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BMJ Open Gastroenterology Jan 2022The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected with this... (Review)
Review
The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected with this condition. Although the most common causes of IDA are gastrointestinal bleeding and menstruation in women, decreased dietary iron and decreased iron absorption are also culpable causes. Patients with IDA should be treated with the aim of replenishing iron stores and returning the haemoglobin to a normal level. This has shown to improve quality of life, morbidity, prognosis in chronic disease and outcomes in pregnancy. Iron deficiency occurs in many chronic inflammatory conditions, including congestive cardiac failure, chronic kidney disease and inflammatory bowel disease. This article will provide an updated overview on diagnosis and management of IDA in patients with chronic conditions, preoperative and in pregnancy. We will discuss the benefits and limitations of oral versus intravenous iron replacement in each cohort, with an overview on cost analysis between the different iron formulations currently on the market.
Topics: Anemia, Iron-Deficiency; Chronic Disease; Female; Humans; Iron; Iron Deficiencies; Iron, Dietary; Pregnancy; Quality of Life
PubMed: 34996762
DOI: 10.1136/bmjgast-2021-000759 -
Nutrients Feb 2020A normal pregnancy consumes 500-800 mg of iron from the mother. Premenopausal women have a high incidence of marginal iron stores or iron deficiency (ID), with or... (Review)
Review
A normal pregnancy consumes 500-800 mg of iron from the mother. Premenopausal women have a high incidence of marginal iron stores or iron deficiency (ID), with or without anemia, particularly in the less developed world. Although pregnancy is associated with a "physiologic" anemia largely related to maternal volume expansion; it is paradoxically associated with an increase in erythrocyte production and erythrocyte mass/kg. ID is a limiting factor for this erythrocyte mass expansion and can contribute to adverse pregnancy outcomes. This review summarizes erythrocyte and iron balance observed in pregnancy; its implications and impact on mother and child; and provides an overview of approaches to the recognition of ID in pregnancy and its management, including clinically relevant questions for further investigation.
Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Child; Child Development; Child, Preschool; Female; Fetal Development; Humans; Infant; Iron; Iron Deficiencies; Iron, Dietary; Male; Nutritional Physiological Phenomena; Nutritional Requirements; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premenopause; Young Adult
PubMed: 32053933
DOI: 10.3390/nu12020447 -
Fertility and Sterility Oct 2022Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent among women across their reproductive age. An iron-deficient state has been associated with... (Review)
Review
Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent among women across their reproductive age. An iron-deficient state has been associated with and causes a number of adverse health consequences, affecting all aspects of the physical and emotional well-being of women. Heavy menstrual bleeding, pregnancy, and the postpartum period are the major causes of ID and IDA. However, despite the high prevalence and the impact on quality of life, ID and IDA among women in their reproductive age is still underdiagnosed and undertreated. In this chapter we summarized the iron metabolism and the diagnosis and treatment of ID and IDA in women.
Topics: Anemia, Iron-Deficiency; Female; Humans; Iron; Iron Deficiencies; Pregnancy; Prevalence; Quality of Life
PubMed: 36075747
DOI: 10.1016/j.fertnstert.2022.08.014 -
Deutsches Arzteblatt International Dec 2021In the western world, 10-15% of women of child-bearing age suffer from iron-deficiency anemia. Iron overload due to chronic treatment with blood transfusions or... (Review)
Review
BACKGROUND
In the western world, 10-15% of women of child-bearing age suffer from iron-deficiency anemia. Iron overload due to chronic treatment with blood transfusions or hereditary hemochromatosis is much rarer.
METHODS
This review is based on pertinent publications retrieved by a selective search on the pathophysiology, clinical features, and diagnostic evaluation of iron deficiency and iron overload.
RESULTS
The main causes of iron deficiency are malnutrition and blood loss. Its differential diagnosis includes iron-refractory iron deficiency anemia (IRIDA), a rare congenital disease in which the hepcidin level is pathologically elevated, as well as the more common anemia of chronic disease (anemia of chronic inflammation), in which increased amounts of hepcidin are formed under the influence of interleukin-6 and enteric iron uptake is blocked as a result. Iron overload comes about through long-term transfusion treatment or a congenital disturbance of iron metabolism (hemochromatosis). Its diagnostic evaluation is based on clinical and laboratory findings, imaging studies, and specific mutation analyses.
