Prevalence of Anemia and Iron Deficiency in Rheumatic Disease Pregnancy

Core Concepts

Approximately one third of women with rheumatic diseases develop anemia by the third trimester of pregnancy, and two thirds are iron deficient.

Abstract

Standalone Note here

• TOPLINE:

  • One third of women with rheumatic diseases develop anemia by the third trimester of pregnancy.
  • Two thirds of women with rheumatic diseases are iron deficient.

• METHODOLOGY:

  • Data from 368 pregnancies in women with rheumatic diseases were analyzed.
  • Different rheumatic diseases were represented in the study.
  • Patients were aged 17-44 years, with a median age of 32 years at the time of birth.

• TAKEAWAY:

  • Prevalence of iron deficiency and anemia in different trimesters.
  • Increased risk for fetal complications associated with maternal connective tissue disease, low maternal hemoglobin levels, and maternal iron deficiency.
  • Lower maternal hemoglobin levels associated with an increased risk for maternal complications.

• IN PRACTICE:

  • Early identification of anemia and iron deficiency in women with rheumatic diseases is crucial for pre-pregnancy counseling.

• SOURCE:

  • Lead author: Ann-Christin Pecher, MD, University Hospital Tübingen, Germany.
  • Published online in Joint Bone Spine on October 4.

• LIMITATIONS:

  • Findings limited by the use of a single dataset.
  • Lack of standardized approach to iron supplementation.

• DISCLOSURES:

  • Study supported by a grant from the Medical Faculty of Tübingen Clinician-Scientist grant to the lead author.
  • Researchers report no relevant financial relationships.

Stats

The prevalence of iron deficiency was 28%, 51%, and 62% in the first, second, and third trimesters, respectively.
The prevalence of anemia was 18%, 27%, and 33% in the first, second, and third trimesters, respectively.
An increased risk for fetal complications was associated with maternal connective tissue disease (odds ratio [OR], 2.14) and low maternal hemoglobin levels and maternal iron deficiency (ORs, 0.52 and 0.86, respectively).
Lower maternal hemoglobin levels were associated with an increased risk for maternal complications (OR, 1.47).
Patients with connective tissue disease had a lower risk for maternal complications (OR, 0.51).
Mean serum ferritin had no significant impact on maternal complications (OR, 1.02).

Quotes

"Patients with rheumatic diseases suffer more often and already in early pregnancy from iron deficiency."

Key Insights Distilled From

Anemia, Iron Deficit Common in Rheumatic Disease Pregnancy

by Heidi Splete at www.medscape.com 10-09-2023

https://www.medscape.com/viewarticle/997203

Deeper Inquiries

How can healthcare providers improve the early identification of anemia and iron deficiency in pregnant women with rheumatic diseases?

Healthcare providers can enhance the early identification of anemia and iron deficiency in pregnant women with rheumatic diseases by implementing regular screening protocols during prenatal visits. This can involve conducting comprehensive blood tests to monitor hemoglobin levels and serum ferritin concentrations. Additionally, educating both patients and providers about the increased risk of these conditions in women with rheumatic diseases can lead to heightened awareness and proactive management strategies. Collaborating with rheumatologists and obstetricians to develop tailored care plans for pregnant women with rheumatic diseases can also facilitate early detection and intervention.

What are the potential implications of the lack of standardized approach to iron supplementation in this population?

The lack of a standardized approach to iron supplementation in pregnant women with rheumatic diseases can have significant implications on maternal and fetal health outcomes. Inconsistent or inadequate iron supplementation may exacerbate existing anemia and iron deficiency, leading to complications such as preterm birth, low birth weight, and maternal morbidity. Moreover, variations in iron supplementation practices can result in suboptimal management of these conditions, potentially impacting the long-term health of both the mother and the child. Establishing guidelines for iron supplementation based on the specific needs of pregnant women with rheumatic diseases is crucial to mitigate these risks and improve overall outcomes.

How can the findings of this study be applied to improve overall maternal and fetal health outcomes in pregnancies complicated by rheumatic diseases?

The findings of this study underscore the importance of early detection and management of anemia and iron deficiency in pregnant women with rheumatic diseases to enhance maternal and fetal health outcomes. Healthcare providers can utilize these findings to implement targeted screening strategies, personalized treatment plans, and close monitoring throughout pregnancy. By recognizing the increased risk of adverse outcomes associated with maternal connective tissue disease, low hemoglobin levels, and iron deficiency, providers can intervene promptly to mitigate these risks and optimize pregnancy outcomes. Incorporating these insights into clinical practice can lead to improved care for pregnant women with rheumatic diseases, ultimately benefiting both maternal and fetal health.