Transfusi darah atau pemberian sesuatu yang merangsangkan tubuh untuk menghasilkan lebih sel‐sel merah (eritropoietin) juga boleh diberikan sebagai rawatan.ĭalam kajian semula ini, kami mengenalpasti 23 kajian yang melibatkan 3198 wanita hamil. Rawatan zat besi boleh diberikan melalui mulut (oral), melalui suntikan kedalam otot‐otot (intramuskular) atau suntikan kedalam vena (intravena). Kekurangan zat besi, bagaimanapun adalah penyebab lazim bagi anemia dalam kehamilan. Kesemua ini diperlukan untuk membina sel‐sel merah dan terdapat dalam diet yang baik. Terdapat beberapa penyebab anemia, termasuk kekurangkan zat besi, asid folik atau vitamin B12. Anemia yang teruk menyebabkan wanita berisiko mendapat kegagalan jantung dan ini biasa berlaku di negara‐negara berpendapatan rendah. Anemia sebenar, bagaimanapun, boleh jadi ringan, sederhana atau teruk dan boleh menyebabkan kelemahan, keletihan dan pening. Kekadang, keadaan ini dipanggil anemia fisiologikal dan tidak memerlukan rawatan. Biasanya, terdapat pengurangan kepekatan hemoglobin dalam darah ibu semasa kehamilan dan ini membenarkan aliran darah yang lebih baik ke sekitar rahim (uterus) dan kepada bayi.
Rawatan untuk anemia semasa kehamilan yang dianggap akibat dari kekurangan zat besiĪpabila darah mengandungi kekurangan sel‐sel darah merah, atau sel‐sel darah merah mengandungi kekurang hemoglobin untuk menghantar oksigen yang mencukupi kepada tisu‐tisu, keadaan ini dikenali sebagai anemia. Large, good quality trials, assessing clinical outcomes (including adverse effects) as well as the effects of treatment by severity of anaemia are required. Parenteral (intramuscular and intravenous) iron enhances haematological response, compared with oral iron, but there are concerns about possible important adverse effects (for intravenous treatment venous thrombosis and allergic reactions and for intramuscular treatment important pain, discolouration and allergic reactions). Daily oral iron treatment improves haematological indices but causes frequent gastrointestinal adverse effects. Authors' conclusionsĭespite the high incidence and burden of disease associated with this condition, there is a paucity of good quality trials assessing clinical maternal and neonatal effects of iron administration in women with anaemia. Daily low‐dose iron supplements may be effective at treating anaemia in pregnancy with less gastrointestinal side effects compared with higher doses. Although the intramuscular and intravenous routes produced better haematological indices in women than the oral route, no clinical outcomes were assessed and there were insufficient data on adverse effects, for example, on venous thrombosis and severe allergic reactions. Most trials reported no clinically relevant outcomes nor adverse effects. A trend was found between dose and reported adverse effects. It was not possible to assess the effects of treatment by severity of anaemia. Oral iron in pregnancy showed a reduction in the incidence of anaemia (risk ratio 0.38, 95% confidence interval 0.26 to 0.55, one trial, 125 women) and better haematological indices than placebo (two trials). They covered a very wide range of differing drugs, doses and routes of administration, making it difficult to pool data. Many of the trials were from low‐income countries they were generally small and frequently methodologically poor.
Three further studies identified are awaiting classification. We identified 23 trials, involving 3.198 women. Randomised controlled trials comparing treatments for anaemia in pregnancy attributed to iron deficiency. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (7 June 2011), CENTRAL (2011, Issue 5), PubMed (1966 to June 2011), the International Clinical Trials Registry Platform (ICTRP) (), Health Technology Assessment Program (HTA) () and LATINREC (Colombia) ().
To assess the effects of different treatments for anaemia in pregnancy attributed to iron deficiency (defined as haemoglobin less than 11 g/dL or other equivalent parameters) on maternal and neonatal morbidity and mortality. Severe anaemia can have very serious consequences for mothers and babies, but there is controversy about whether treating mild or moderate anaemia provides more benefit than harm. Iron deficiency, the most common cause of anaemia in pregnancy worldwide, can be mild, moderate or severe.
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