Doctor Sarah Haynes1, Professor Jane Hirst1,3, Professor Simon Stanworth2,4, Associate Professor Noemi Roy2,4
1Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom, 2Radcliffe Department of Medicine, University of Oxford , Oxford, United Kingdom, 3Imperial College London, London, United Kingdom , 4Oxford University Hospital Haematology, University of Oxford, Oxford, United Kingdom
Biography:
Sarah is a junior doctor from Sydney currently undertaking a Doctor of Philosophy in Women’s and Reproductive Health at the University of Oxford. Sarah graduated from the University of New South Wales and completed her junior medical training in Sydney before being awarded the New South Wales Rhodes Scholarship.
Abstract:
Background: Iron deficiency anaemia in pregnancy (IDAP) persists as a major global health challenge and timely and effective iron therapy can mitigate adverse outcomes (1). However, the use of intravenous (IV) iron is increasing, despite a lack of substantial evidence of its clinical superiority (2). Accurate assessment of response to oral iron is vital for identifying the non-responder and therefore allow for early and appropriate allocation of IV iron. Whilst there is consensus on the importance of monitoring response to oral iron, there is a lack of evidence on how to do so in pregnancy (3).
This review aims to critically evaluate current guidelines and their evidence for assessing response to oral iron in pregnancy and identify alternative methods.
Methods: This scoping review was conducted using the JBI guideline for scoping reviews. Two databases along with national and professional organisation websites were searched using a librarian-developed search strategy. Titles and abstracts were screened, references of papers identified were checked for relevant literature. The search was limited to English language publications and guidelines from 2010 to 2024.
Results: At the time of abstract submission this review is ongoing. Our initial search identified 507 papers and guidelines. Most guidelines recommend monthly haemoglobin to monitor response to oral iron therapy. The studies cited to support this method often did not include pregnant women. We also review and report alternative methods for measuring response to oral iron therapy: serum ferritin, reticulocyte count, red cell distribution width, serum hepcidin and soluble transferrin receptor.
Discussion: We will discuss current clinical practice and the evidence for monitoring assessment to oral iron therapy in pregnancy.
Keywords
Pregnancy, Iron Deficiency Anaemia, Biomarkers.
References
1. Iqbal S, Ekmekcioglu C. Maternal and neonatal outcomes related to iron supplementation or iron status: a summary of meta-analyses. J Matern Fetal Neonatal Med. 2019 May 3;32(9):1528–40.
2. Smith-Wade S, Kidson-Gerber G, Shand A, Grzeskowiak L, Henry A. The use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians. BMC Pregnancy Childbirth. 2020 Dec;20(1):1–11.
3. Elmore C, Ellis J. Screening, Treatment, and Monitoring of Iron Deficiency Anemia in Pregnancy and Postpartum. J Midwifery Womens Health. 2022 May;67(3):321–31.