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Review
. 2015 Sep;12(3):173-181.
doi: 10.4274/tjod.01700. Epub 2015 Sep 15.

Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period: Iron deficiency anemia working group consensus report

Olus Api  1 , Christian Breyman  2 , Mustafa Çetiner  3 , Cansun Demir  4 , Tevfik Ecder  5
Affiliations
Review

Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period: Iron deficiency anemia working group consensus report

Olus Api et al. Turk J Obstet Gynecol. 2015 Sep.

Abstract

According to the World Health Organization (WHO), anemia is the most common disease, affecting >1.5 billion people worldwide. Furthermore, iron deficiency anemia (IDA) accounts for 50% of cases of anemia. IDA is common during pregnancy and the postpartum period, and can lead to serious maternal and fetal complications. The aim of this report was to present the experiences of a multidisciplinary expert group, and to establish reference guidelines for the optimal diagnosis and treatment of IDA during pregnancy and the postpartum period. Studies and guidelines on the diagnosis and treatment of IDA published in Turkish and international journals were reviewed. Conclusive recommendations were made by an expert panel aiming for a scientific consensus. Measurement of serum ferritin has the highest sensitivity and specificity for diagnosis of IDA unless there is a concurrent inflammatory condition. The lower threshold value for hemoglobin (Hb) in pregnant women is <11 g/dL during the 1st and 3rd trimesters, and <10.5 g/dL during the 2nd trimester. In postpartum period a Hb concentration <10 g/dL indicates clinically significant anemia. Oral iron therapy is given as the first-line treatment for IDA. Although current data are limited, intravenous (IV) iron therapy is an alternative therapeutic option in patients who do not respond to oral iron therapy, have adverse reactions, do not comply with oral iron treatment, have a very low Hb concentration, and require rapid iron repletion. IV iron preparations can be safely used for the treatment of IDA during pregnancy and the postpartum period, and are more beneficial than oral iron preparations in specific indications.

Keywords: Iron deficiency anemia; Pregnancy; intravenous iron therapy; postpartum period.

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Conflict of interest statement

Conflict of Interest: C Breymann is a medical advisor of Vifor International/Switzerland in the field of iron deficiency in Obstetrics and Gynecology. O Api, M Çetiner, C Demir, T Ecder, and F Yavuz declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1. Algorithm for the diagnosis and treatment of iron deficiency anemia during pregnancy
Figure 2
Figure 2. Algorithm for the diagnosis and treatment of iron deficiency anemia during the postpartum period
See this image and copyright information in PMC

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