Pfeiffer Alixandria F, Chang Nathalie, Zarudskaya Oxana, Cheng Cece, Berkus Michael D, Boyd Angela R, Byrne John J, Doyle Nora M
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Texas Health San Antonio, San Antonio, TX, United States.
Department of Obstetrics and Gynecology, University of Texas Health San Antonio, San Antonio, TX, United States.
Eur J Obstet Gynecol Reprod Biol. 2025 May;309:42-47. doi: 10.1016/j.ejogrb.2025.03.045. Epub 2025 Mar 17.
Little is known about the effects of intravenous iron (IVFe) supplementation on maternal hemoglobin (Hb) by timing of infusion and dosage.
To identify the association of IVFe timing and dose on pre-delivery Hb.
A retrospective cohort study of pregnant patients with iron deficiency anemia (IDA) who received iron sucrose (Venofer®) at our Level IV maternity care center following the implementation of a quality improvement (QI) transfusion reduction bundle from January 2020 to December 2023. The primary outcome was the association between IVFe timing and pre-delivery Hb. Secondary outcomes included the impact of IVFe dosage and infusion-to-delivery interval on Hb. Statistical analyses included paired t-tests, Mann-Whitney U tests, χ tests, ANOVA, and post-hoc Tukey multiple comparisons (significance set at p < 0.05).
295 patients were included. Mean age, BMI, and ferritin were 26.6 ± 6.3 years, 28.1, and 7.2 ± 7.8 μg/L, respectively. Mean GA for IVFe administration was 34 weeks. Two patients required intrapartum/postpartum red blood cell transfusions. A greater mean Hb difference (2.5 g/dL vs 1.3 g/dL), was observed with IVFe at <34 weeks compared to ≥34 weeks (p < 0.001). Higher IVFe doses were associated with increased pre-delivery Hb levels (p = 0.002) and a longer infusion-to-delivery interval (p = 0.049). The strongest Hb improvement was seen with latency from ≥6-8 weeks with doses >800 mg versus <2 weeks at doses ≤ 800 mg (increase of 2.6 - 3.1 g/dL, p < 0.0001).
Substantial benefit is seen when IVFe is given in the early third trimester, especially with ≥6 weeks of latency and doses ≥800 mg.
关于静脉注射铁剂（IVFe）补充剂的输注时间和剂量对母体血红蛋白（Hb）的影响，目前了解甚少。
确定IVFe的输注时间和剂量与分娩前Hb之间的关联。
一项回顾性队列研究，研究对象为2020年1月至2023年12月在我们的四级产科护理中心接受蔗糖铁（Venofer®）治疗的缺铁性贫血（IDA）孕妇。在实施质量改进（QI）输血减少方案后进行研究。主要结局是IVFe输注时间与分娩前Hb之间的关联。次要结局包括IVFe剂量和输注至分娩间隔对Hb的影响。统计分析包括配对t检验、曼-惠特尼U检验、χ检验、方差分析和事后Tukey多重比较（显著性设定为p < 0.05）。
纳入295例患者。平均年龄、BMI和铁蛋白分别为26.6±6.3岁、28.1和7.2±7.8μg/L。IVFe给药时的平均孕周为34周。两名患者在分娩期间/产后需要输注红细胞。与≥34周相比，<34周时接受IVFe治疗的患者平均Hb差异更大（2.5g/dL对1.3g/dL）（p < 0.001）。较高的IVFe剂量与分娩前Hb水平升高（p = 0.002）和较长的输注至分娩间隔相关（p = 0.049）。与剂量≤800mg时<2周的潜伏期相比，剂量>800mg时≥6 - 8周的潜伏期Hb改善最为明显（增加2.6 - 3.1g/dL，p < 0.0001）。
在妊娠晚期早期给予IVFe可带来显著益处，尤其是潜伏期≥6周且剂量≥800mg时。
