000			03517nam a22005057a 4500
008			170731s20172017 xxu||||| |||| 00| 0 eng d
022			_a0002-9343
040			_aOvid MEDLINE(R)
099			_a28739199
245			_aResults of the First American Prospective Study of Intravenous Iron in Oral Iron Intolerant Iron Deficient Gravidas.
251			_aAmerican Journal of Medicine. 130(12):1402-1407, 2017 Dec
252			_aAm J Med. 130(12):1402-1407, 2017 Dec
253			_aThe American journal of medicine
260			_c2017
260			_fFY2018
266			_d2017-07-31
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present
520			_aBACKGROUND: 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.
520			_aCONCLUSION: Intravenous iron has less toxicity and is more effective supporting moving it closer to front line therapy.
520			_aCopyright (c) 2017. Published by Elsevier Inc.
520			_aMETHODS: 74 oral iron intolerant, 2<sup>nd</sup> and 3<sup>rd</sup> 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.
520			_aRESULTS: 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.
546			_aEnglish
650			_a*Iron Compounds/ad [Administration & Dosage]
650			_a*Iron/df [Deficiency]
650			_a*Pregnancy Complications/dt [Drug Therapy]
650			_aAdministration, Intravenous
650			_aAdministration, Oral
650			_aFemale
650			_aHumans
650			_aIron Compounds/ae [Adverse Effects]
650			_aPregnancy
650			_aProspective Studies
651			_aMedStar Franklin Square Medical Center
656			_aFamily Medicine
656			_aObstetrics and Gynecology
657			_aJournal Article
700			_aLenowitz, Steven
700			_aLondon, Nicola
700			_aNicoletti, Melissa
700			_aSmith, Samuel
790			_aAuerbach M, Bahrain HF, Derman R, James SE, Lenowitz S, London N, Nicoletti M, Smith S
856			_uhttps://dx.doi.org/10.1016/j.amjmed.2017.06.025 _zhttps://dx.doi.org/10.1016/j.amjmed.2017.06.025
942			_cART _dArticle
999			_c2953 _d2953