Management of iron deficiency in pregnancy

This article reviews a study, published in Clinical and Laboratory Haematology (2003), which looked at using iron-rich spa water (Spatone) as a prophylaxis against iron deficiency in pregnancy. Anaemia is a significant problem in pregnant women that can have a detrimental effect on the baby and mother. The problems of non-compliance with oral iron supplements in this population are well-documented. This was a prospective, randomised, double-blind, placebo-controlled trial, and 102 patients were recruited into the study. Inclusion criteria included singleton pregnancy, booking haemoglobin >10.4g/dl and gestational age confirmed by ultrasound at 20 weeks. Primary outcome measures were compliance with treatments during the trial period, ferritin levels at 22 and 28 weeks and dyspepsia scores at 22 and 26 weeks.

Mean ferritin levels fell by 24% in the Spatone group compared with a mean fall of 51% in ferritin levels in the control group, p = 0.016. In the Spatone group, 31% of patients raised their ferritin levels during the trial period compared with 11% in the control group. The authors concluded that Spatone is effective in maintaining iron stores in non-anaemic patients and is well-tolerated. The study delivers a clear message to midwives--namely that Spatone has a place in the management of iron-deficient pregnant women, because it is well-tolerated and provides iron in a highly bioavailable form.