Results of the First American Prospective Study of Intravenous Iron in Oral Iron Intolerant Iron Deficient Gravidas.
- 2017
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present
BACKGROUND: Anemia affects up to 42% of gravidas. Neonatal iron deficiency is associated with low birth weight, delayed growth and development, and increased cognitive and behavioral abnormalities. While oral iron is convenient, up to 70% report significant gastrointestinal toxicity. Intravenous iron formulations allowing replacement in one visit with favorable side-effect profiles decrease rates of anemia with improved hemoglobin responses and maternal fetal outcomes. CONCLUSION: Intravenous iron has less toxicity and is more effective supporting moving it closer to front line therapy. Copyright (c) 2017. Published by Elsevier Inc. METHODS: 74 oral iron intolerant, 2nd and 3rd trimester iron deficient gravidas were questioned for oral iron intolerance and treated with intravenous iron. All received 1,000 mg of low molecular weight iron dextran in 250 ml normal saline. Fifteen minutes after a test dose, the remainder was infused over balance of 1 hour. Subjects were called at 1, 2 and 7 days to assess delayed reactions. Four weeks post-infusion or postpartum, hemoglobin levels and iron parameters were measured. Paired T-test was used for hemoglobin and iron. 58/73 women were questioned about interval growth and development of their babies. RESULTS: 73 of 74 enrolled subjects completed treatment. Sixty had paired pre- and post-treatment data. The mean pre- and post-hemoglobin concentrations were 9.7 and 10.8 g/dl (P<0.00001), TSATs 11.7% and 22.6% (P=0.0003) and ferritins 14.5 and 126.3 ng/mL respectively (P<0.000001). Six experienced minor infusion reactions. All resolved. Data for 58 infants was available; one was low on its growth charts for 11 months. The remaining 57 were normal. None were diagnosed with iron deficiency anemia.