The Systematic Review Of Treaments For Iron-deficiency Anaemia In Pregnancy

Backgroud:Iron deficiency anaemia, the most common disease of pregnant women. It is different in treatments drugs and effects. In order to provied valid evidence for the clinical, the research group systematically evaluated all the related articles reported before compared with traditional review method.Objective:To evaluate the difference of effects, adverse reactions and outcomes between different treatments, and provide clinical doctors more and comprehensive evidence in treating of IDA.Method:A search strategy was formulated according to the research topic.Two researchers have retrieved the MEDLINE, EMBASE, BIOS IS, Cohrance library and CBM independently. All articles included were screened by the inclusion criteria, then assess Jadad score and extract the dates by a data extraction form which was consistent with the PICOS principal. All the date extracted was analyzed or integrated by Rev Man5.0.Results:26articles,3015pregnances were included in our study.1694cases and1321cases were respectively included in test groups and control groups. Expect for6articles, the authors of the rest20articles were all came from developing countries.66.7%of articles about the intravenous treatments were came from developing countries.(1) Compared with oral ferrous sulfate, polysaccharide iron complex, bovine lactoferrin, poly maltose iron and glycine iron etc. can be more pronounced improve hemoglobin levels; Ferrous sulfate added folic acid and vitamin B2could significantly improve hemoglobin level. Vitamin B2could significantly improve the serum ferritin (WMD=3.44,95%CI:1.12-5.26, P=0.004). The Tie Zhi Yuan tablet united E Gui Yang Xue granules or Yi Qi Wei Xue granules could significantly improve the serum ferritin levels.(2) Comparing with difference dose of oral iron, the hemoglobin level of20mg group have reached HOg/L, but lower than80mg group and less adverse effects; The hemoglobin level and serum ferritin of daily iron groups was significantly higher than two times per week oral iron groups.(3) Both intravenous and intramuscular therapy could significantly improve serum ferritin (sucrose by intravenous: WMD=0.57,95%CI:0.16-0.99, P=0.007; sorbitol by intramuscular:WMD=5.42,95%CI:2.62-8.22) and less adverse effects.(4)There was no significantly difference between the outcomes of test groups and control groups, but we found that the preeclampsia and preterm birth rate had dropped significantly in test groups compared to control groups.Conclusions:(l) Interventions methods included in our study are mostly carried out in developing countries. The developed countries are more interested in study intravenous therapy. The researches of China are more related to oral iron therapy;(2) Oral polysaccharide iron complex, bovine lactoferrin multi-polymaltose iron, glycine iron, Chinese medicine etc. or adding vitamin B2,folic acid and other ingredients would be more effective than ferrous sulfate in treating pregnancy IDA, but this conclusion is limited by the quality and number of participants of the articles involved;(3) Daily low-dose oral treatment is an effective and comprehensive treatment;(4) Intravenous and intramuscular therapy are alternative option if the pregnancy does not tolerate to oral iron or have severe anemia, they both can improve iron stores and have fewer side effects and better tolerance and compliance. Because the articles and participants are limited, more researches are needed;(5) The systematic review is more convincing than traditional review.