Michael G. DeGroote Centre for Transfusion Research, McMaster University, 1200 Main Street West HSC-3H50, Hamilton, ON, L8N 3Z5, Canada.
Department of Medicine and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Syst Rev. 2023 Jul 14;12(1):121. doi: 10.1186/s13643-023-02222-4.
Abnormal uterine bleeding (AUB), which includes heavy menstrual bleeding (HMB), is a common condition placing women at increased risk for developing iron deficiency and iron deficiency anemia (IDA). Depletion of iron stores has negative implications on physical, social, and emotional health, as well as quality of life. Iron supplements are safe, effective, and readily available, while red blood cell (RBC) transfusions have inherent risks including infectious and immune reactions. Despite high prevalence of IDA among women with AUB, there are limited studies on the impact of iron therapies on patient outcomes. This systematic review and meta-analysis will evaluate the impact of iron supplementation on patient outcomes for women with AUB, when compared to combination therapy, no intervention, placebo, or standard of care.
We will conduct a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the impact of iron interventions on patient outcomes for women with AUB. Systematic literature searches will be conducted in major databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and Web of Science. Studies assessing the impact of iron interventions on patient outcomes in women experiencing AUB, in comparison to combination therapy, no intervention, placebo, or standard of care, will be included in the review. Independent reviewers will screen for eligibility, assess risk of bias, and abstract data. Overall certainty of evidence for each outcome will be assessed using the GRADE approach. We will meta-analyze outcomes which are sufficiently homogeneous to summarize intervention effects and narratively synthesize nonhomogeneous outcomes. The main outcomes of interest are hemoglobin levels immediately prior to surgery and post-operatively, number of RBC transfusions, and adverse effects. Secondary outcomes will include length of hospital stay, intraoperative blood loss, adverse and side effects, quality of life, and iron indices.
This review will evaluate the impact of iron interventions on patient outcomes in women with IDA secondary to AUB with focus on changes in hematological and iron indices, red blood cell utilization, quality of life, cost of treatment, and adverse events. The results will inform evidence-based clinical practice for the management of iron deficiency and IDA secondary to AUB.
PROSPERO CRD42019137282.
异常子宫出血（AUB）包括月经过多（HMB），是一种常见病症，会使女性缺铁和缺铁性贫血（IDA）的风险增加。铁储存的消耗对身体、社交和情感健康以及生活质量都有负面影响。铁补充剂安全、有效且易于获得，而红细胞（RBC）输血存在感染和免疫反应等固有风险。尽管 AUB 女性中 IDA 的患病率很高，但关于铁治疗对患者结局影响的研究有限。本系统评价和荟萃分析将评估与联合治疗、无干预、安慰剂或标准治疗相比，铁补充剂对 AUB 女性患者结局的影响。
我们将对评估铁干预对 AUB 女性患者结局影响的随机对照试验和观察性研究进行系统评价和荟萃分析。系统文献检索将在主要数据库中进行，包括 MEDLINE、EMBASE、CENTRAL、CINAHL 和 Web of Science。将纳入评估铁干预对 AUB 女性患者结局影响的研究，与联合治疗、无干预、安慰剂或标准治疗进行比较。独立评审员将筛选合格性、评估偏倚风险并提取数据。使用 GRADE 方法评估每个结局的证据总体确定性。我们将对足够同质以总结干预效果的结局进行荟萃分析，并对非同质结局进行叙述性综合。主要结局是手术前和手术后血红蛋白水平、RBC 输血数量以及不良反应。次要结局将包括住院时间、术中失血量、不良反应和副作用、生活质量以及铁指标。
本综述将评估铁干预对 AUB 继发 IDA 女性患者结局的影响，重点关注血液学和铁指标、红细胞利用、生活质量、治疗成本和不良反应的变化。结果将为 AUB 继发 IDA 的管理提供循证临床实践依据。
PROSPERO CRD42019137282。
