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Maternal Anemia
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Ashley E. Benson, Marcela C. Smid
Risk factors for iron deficiency or iron deficiency anemia include diet poor in iron-rich food, a diet poor in iron absorption enhancers (vitamin C rich foods), a diet rich in foods that diminish iron absorption (dairy, soy products, coffee, spinach), pica (eating nonfood substances such as clay), gastrointestinal compromise affecting absorption (e.g., celiac disease, Crohn's disease, bariatric surgery), short pregnancy interval, parity ≥2, multiple gestation, low socioeconomic status and history of blood loss (heavy menses, postpartum hemorrhage). Though iron deficiency anemia from ongoing blood loss from the gastrointestinal system is less common in women of reproductive age, when iron deficiency is recognized during pregnancy, all possible causes should be considered.
Hereditary Haemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome)
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Hereditary haemorrhagic telangiectasia is inherited as an autosomal dominant condition. The telangiectases may first be seen in adolescence, their number increasing thereafter, peaking between the ages of 45-60 years. Visceral telangiectases and AV malformations may occur in the lungs, liver and spleen. Patients generally require continuous iron therapy to correct the tendency to iron deficiency anaemia.
Nonhematological Manifestations of Iron Deficiency
Published in Bo Lönnerdal, Iron Metabolism in Infants, 2020
Iron deficiency is present when body iron content is diminished.1,2 The presence of iron deficiency implies neither the degree of depletion nor the presence of anemia. Iron deficiency anemia refers to a hematologic state resulting from iron deficiency. Its occurrence implies that body iron stores as present in ferritin and hemosiderin have been exhausted and the organism is in the last stages of serious iron depletion. Thus, an individual may be iron deficient without manifesting iron deficiency anemia. The converse, however, does not occur.3
Iron supplementation given to nonanemic infants: neurocognitive functioning at 16 years
Published in Nutritional Neuroscience, 2023
Patricia L. East, Brie Reid, Estela Blanco, Raquel Burrows, Betsy Lozoff, Sheila Gahagan
Two points are important to emphasize regarding our study. The first is that iron status was not determined for all infants at enrollment into the preventive trial. Rather, enrollment was based on hemoglobin at 6 months. Because we did not have additional iron indices at 6 months, some participants could have been iron-insufficient at entry into the trial. The current results pertain only to nonanemic infants and cannot directly address the issue of iron-repletion. Secondly, this was a population at high risk for iron deficiency in infancy, and iron supplementation was highly effective in reducing that risk. Infants randomized to the iron-supplemented condition in the preventive trial were diagnosed with iron-deficiency anemia at 7-times lower rates than those randomized to the no-added iron condition (4.5% vs. 31.7%, respectively). Thus, iron supplementation for the purpose of preventing iron-deficiency anemia remains important. The question is the optimal level of supplementation. Our study used formula fortified at the level of iron recommended by the American Academy of Pediatrics at the time of the study (12.7 mg/L). Earlier results using the Chilean preventive trial sample showed that 2.3 mg/L of iron fortification in formula was sufficient to prevent IDA while resulting in better outcomes than fortification at the high level of iron supplementation [7,8]. Iron fortification in the lower range (2 mg/L) has been widely endorsed recently, with recommendations to stage formula iron content by age and breastfeeding status [25].
Evaluation of the reported rates of hypersensitivity reactions associated with iron dextran and ferric carboxymaltose based on global data from VigiBase™ and IQVIA™ MIDAS® over a ten-year period from 2008 to 2017
Published in Expert Review of Hematology, 2020
Darshana Durup, Philip Schaffalitzky de Muckadell, Claes Christian Strom
According to the Global Burden of Disease Study 2017, anemia is the most common medical impairment in the world, affecting 1.95 billion people [1]. Anemia is most prevalent in the poorest regions of the world, though it is also problematic in developed countries, with the most vulnerable population groups being young children, pregnant women, and women of childbearing age [2,3]. The most common cause of anemia is iron deficiency, responsible for more than half of cases [3]. There are many causes of iron deficiency, including malnutrition, the increased iron demand of pregnancy, heavy menstrual bleeding, chronic diseases such as chronic kidney disease or inflammatory bowel disease, and the increasing prevalence of bariatric surgery [4]. Iron deficiency anemia is harmful, being associated with impaired cognitive development in children, increased morbidity, adverse outcomes in pregnancy, and reduced work capacity [5]. Oral iron formulations are beneficial for some patients with iron deficiency anemia, but their use is limited by gastrointestinal side effects which can result in nonadherence to treatment [4,6]. Intravenous (IV) iron formulations, consisting of iron–carbohydrate complexes, are generally recommended in cases where oral iron is inefficient, poorly tolerated, or poorly absorbed [7,8].
Efficacy and tolerability of oral iron protein succinylate: a systematic review of three decades of research
Published in Current Medical Research and Opinion, 2020
Antonio Martínez Francés, Javier Leal Martínez-Bujanda
Anemia caused by iron deficiency is a widespread nutritional disorder, with important consequences for human health1. Although the overall prevalence of anemia drops in middle- and high-income countries due to better access to adequate food, specific populations in these countries remain at high risk of iron deficiency. This is the case of pregnant2,3 and menstruating women4,5, particularly adolescents, in whom the onset of menstruation overlaps with a stage of rapid growth and increased iron requirements6. Iron-deficiency anemia causes lethargy, fatigue, irritability, and breathlessness. However, various authors have suggested that iron deficiency in the absence of anemia may impair exercise performance and affect muscle fatigue and work4,7,8.