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孕期缺铁性贫血:针对老问题的新方法

Iron Deficiency Anemia in Pregnancy: Novel Approaches for an Old Problem.

作者信息

Garzon Simone, Cacciato Patrizia Maria, Certelli Camilla, Salvaggio Calogero, Magliarditi Maria, Rizzo Gianluca

机构信息

Department of Obstetrics and Gynecology, University of Insubria, Filippo Del Ponte Hospital, Varese, Italy.

University of Catania, Catania, Italy.

出版信息

Oman Med J. 2020 Sep 1;35(5):e166. doi: 10.5001/omj.2020.108. eCollection 2020 Sep.

Abstract

Iron needs increase exponentially during pregnancy to meet the increased demands of the fetoplacental unit, to expand maternal erythrocyte mass, and to compensate for iron loss at delivery. In more than 80% of countries in the world, the prevalence of anemia in pregnancy is > 20% and could be considered a major public health problem. The global prevalence of anemia in pregnancy is estimated to be approximately 41.8%. Undiagnosed and untreated iron deficiency anemia (IDA) can have a great impact on maternal and fetal health. Indeed, chronic iron deficiency can affect the general wellbeing of the mother and leads to fatigue and reduced working capacity. Given the significant adverse impact on maternal-fetal outcomes, early recognition and treatment of this clinical condition is fundamental. Therefore, the laboratory assays are recommended from the first trimester to evaluate the iron status. Oral iron supplementation is the first line of treatment in cases of mild anemia. However, considering the numerous gastrointestinal side effects that often lead to poor compliance, other therapeutic strategies should be evaluated. This review aims to provide an overview of the current evidence about the management of IDA in pregnancy and available treatment options.

摘要

孕期铁需求呈指数级增长,以满足胎儿 - 胎盘单位增加的需求、扩充母体红细胞量,并补偿分娩时的铁流失。在世界上超过80%的国家,孕期贫血患病率>20%,可被视为一个重大的公共卫生问题。全球孕期贫血患病率估计约为41.8%。未诊断和未治疗的缺铁性贫血(IDA)会对母婴健康产生重大影响。确实,慢性缺铁会影响母亲的总体健康状况,导致疲劳和工作能力下降。鉴于对母婴结局有重大不利影响,早期识别和治疗这种临床状况至关重要。因此,建议从孕早期开始进行实验室检测以评估铁状态。轻度贫血病例的一线治疗是口服铁补充剂。然而,考虑到众多常导致依从性差的胃肠道副作用,应评估其他治疗策略。本综述旨在概述目前关于孕期IDA管理及可用治疗选择的证据。

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