Obianeli Chidi, Afifi Khaled, Stanworth Simon, Churchill David
The Royal Wolverhampton NHS Trust, New Cross Hospital, Wednesfield, Wolverhampton WV10 0QP, UK.
NHS Blood and Transplant, Oxford OX3 9DU, UK.
Diagnostics (Basel). 2024 Oct 17;14(20):2306. doi: 10.3390/diagnostics14202306.
Anaemia in pregnancy is a global problem of significance in all settings. The most common cause is iron deficiency. Large numbers of women are affected, ranging up to 25-30% antenatally and 20-40% postnatally. It is associated with serious adverse outcomes for both the mother and her baby. The risk of low birth weight, preterm birth, postpartum haemorrhage, stillbirth, and neonatal death are all increased in the presence of anaemia. For the infants of affected pregnancies, complications may include neurocognitive impairment. Making an accurate diagnosis during pregnancy has its challenges, which include the choice of thresholds of haemoglobin below which a diagnosis of anaemia in each trimester of pregnancy can be made and, aligned with this question, which are the most appropriate biomarkers to use to define iron deficiency. Treatment with oral iron supplements increases the haemoglobin concentration and corrects iron deficiency. But high numbers of women fail to respond, probably due to poor adherence to medication, resulting from side effects. This has resulted in an increased use of more expensive intravenous iron. Doubts remain about the optimal regimen to of oral iron for use (daily, alternate days, or some other frequency) and the cost-effectiveness of intravenous iron. There is interest in strategies for prevention but these have yet to be proven clinically safe and effective.
孕期贫血是一个在所有环境中都具有重要意义的全球性问题。最常见的原因是缺铁。大量女性受到影响，产前受影响的比例高达25% - 30%，产后为20% - 40%。它与母亲及其婴儿的严重不良后果相关。贫血会增加低出生体重、早产、产后出血、死产和新生儿死亡的风险。对于受影响妊娠的婴儿，并发症可能包括神经认知障碍。在孕期进行准确诊断存在挑战，这包括选择每个孕期可诊断贫血的血红蛋白阈值，与此问题相关的是，用于定义缺铁的最合适生物标志物是什么。口服铁剂治疗可提高血红蛋白浓度并纠正缺铁。但大量女性没有反应，可能是由于副作用导致对药物的依从性差。这导致了更昂贵的静脉铁剂使用增加。关于口服铁剂的最佳用药方案（每日、隔日或其他频率）以及静脉铁剂的成本效益仍存在疑问。人们对预防策略感兴趣，但这些策略尚未在临床上被证明是安全有效的。
