Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG)

Thorsten Fischer; Hanns Helmer; Philipp Klaritsch; Claudius Fazelnia; Gerhard Bogner; Katharina M. Hillerer; Christoph Wohlmuth; Heidi Jaksch-Bogensperger; for the Board of the Austrian Society for Gynecolgy and Obstetrics (OEGGG)

doi:10.1055/a-1710-3387

Geburtshilfe und Frauenheilkunde, Table of Contents

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2022; 82(04): 392-399
DOI: 10.1055/a-1710-3387

GebFra Science

Statement/Stellungnahme

Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG)

Article in several languages: English | deutsch

Authors

Thorsten Fischer

¹Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Austria
Hanns Helmer

²Leitliniengruppe der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe, Univ.-Klinik f. Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
Philipp Klaritsch

³Abteilung für Geburtshilfe, Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
Claudius Fazelnia

¹Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Austria
Gerhard Bogner

¹Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Austria
Katharina M. Hillerer

¹Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Austria
Christoph Wohlmuth

¹Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Austria
Heidi Jaksch-Bogensperger

¹Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Austria

for the Board of the Austrian Society for Gynecolgy and Obstetrics (OEGGG)

Abstract

This overview analyzes the data on the controversial therapy of iron substitution during pregnancy, the diagnosis of iron deficiency anemia and the indication-related therapy, and is the first recommendation issued by the OEGGG on the appropriate therapy. The effects of anemia during pregnancy on postnatal outcomes have been intensively investigated with heterogeneous results. A final scientific conclusion with regards to the “optimal” maternal hemoglobin level is limited by the heterogeneous results of various studies, many of which were conducted in emerging nations (with different dietary habits and structural differences in the respective healthcare systems). The current literature even suggests that there may be a connection between both decreased and increased maternal serum hemoglobin concentrations and unfavorable short-term and long-term neonatal outcomes. In Austria, 67 percent of pregnant women take pharmacological supplements or use a variety of dietary supplements. Clinically, the prevalence of maternal anemia is often overestimated, leading to overtreatment of pregnant women (iron substitution without a medical indication). To obtain a differential diagnosis, a workup of the indications for treatment should be carried out prior to initiating any form of iron substitution during pregnancy. If treatment is medically indicated, oral iron substitution is usually sufficient. Because of the restricted approval and potential side effects, medical indications for intravenous iron substitution should be limited. Intravenous iron substitution without a prior detailed diagnostic workup is an off-label use and should only be used in very limited cases, and women should be advised accordingly.

Key words

pregnancy - anemia - hemoglobin - iron substitution - neonatal outcome

Full Text

References

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