Somnuk Apiwantanagul
Sakon Nakhon Hospital, ThailandPresentation Title:
Oral iron supplementation in pregnant women with heterozygous hemoglobin E and homozygous hemoglobin E in Sakon Nakhon Hospital
Abstract
Background and Objectives: Pregnant women with heterozygous HbE and homozygous HbE are more likely to develop anemia. This may affect pregnant women and the fetus leading to increased morbidity and mortality rates. Iron supplements have been widely deployed to prevent anemia in pregnant women. Therefore, this study aimed to compare the change of hemoglobin (Hb) after receiving various iron supplements in pregnant women with heterozygous HbE and homozygous HbE.
Methods: This vandomized controlled trial was conducted on 66 pregnant women with thalassemia Hb E from December 2021 to September 2022 in Sakon Nakhon hospital. Data were collected at antenatal care by questionnaires. The demographic data were analyzed using descriptive statistics, Chi-square test and One - way ANOVA.
Results: Amongst 66 pregnant women, they were characterized as 78.8% heterozygous HbE and 21.2% homozygous HbE. The average Hb concentration in the first blood test was 11.8 g/dl (Min = 9.2, Max = 14.2, S.D. = 1.0), and the second blood test was 11.1 g/dl (Min = 9.1, Max = 13.1, S.D. = .9). The average Hb levels in the first and second blood tests of group I, who received 1 tablet of triferdine were 12.0 g/dl and 11.1 g/dl; group II received 1 tablet of triferdine and 1 tablet of ferrous fumarate, which showed 12.1 g/dl and 11.4 g/dl; and group III received 1 tablet of triferdine and 2 tablets of ferrous fumarate, representing 11.3 g/dl and 10.8 g/dl, respectively. The changes in hemoglobin concentration using Chi-square test revealed that 86.4% of group I had statistically significant increased Hb level while 13.6% were decreased (p=0.01). Interestingly, 27.3% of group III showed an increase in Hb level with a decrease at 73.7% (p=0.02).
Conclusion: Iron deficiency should be screened for preg n ant women with Hb E thalassemia in order to provide appropriate treatment to rule out iron deficiency in pregnant women with Hb E thalassemia. Thus affecting pregnancy outcomes in particular intrauterine growth retardation (IUGR) and preterm labor. Therefore, appropriate detection of iron deficiency should be undertaken, to treat and prevent iron deficiency in the first and third trimesters (at 12 weeks and 32 weeks of gestation) in pregnant women with Hb E thalassemia with anemia (Hb < 11 g/dl)
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