Железодефицит у женщин: как снизить распространенность?

Виноградова М.А. Железодефицит у женщин: как снизить распространенность? Consilium Medicum. 2022;24(7):473–476. DOI: 10.26442/20751753.2022.7.201850

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Vinogradova MA. Iron deficiency in women: ways to reduce prevalence. Consilium Medicum. 2022;24(7):473–476. DOI: 10.26442/20751753.2022.7.201850

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Аннотация

Железодефицитные состояния (ЖДС) – распространенная патология на стыке специальностей. Этиология и патогенез ЖДС хорошо изучены за последние десятилетия, однако сохраняется их значительная распространенность. Наибольшая частота встречаемости ЖДС регистрируется среди женщин репродуктивного возраста, а своевременная коррекция железодефицита позволяет не только улучшить качество жизни женщин, но и снизить частоту осложнений беременности и заболеваемости новорожденных. Настороженность в группах риска, ранняя диагностика, физиологичная терапия и дальнейший мониторинг – необходимые требования для достижения эффекта и его сохранения. Препараты сульфата железа хорошо известны как эффективный способ коррекции железодефицитной анемии. Однако высокая частота регистрируемых ранее побочных эффектов создавала значительные сложности для проведения полноценных курсов терапии. Создание новой молекулы с пролонгированным высвобождением железа минимизирует осложнения терапии, открывая новые возможности коррекции железодефицита, а добавление к сульфату железа фолиевой кислоты в составе одной таблетки не только упрощает схемы профилактики и терапии для беременных и планирующих беременность женщин, но и сокращает время, необходимое для достижения эффекта.

Ключевые слова: железодефицит, анемия, беременность, женщины репродуктивного возраста

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Iron deficiency states (IDSs) are common disorders at the nexus of various fields. The etiology and pathogenesis of IDSs have been well studied in recent decades, but their prevalence is still high. The highest incidence of IDSs is reported in women of reproductive age. The timely correction of iron deficiency improves women's quality of life and reduces pregnancy complications and infant morbidity. To achieve and maintain the improvement, caution in risk groups, early diagnosis, physiology-based therapy, and follow-up are necessary. Iron sulfate agents are well known as an effective way to treat iron deficiency anemia. However, the high rate of previously reported side effects posed significant challenges to the complete course of therapy. The development of a new molecule with prolonged iron release minimizes the complications of therapy, providing new prospects for iron deficiency treatment. The combination of folic acid to iron sulfate in one tablet simplifies prevention regimens and therapy for pregnant women and those planning to become pregnant and reduces the time to improve.

Keywords: iron deficiency, anemia, pregnancy, women of reproductive age

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Список литературы

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1. Bathla S, Arora S. Prevalence and approaches to manage iron deficiency anemia (IDA). Crit Rev Food Sci Nutr. 2021:1-14.
2. FIGO Working Group on Good Clinical Practice in Maternal-Fetal Medicine. Good clinical practice advice: Iron deficiency anemia in pregnancy. Int J Gynaecol Obstet. 2019;144(3):322-4. DOI:10.1002/ijgo.12740
3. Bothwell TH. Iron requirements in pregnancy and strategies to meet them. Am J Clin Nutr. 2000;72(Suppl. 1):257S-64S.
4. Breymann C, Auerbach M. Iron deficiency in gynecology and obstetrics: clinical implications and management. Hematology Am Soc Hematol Educ Program. 2017;2017(1):152-9.
5. Ren A, Wang J, Ye RW, et al. Low first-trimester hemoglobin and low birthweight, preterm birth and small for gestational age newborns. Int J Gynaecol Obstet. 2007;98(2):124-8.
6. Lozoff B, Beard J, Connor J, et al. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006;64(5, Pt. 2):S34-43.
7. Wassef A, Nguyen QD, St-André M. Anaemia and depletion of iron stores as risk factors for postpartum depression: a literature review. J Psychosom Obstet Gynaecol. 2019;40(1):19-28. DOI:10.1080/0167482X.2018.1427725
8. Elstrott B, Khan L, Olson S, et al. The role of iron repletion in adult iron deficiency anemia and other diseases. Eur J Haematol. 2020;104(3):153-61. DOI:10.1111/ejh.13345
9. Ning S, Zeller MP. Management of iron deficiency. Hematology. 2019;2019(1):315-22.
10. Hentze MW, Muckenthaler MU, Galy B, Camaschella C. Two to tango: regulation of mammalian iron metabolism. Cell. 2010;142(1):24-38.
11. McLean E, Cogswell M, Egli I, et al. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr. 2009;12(4):444-54.
12. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016;387(10021):907-16.
13. Mirza FG, Abdul-Kadir R, Breymann C, et al. Impact and management of iron deficiency and iron deficiency anemia in women’s health. Expert Rev Hematol. 2018;11(9):727-36.
14. Trotti LM, Becker LA. Iron for the treatment of restless legs syndrome. Cochrane Database Syst Rev. 2019;1:Cd007834.
15. Talbot NP, Smith TG, Privat C, et al. Intravenous iron supplementation may protect against acute mountain sickness: a randomized, double-blinded, placebo-controlled trial. High Alt Med Biol. 2011;12(3):265-9.
16. Kumar A, Sharma E, Marley A, et al. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastro. 2022;9:e000759.
DOI:10.1136/ bmjgast-2021-000759
17. Goodnough LT, Nemeth E, Ganz T. Detection, evaluation, and management of iron-restricted erythropoiesis. Blood. 2010;116(23):4754-61.
18. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005;352(10):1011-23.
19. Snook J, Bhala N, Beales ILP, et al. British Society of gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021;70:2030-51.
20. Pena-Rosas JP, De-Regil LM, Gomez Malave H, et al. Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015;10:CD009997.
21. Leary A, Barthe L, Clavel T, et al. Iron Pharmacokinetics in Women with Iron Deficiency Anaemia Following A Single Oral Dose of a Novel Formulation of Tardyferon (Prolonged Release Ferrous Sulphate). Drug Res (Stuttg). 2017;67(11):647-52. DOI:10.1055/s-0043-113636
22. Tiutiunnik VL, Kan NE, Mikhailova OI. Korrektsiia zhelezodefitsitnoi anemii u beremennykh. Akusherstvo i ginekologiia. 2018;8:105-10 (in Russian).
23. Palacios S. The management of iron deficiency in menometrorrhagia. Gynecol Endocrinol. 2011;27 Suppl. 1:1126-30. DOI:10.3109/09513590.2012.636916
24. Dobrokhotova YuE, Markova EA. Peroral retard iron preparation for iron-deficiency anemia: case study and pharmacoeconomic analysis. RMZh. Mat' i ditia. 2020;3:1-7 (in Russian). DOI:10.32364/2618-8430-2020-3-2-88-94
25. Mosha D, Mazuguni F, Mrema S, et al. Medication exposure during pregnancy: a pilot pharmacovigilance system using health and demographic surveillance platform. BMC Pregnancy and Childbirth. 2014;14:322. DOI:10.1186/1471-2393-14-322

Авторы

М.А. Виноградова*

ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава России, Москва, Россия
*mary-grape@ya.ru

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Maria A. Vinogradova*

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
*mary-grape@ya.ru

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