Latent iron deficiency therapy in pregnant women

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According to various studies, the overall population incidence of latent iron deficiency (LID) ranges from 70% and more. However, routine tests cannot detect LID during preconception examination and in the first trimester of pregnancy; therefore, women receive no proper treatment, and iron deficiency manifest in the second and third trimesters of pregnancy. LID causes hypoxia, leading to pregnancy, labor, and postpartum complications.

Aim. To evaluate the effectiveness of iron with folic acid supplements compared to vitamin-mineral complexes in pregnant women with LID to improve maternal and perinatal outcomes.

Materials and methods. A prospective cohort non-interventional study (observational program) in real clinical practice was conducted. In total 461 pregnant women aged 19 to 35 with LID were included in the study. During the study, women were divided into two groups according to the method of LID correction: administration of iron sulfate 247.25 mg, which corresponds to an iron content of 80 mg + folic acid 350 μg (Gyno-Tardyferon®), or vitamin-mineral complexes with an iron content of 14–18 mg. Routine complete blood count, serum iron, serum ferritin, and transferrin were monitored over time.

Results. Gyno-Tardyferon® showed high therapeutic and prophylactic efficacy; the rate of favorable outcomes was 100% and 35% for multivitamin iron-containing complexes. No LID progression to manifest iron deficiency during pregnancy can also be considered a favorable outcome.

Conclusion. The results showed that timely treatment of LID with an iron-containing medication (Gyno-Tardyferon®) prevents manifested iron deficiency and hemic and circulatory hypoxia, which ultimately reduces the rate of pregnancy, labor, and postpartum complications.

作者简介

Irina Kutsenko

Kuban State Medical University

Email: iikucenko@mail.ru
ORCID iD: 0000-0003-0938-8286
SPIN 代码: 7912-9184

D. Sci. (Med.), Prof., Kuban State Medical University

俄罗斯联邦, Krasnodar

Elena Kravtsova

Kuban State Medical University

编辑信件的主要联系方式.
Email: luzum69@mail.ru
ORCID iD: 0000-0001-8987-7375
SPIN 代码: 5579-9910

Cand. Sci. (Med.), Kuban State Medical University

俄罗斯联邦, Krasnodar

Lyudmila Kholina

Kuban State Medical University

Email: holina1667@mail.ru
ORCID iD: 0000-0002-6778-4087
SPIN 代码: 5011-2962

Cand. Sci. (Med.), Kuban State Medical University

俄罗斯联邦, Krasnodar

Oksana Tomina

Kuban State Medical University

Email: tominaoksana@mail.ru
ORCID iD: 0000-0002-2986-0202

Cand. Sci. (Med.), Kuban State Medical University

俄罗斯联邦, Krasnodar

参考

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  2. Дикке Г.Б., Стуклов Н.И. Латентный дефицит железа и железодефицитная анемия у беременных. Алгоритмы диагностики и лечения. Фарматека. 2021;28(6):19-24 [Dikke GB, Stuklov NI. Latent iron deficiency and iron deficiency anemia in pregnant women. Algorithms of diagnosis and treatment. Pharmateca. 2021;28(6):19-24 (in Russian)].
  3. Зефирова Т.П., Юпатов Е.Ю., Мухаметова Р.Р. Железодефицитная анемия в акушерской практике. РМЖ. Мать и дитя. 2021;4(1):53-8 [Zefirova TP, Yupatov EYu, Mukhametova RR. Iron deficiency anemia in obstetric practice. RMJ. Mother and child. 2021;4(1):53-8 (in Russian)]. doi: 10.32364/2618-8430-2021-4-1-53-58
  4. Большакова М.В., Беженарь В.Ф., Павлова Н.Г., и др. Современные представления о патогенезе гипоксии плода и роли в нем гипоксия-индуцируемого фактора (HIF). Акушерство и гинекология Санкт-Петербурга. 2019;1:19-24 [Bolshakova MV, Refugee VF, Pavlova NG, et al. Modern ideas about the pathogenesis of fetal hypoxia and the role of hypoxia-induced factor (HIF) in it. Obstetrics and Gynecology of St. Petersburg. 2019;1:19-24 (in Russian)].
  5. Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011;4(2):52-9.
  6. Handiso YH, Belachew T, Abuye C, et al. A community-based randomized controlled trial providing weekly iron-folic acid supplementation increased serum-ferritin, -folate and hemoglobin concentration of adolescent girls in southern Ethiopia. Sci Rep. 2021;11(1):9646. doi: 10.1038/s41598-021-89115-5

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2. Fig. 1. Rate of pregnancy complications in patients of the studied groups.

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3. Fig. 2. Rate of labor and post-partum complications.

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