CONCLUSION
Our improving understanding of the molecular pathophysiology of iron metabolism aids in the evaluation of iron deficiency and iron overload and may in future enable treatment not just with iron supplementation or iron chelation, but also with targeted pharmacological modulation of the hepcidin regulatory system.
Topics: Anemia; Anemia, Iron-Deficiency; Female; Humans; Iron; Iron Deficiencies; Iron Overload
PubMed: 34755596
DOI: 10.3238/arztebl.m2021.0290 -
Fertility and Sterility Oct 2022Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent among women across their life span, especially during the reproductive age. An iron-deficient... (Review)
Review
Iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent among women across their life span, especially during the reproductive age. An iron-deficient state has been associated with a number of adverse health consequences, affecting all aspects of the physical and emotional well-being of women. Heavy menstrual bleeding, pregnancy state, and the postpartum period are the major causes of ID/IDA. However, despite the high prevalence and the impact on quality of life, ID/IDA among fertile age women remains underdiagnosed and undertreated. The present Views and Reviews provides an overview on IDA in women's health, describing the background on iron metabolism, heavy menstrual bleeding pathogenetic mechanisms, including a focus on uterine disorders, such as uterine fibroids and adenomyosis. Iron replacement therapies, patient blood management, and treatment options for uterine disorders also are explored.
Topics: Anemia, Iron-Deficiency; Female; Humans; Iron; Iron Deficiencies; Menorrhagia; Pregnancy; Quality of Life; Reproductive Health; Women's Health
PubMed: 36182259
DOI: 10.1016/j.fertnstert.2022.08.850 -
European Journal of Haematology Dec 2022Iron deficiency and/or iron deficiency anemia (IDA) complicate nearly 50% of pregnancies globally, negatively impacting both maternal and fetal outcomes. Iron deficiency... (Review)
Review
Iron deficiency and/or iron deficiency anemia (IDA) complicate nearly 50% of pregnancies globally, negatively impacting both maternal and fetal outcomes. Iron deficiency can cause a range of symptoms that range from aggravating to debilitating including fatigue, poor quality of life, pagophagia, and restless leg syndrome. Iron deficiency and IDA are also associated with maternal complications including preterm labor, increased rates of cesarean delivery, postpartum hemorrhage, and maternal death. Fetal complications include increased rates of low birth weight and small for gestational age newborns. Prenatal maternal anemia has also been associated with autism spectrum disorders in the neonate, although causation is not established. Deficiency in the newborn is associated with compromised memory, processing, and bonding, with some of these deficits persisting into adulthood. Despite the prevalence and consequences associated with iron deficiency in pregnancy, data show that it is routinely undertreated. Due to the physiologic changes of pregnancy, all pregnant individuals should receive oral iron supplementation. However, the bioavailability of oral iron is poor and it is often ineffective at preventing and treating iron deficiency. Likewise, it frequently causes gastrointestinal symptoms that can worsen the quality of life in pregnancy. Intravenous iron formulations administered in a single or multiple dose series are now available. There is increasing data suggesting that newer intravenous formulations are safe and effective in the second and third trimesters and should be strongly considered in pregnant individuals without optimal response to oral iron repletion.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Adult; Iron Deficiencies; Incidence; Quality of Life; Anemia, Iron-Deficiency; Iron; Anemia; Pregnancy Complications, Hematologic
PubMed: 36153674
DOI: 10.1111/ejh.13870 -
Nutrients Jul 2022Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0-5-year-old... (Review)
Review
Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0-5-year-old children and young women of childbearing age, especially during pregnancy. Iron deficiency can lead to life-threatening loss of red blood cells, muscle function, and energy production. Therefore, the pathogenic features associated with IDA are weakness and impaired growth, motor, and cognitive performance. IDA affects the well-being of the young generation and the economic advancement of developing countries, such as India. The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA. However, numerous strategic programs aimed to increase iron intake have shown that improvement of iron intake alone has not been sufficient to mitigate IDA. Emerging critical risk factors for IDA include a composition of cultural diets, infections, genetics, inflammatory conditions, metabolic diseases, dysbiosis, and socioeconomic parameters. In this review, we discuss numerous IDA mitigation programs in India and their limitations. The new multifactorial mechanism of IDA pathogenesis opens perspectives for the improvement of mitigation programs and relief of IDA in India and worldwide.
