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Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews.

Parker JA, Barroso F, Stanworth SJ, Spiby H, Hopewell S, Doree CJ, Renfrew MJ, Allard S - BMC Pregnancy Childbirth (2012)

Bottom Line: However, there is evidence of significant variation in management.Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen.Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetric Anaesthesia, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9BQ, UK. jacquismail@gmail.com

ABSTRACT

Background: Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care.

Methods: Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology.

Results: 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24) and postnatal periods (n = 3). Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19). Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia.

Conclusions: The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

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Related in: MedlinePlus

Flow diagram. A diagram mapping out the number of records identified, included and excluded, during the review process and the reasons for exclusions.
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Figure 1: Flow diagram. A diagram mapping out the number of records identified, included and excluded, during the review process and the reasons for exclusions.

Mentions: The search identified 1,378 records of which the majority (nā€‰=ā€‰1,123) were eliminated by title/abstract (see Figure 1). 255 records were reviewed as full text articles, with 163 excluded because they were not a systematic review or did not fulfil the inclusion criteria. A further 65 were excluded as they focussed on the intrapartum period.


Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews.

Parker JA, Barroso F, Stanworth SJ, Spiby H, Hopewell S, Doree CJ, Renfrew MJ, Allard S - BMC Pregnancy Childbirth (2012)

Flow diagram. A diagram mapping out the number of records identified, included and excluded, during the review process and the reasons for exclusions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475131&req=5

Figure 1: Flow diagram. A diagram mapping out the number of records identified, included and excluded, during the review process and the reasons for exclusions.
Mentions: The search identified 1,378 records of which the majority (nā€‰=ā€‰1,123) were eliminated by title/abstract (see Figure 1). 255 records were reviewed as full text articles, with 163 excluded because they were not a systematic review or did not fulfil the inclusion criteria. A further 65 were excluded as they focussed on the intrapartum period.

Bottom Line: However, there is evidence of significant variation in management.Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen.Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetric Anaesthesia, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9BQ, UK. jacquismail@gmail.com

ABSTRACT

Background: Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care.

Methods: Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology.

Results: 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24) and postnatal periods (n = 3). Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19). Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia.

Conclusions: The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

Show MeSH
Related in: MedlinePlus