Iron deficiency anaemia in pregnancy and postpartum: pathophysiology and effect of oral versus intravenous iron therapy

J Pregnancy. 2012:2012:630519. doi: 10.1155/2012/630519. Epub 2012 Jun 26.

Abstract

Nutritional iron-deficiency anaemia (IDA) is the most common disorder in the world, affecting more than two billion people. The World Health Organization's global database on anaemia has estimated a prevalence of 14% based on a regression-based analysis. Recent data show that the prevalence of IDA in pregnant women in industrialized countries is 17.4% while the incidence of IDA in developing countries increases significantly up to 56%. Although oral iron supplementation is widely used for the treatment of IDA, not all patients respond adequately to oral iron therapy. This is due to several factors including the side effects of oral iron which lead to poor compliance and lack of efficacy. The side effects, predominantly gastrointestinal discomfort, occur in a large cohort of patients taking oral iron preparations. Previously, the use of intravenous iron had been associated with undesirable and sometimes serious side effects and therefore was underutilised. However, in recent years, new type II and III iron complexes have been developed, which offer better compliance and toleration as well as high efficacy with a good safety profile. In summary, intravenous iron can be used safely for a rapid repletion of iron stores and correction of anaemia during and after pregnancy.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anemia, Iron-Deficiency / diagnosis
  • Anemia, Iron-Deficiency / drug therapy*
  • Anemia, Iron-Deficiency / metabolism
  • Anemia, Iron-Deficiency / therapy
  • Biomarkers / blood
  • Blood Transfusion
  • Female
  • Hematinics / administration & dosage*
  • Hematinics / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Iron / metabolism
  • Iron Compounds / administration & dosage*
  • Iron Compounds / blood
  • Iron Compounds / therapeutic use
  • Pregnancy
  • Pregnancy Complications, Hematologic / diagnosis
  • Pregnancy Complications, Hematologic / drug therapy*
  • Pregnancy Complications, Hematologic / metabolism
  • Pregnancy Complications, Hematologic / therapy
  • Puerperal Disorders / diagnosis
  • Puerperal Disorders / drug therapy*
  • Puerperal Disorders / metabolism
  • Puerperal Disorders / therapy

Substances

  • Biomarkers
  • Hematinics
  • Iron Compounds
  • Iron