Topics: Anemia, Iron-Deficiency; Child, Preschool; Diet; Female; Humans; Iron; Iron Deficiencies; Nutritional Status; Pregnancy
PubMed: 35889932
DOI: 10.3390/nu14142976 -
Nutricion Hospitalaria Jun 2014Anemia is one of the most important nutritional deficiencies affecting various social and socioeconomic strata. It is more common in developing countries, with children... (Review)
Review
INTRODUCTION
Anemia is one of the most important nutritional deficiencies affecting various social and socioeconomic strata. It is more common in developing countries, with children and adolescents being at a significantly higher risk for the condition.
OBJECTIVE
To perform a literature review on iron deficiency anemia in adolescence as a public health issue and on the risk factors that may contribute towards nutritional deficiencies, stunted growth and development in this age group, emphasizing the physiopathology and causes of anemia, the different diagnostic approaches, and its clinical characteristics, prevention and treatment.
METHODOLOGY
The LILACS-BIREME, SCIELO and PUBMED databases were consulted for the study. Scientific papers published in Spanish, Portuguese or English between 2000 and 2013 on the subject of iron deficiency anemia in adolescents were selected for inclusion. A total of 102 studies published between January 1st, 2000 and June 30th, 2013 were identified and evaluated. Forty-two articles meeting the inclusion criterion (adolescents with anemia) were selected for this review. Finally, an analysis was conducted and the papers were evaluated in accordance with the study objectives.
RESULTS AND DISCUSSION
The studies reviewed revealed a prevalence of iron deficiency anemia of around 20% in adolescents and described the harmful effects of anemia in this age group.
CONCLUSION
Preventive action is required with respect to iron deficiency anemia. Healthcare professionals should be aware of the need for early diagnosis, prophylaxis and treatment.
Topics: Adolescent; Anemia, Iron-Deficiency; Female; Humans; Male; Prevalence; Risk Factors
PubMed: 24972460
DOI: 10.3305/nh.2014.29.6.7245 -
Neonatology 2019Iron deficiency, with or without anemia, is common in pregnant women. In fact, nearly 30% of reproductive-age women are anemic worldwide, and anemia in pregnancy has an... (Review)
Review
Iron deficiency, with or without anemia, is common in pregnant women. In fact, nearly 30% of reproductive-age women are anemic worldwide, and anemia in pregnancy has an estimated global prevalence of 38%. Severe anemia can substantially increase the risk of maternal mortality, and can adversely affect fetal development. In this review, we examine the available data regarding epidemiology and consequences of iron deficiency in mothers and infants, current treatment strategies, and make recommendations for screening and treatment of iron deficiency anemia in gravidas and neonates.
Topics: Anemia; Anemia, Iron-Deficiency; Female; Fetal Blood; Fetal Death; Gestational Age; Hemoglobins; Humans; Infant, Newborn; Iron Deficiencies; Pregnancy; Prevalence
PubMed: 30759449
DOI: 10.1159/000495978 -
Nutrients May 2021The iron absorption process developsmainly in the proximal duodenum. This portion of the intestine is typically destroyed in celiac disease (CD), resulting in a... (Review)
Review
The iron absorption process developsmainly in the proximal duodenum. This portion of the intestine is typically destroyed in celiac disease (CD), resulting in a reduction in absorption of iron and subsequent iron deficiency anemia (IDA). In fact, the most frequent extra-intestinal manifestation (EIM) of CD is IDA, with a prevalence between 12 and 82% (in relation with the various reports) in patients with new CD diagnosis. The primary treatment of CD is the gluten-free diet (GFD), which is associated with adequate management of IDA, if present. Iron replacement treatment historically has been based on oral products containing ferrous sulphate (FS). However, the absorption of FS is limited in patients with active CD and unpredictable in patients on a GFD. Furthermore, a poor tolerability of this kind of ferrous is particularly frequent in patients with CD or with other inflammatory bowel diseases. Normalization from anemic state typically occurs after at least 6 months of GFD, but the process can take up to 2 years for iron stores to replenish.
Topics: Anemia, Iron-Deficiency; Celiac Disease; Diet, Gluten-Free; Duodenum; Humans; Intestinal Absorption; Iron; Iron Deficiencies
PubMed: 34067622
DOI: 10.3390/nu13051695