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The use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians

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dc.contributor.authorSmith-Wade, S.
dc.contributor.authorKidson-Gerber, G.
dc.contributor.authorShand, A.
dc.contributor.authorGrzeskowiak, L.
dc.contributor.authorHenry, A.
dc.date.issued2020
dc.description.abstractBackground: Iron deficiency anaemia in pregnancy (IDAP) affects 11–18% of Australian pregnancies and is associated with adverse perinatal outcomes. National prescribing data suggests the use of intravenous iron in pregnancy is increasingly common. This study aimed to: 1) Establish the current patterns of intravenous iron use by Fellows of the Royal Australian and New Zealand College of Obstetricians (FRANZCOG) when treating iron deficiency and IDAP including immediately postpartum and; 2) Assess FRANZCOG opinions regarding potential trial of intravenous iron for first-line treatment of IDAP. Methods: An online survey of RANZCOG Fellows practicing obstetrics was distributed in September 2018. Results were analysed descriptively and responses compared by clinician demographics using Chi-squared testing. Results: Of 484 respondents (21% of FRANZCOG), 457 were currently practicing obstetrics. Most prescribed intravenous iron in pregnancy (96%) and/or postpartum (85%). Most intravenous iron was prescribed for IDAP (98%) rather than iron deficiency without anaemia (53%), and for IDAP most commonly second-line to failed oral iron supplementation and first-line in special circumstances (59%). Intravenous iron prescribing was associated with shorter time since FRANZCOG completion (p = 0.01), public hospital practice (p = 0.008) and higher hospital birth numbers (p = 0.01). Most respondents (90%) would consider a randomised controlled trial of first-line intravenous iron for IDAP, although views on appropriate thresholds differed. Conclusions: Almost all respondents prescribed intravenous iron for IDAP, and while mostly used for second-line treatment over half sometimes used it first-line. With accelerating intravenous iron use, further research is required into its optimal use in pregnancy, recognizing important clinical outcomes and cost effectiveness.
dc.description.statementofresponsibilitySarah Smith-Wade, Giselle Kidson-Gerber, Antonia Shand, Luke Grzeskowiak and Amanda Henry
dc.identifier.citationBMC Pregnancy and Childbirth, 2020; 20(1):665-1-665-11
dc.identifier.doi10.1186/s12884-020-03363-3
dc.identifier.issn1471-2393
dc.identifier.issn1471-2393
dc.identifier.orcidGrzeskowiak, L. [0000-0001-8554-4696]
dc.identifier.urihttps://hdl.handle.net/2440/132003
dc.language.isoen
dc.publisherSpringer Nature
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1141570
dc.rights© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
dc.source.urihttps://doi.org/10.1186/s12884-020-03363-3
dc.subjectHumans
dc.subjectPregnancy Complications, Hematologic
dc.subjectAnemia, Iron-Deficiency
dc.subjectIron
dc.subjectFerric Compounds
dc.subjectHematinics
dc.subjectAdministration, Oral
dc.subjectInfusions, Intravenous
dc.subjectObstetrics
dc.subjectPostpartum Period
dc.subjectPregnancy
dc.subjectCost-Benefit Analysis
dc.subjectAustralia
dc.subjectNew Zealand
dc.subjectFemale
dc.subjectRandomized Controlled Trials as Topic
dc.subjectPractice Guidelines as Topic
dc.subjectDrug Prescriptions
dc.subjectMedication Adherence
dc.subjectSurgeons
dc.subjectSurveys and Questionnaires
dc.subjectPractice Patterns, Physicians'
dc.subjectIron Deficiencies
dc.subject.meshHumans
dc.subject.meshPregnancy Complications, Hematologic
dc.subject.meshAnemia, Iron-Deficiency
dc.subject.meshIron
dc.subject.meshFerric Compounds
dc.subject.meshHematinics
dc.subject.meshAdministration, Oral
dc.subject.meshInfusions, Intravenous
dc.subject.meshObstetrics
dc.subject.meshPostpartum Period
dc.subject.meshPregnancy
dc.subject.meshCost-Benefit Analysis
dc.subject.meshAustralia
dc.subject.meshNew Zealand
dc.subject.meshFemale
dc.subject.meshRandomized Controlled Trials as Topic
dc.subject.meshPractice Guidelines as Topic
dc.subject.meshDrug Prescriptions
dc.subject.meshMedication Adherence
dc.subject.meshSurgeons
dc.subject.meshSurveys and Questionnaires
dc.subject.meshPractice Patterns, Physicians'
dc.titleThe use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians
dc.typeJournal article
pubs.publication-statusPublished

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