Optimizing diagnosis and treatment of iron deficiency and iron deficiency anemia in women and girls of reproductive age : Clinical opinion
© 2023 The Author. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics..
Iron deficiency (ID) is the world's most common disorder and one of the top five causes of years lived with disability. Whereas low serum ferritin is diagnostic of ID, ferritin-an acute phase reactant-may be elevated in inflammatory states and the first trimester of pregnancy even if ID exists. Consequently, in early pregnancy or chronic inflammation, percent transferrin saturation (TSAT) measurement is the best indicator of iron status. Unfortunately, current guidelines do not recommend routine screening for ID in either pregnant or nonpregnant women in the absence of anemia. This circumstance should be urgently reviewed based on available data. While oral formulations have long been the standard for iron replacement therapy and are widely available and inexpensive, oral iron is frequently associated with adverse gastrointestinal effects for the majority-a major reason for poor adherence, inadequate repletion, and persisting ID symptoms and sequellae. Although safe intravenous iron administration was introduced in the mid-1950s, formulations with cores binding the elemental iron more tightly became available in the 2000s, allowing complete and safe replacement, even in a single setting. Prospectively acquired neonatology evidence reports oral iron's failure to reach the developing fetus when the mother is iron deficient. Consequently, while oral iron remains frontline in the first trimester because of insufficient safety data for intravenous iron, the author recommends that the intravenous route should be the gold standard for second-trimester ID when hemoglobin concentrations are less than 10.5 g/dL and for all iron-deficient women in their third trimester.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:162 Suppl 2 |
|---|---|
| Enthalten in: |
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics - 162 Suppl 2(2023) vom: 16. Aug., Seite 68-77 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Auerbach, Michael [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
9007-73-2 |
|---|
| Anmerkungen: |
Date Completed 07.08.2023 Date Revised 07.08.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1002/ijgo.14949 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM360377351 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM360377351 | ||
| 003 | DE-627 | ||
| 005 | 20231226082903.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/ijgo.14949 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1201.xml |
| 035 | |a (DE-627)NLM360377351 | ||
| 035 | |a (NLM)37538014 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Auerbach, Michael |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Optimizing diagnosis and treatment of iron deficiency and iron deficiency anemia in women and girls of reproductive age |b Clinical opinion |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.08.2023 | ||
| 500 | |a Date Revised 07.08.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Author. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. | ||
| 520 | |a Iron deficiency (ID) is the world's most common disorder and one of the top five causes of years lived with disability. Whereas low serum ferritin is diagnostic of ID, ferritin-an acute phase reactant-may be elevated in inflammatory states and the first trimester of pregnancy even if ID exists. Consequently, in early pregnancy or chronic inflammation, percent transferrin saturation (TSAT) measurement is the best indicator of iron status. Unfortunately, current guidelines do not recommend routine screening for ID in either pregnant or nonpregnant women in the absence of anemia. This circumstance should be urgently reviewed based on available data. While oral formulations have long been the standard for iron replacement therapy and are widely available and inexpensive, oral iron is frequently associated with adverse gastrointestinal effects for the majority-a major reason for poor adherence, inadequate repletion, and persisting ID symptoms and sequellae. Although safe intravenous iron administration was introduced in the mid-1950s, formulations with cores binding the elemental iron more tightly became available in the 2000s, allowing complete and safe replacement, even in a single setting. Prospectively acquired neonatology evidence reports oral iron's failure to reach the developing fetus when the mother is iron deficient. Consequently, while oral iron remains frontline in the first trimester because of insufficient safety data for intravenous iron, the author recommends that the intravenous route should be the gold standard for second-trimester ID when hemoglobin concentrations are less than 10.5 g/dL and for all iron-deficient women in their third trimester | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anemia | |
| 650 | 4 | |a iron deficiency | |
| 650 | 4 | |a iron deficiency anemia | |
| 650 | 4 | |a iron replacement | |
| 650 | 7 | |a Iron |2 NLM | |
| 650 | 7 | |a E1UOL152H7 |2 NLM | |
| 650 | 7 | |a Ferritins |2 NLM | |
| 650 | 7 | |a 9007-73-2 |2 NLM | |
| 650 | 7 | |a Hemoglobins |2 NLM | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics |d 1973 |g 162 Suppl 2(2023) vom: 16. Aug., Seite 68-77 |w (DE-627)NLM000003336 |x 1879-3479 |7 nnns |
| 773 | 1 | 8 | |g volume:162 Suppl 2 |g year:2023 |g day:16 |g month:08 |g pages:68-77 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/ijgo.14949 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 162 Suppl 2 |j 2023 |b 16 |c 08 |h 68-77 | ||