究旨在评估与英国国家筛查委员会（UKNSC）标准相悖的证据，以确定全国性筛查计划是否能降低孕期缺铁性贫血和/或缺铁的患病率，并改善母婴结局。
针对Cochrane图书馆、Medline和Embase制定检索策略，以识别与英国国家筛查委员会（UKNSC）评估标准相关的证据，这些标准涵盖缺铁和缺铁性贫血的自然史、筛查试验、临床管理以及成本效益证据。
许多研究评估了贫血的血液学结局，但很少分析临床后果。血红蛋白和铁蛋白似乎是最合适的筛查试验，不过未来的选择可能会遵循铁稳态认识方面的最新进展。缺铁但无贫血的临床后果尚不清楚。口服和静脉补铁对改善血红蛋白和铁参数有效。目前尚无关于孕期缺铁性贫血全国筛查计划的试验或经济评估。
尽管有有效的检测和治疗方法，但孕期缺铁仍然是一个重要问题。全国性筛查计划可能对早期发现和干预有价值。然而，需要高质量的研究来证实这是否会降低母婴发病率并具有成本效益。
