Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA.
Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.
Eur J Haematol. 2024 Dec;113(6):842-851. doi: 10.1111/ejh.14298. Epub 2024 Sep 3.
To determine maternal and neonatal outcomes in individuals with iron deficiency receiving antepartum intravenous (IV) iron supplementation, stratified by the degree of anemia.
Retrospective cohort study of iron-deficient pregnant patients who received at least one IV infusion of iron (iron sucrose, low molecular weight iron dextran [LMWID], or ferric carboxymaltose) during their pregnancy from January 1, 2011 through June 16, 2022. Our primary outcomes included both neonatal composite morbidity and maternal composite morbidity in the context of maternal anemia.
Patients who received LMWID had fewer infusion visits, received higher total doses of iron and had a more substantial correction of hemoglobin compared to those who received iron sucrose (p < 0.01). Maternal anemia at the time of admission was not associated with neonatal composite morbidity. However, there was a significant association between anemia status and maternal composite outcome (p = 0.05). Anemia at time of delivery was associated with the likelihood of requiring a blood transfusion (p = 0.01).
This study reinforces previous findings emphasizing the adverse effects of iron deficiency on maternal health and the role of IV iron in reducing these risks.
根据贫血程度,确定接受产前静脉(IV)补铁的缺铁个体的母婴结局。
这是一项回顾性队列研究,纳入了 2011 年 1 月 1 日至 2022 年 6 月 16 日期间至少接受过一次 IV 铁输注(蔗糖铁、低分子右旋糖酐铁[LMWID]或羧基麦芽糖铁)的缺铁孕妇患者。我们的主要结局包括在母体贫血的情况下新生儿复合发病率和母体复合发病率。
与接受蔗糖铁的患者相比,接受 LMWID 的患者输注次数更少,接受的总铁剂量更高,血红蛋白纠正更显著(p<0.01)。入院时的母体贫血与新生儿复合发病率无关。然而,贫血状态与母体复合结局之间存在显著关联(p=0.05)。分娩时的贫血与需要输血的可能性相关(p=0.01)。
本研究强化了之前的研究结果,强调了缺铁对产妇健康的不良影响以及 IV 铁在降低这些风险中的作用。