Morita Akihito, Higeta Daisuke, Kitahara Yoshikazu, Inoue Maki, Iwase Akira
Obstetrics and Gynecology, Gunma University Hospital, Maebashi, JPN.
Cureus. 2024 Jul 24;16(7):e65276. doi: 10.7759/cureus.65276. eCollection 2024 Jul.
Background This study aimed to investigate the efficacy of iron therapy in the treatment of mild postpartum anemia. Methods We conducted a case-control study involving women who underwent cesarean section at our hospital between 2015 and 2020. Following propensity score matching, participants were categorized into two groups based on whether or not they received iron therapy. These patients were evaluated for mean hemoglobin (Hb) levels on the seventh postoperative day (POD 7), the percentage of subjects achieving Hb greater than 10 g/dL on POD 7, and the incidence of adverse events. The efficacy of iron administration was evaluated using a superiority test, and receiver operating characteristic analyses were employed to generate area under the receiver operating characteristic curves (AUROC). Results The mean Hb level on POD 7 was 10.12 g/dL in the iron group and 9.89 g/dL in the iron-free group (P = 0.206). The superiority test revealed that the percentage of subjects achieving Hb levels greater than 10 g/dL on POD 7 was 56.1% in the iron group and 48.8% in the iron-free group (P = 0.880), indicating that the iron group did not demonstrate superiority over the iron-free group. The incidence of adverse events was significantly higher in the iron group (P = 0.027). The highest AUROC was observed with preoperative mean corpuscular Hb, measuring 0.632 (95% CI: 0.509-0.755), with a cutoff point of 28.5 pg. Conclusion Consideration should be given to the uniform administration of iron for the management of mild postpartum anemia.
背景 本研究旨在探讨铁剂治疗轻度产后贫血的疗效。方法 我们进行了一项病例对照研究，纳入了2015年至2020年在我院行剖宫产的女性。经过倾向得分匹配后，根据是否接受铁剂治疗将参与者分为两组。评估这些患者术后第7天（POD 7）的平均血红蛋白（Hb）水平、POD 7时Hb大于10 g/dL的受试者百分比以及不良事件的发生率。使用优效性检验评估铁剂给药的疗效，并采用受试者工作特征分析来生成受试者工作特征曲线下面积（AUROC）。结果 铁剂组POD 7的平均Hb水平为10.12 g/dL，非铁剂组为9.89 g/dL（P = 0.206）。优效性检验显示，铁剂组POD 7时Hb水平大于10 g/dL的受试者百分比为56.1%，非铁剂组为48.8%（P = 0.880），表明铁剂组并不优于非铁剂组。铁剂组不良事件的发生率显著更高（P = 0.027）。术前平均红细胞Hb的AUROC最高，为0.632（95%CI：0.509 - 0.755），截断点为28.5 pg。结论 在管理轻度产后贫血时应考虑统一给予铁剂。
