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| Meta-analysis of the effect of intravenous injection of iron disaccharide in the treatment of postpartum iron deficiency anemia |
| QIU Wen-wen1,2 WEI Li-li3,4 LI Hai-hong1,2 ▲ QIU Jie5 LIAN Rui-han1 HU Ya-guang5 LIU Yu-yu1,2 YANG Ke-hu |
1.School of Nursing,Gansu University of Chinese medicine,Gansu Province,Lanzhou 730000,China;
2.Department of Nursing,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;
3.Center for Evidencebased Medicine,Lanzhou University,Gansu Province,Lanzhou 730030,China;
4.Key Laboratory of Evidence-based Medicine and Clinical Translational Medicine in Gansu Province,Lanzhou 730030,China;
5.Department of Administration,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China |
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Abstract Objective To systematically evaluate the effectiveness and safety of intravenous injection of iron disaccharide and oral ferrous sulfate in patients with postpartum iron deficiency anemia. Methods PubMed,Cochrane Library,Web of Science,EMbase,CBM,WanFang Data,CNKI,VIP database were searched by the computer.At the same time,the relevant references were traced,and the randomized controlled trials (RCTs) of the effect of the intravenous injection of iron disaccharide (iron sucrose,iron carboxymaltose) in the experimental group and the oral ferrous sulfate in the control group on hemoglobin and ferritin after postpartum iron deficiency anemia were collected.The retrieval period was from database construction to June 2019.According to the inclusion criteria and exclusion criteria,two researchers independently screened the literature,extracted the data and evaluated the risk of bias in the included study.Then,RevMan 5.3 software was used for Meta-analysis. Results A total of 1877 patients were included in 10 RCTs.Meta-analysis results showed that the hemoglobin levels of the experimental group were higher than those of the control group on 14 and 28 days after treatment,and the differences were statistically significant (SMD=0.39,95%CI[0.18,0.60],P=0.0003;SMD=0.78,95%CI [0.59,0.96],P<0.000 01).There were no statistically significant differences in ferritin and 24 h hemoglobin levels between the two groups after treatment (SMD=0.47,95%CI[-0.56,1.50],P=0.37;SMD=0.31,95%CI[-0.32,0.94],P=0.33).Conclusion Intravenous injection of iron disaccharide can improve the hemoglobin levels at 14 and 28 days and improve the clinical effectiveness.However,due to the limitations of the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality randomized controlled studies.
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| [1] |
王莉芹.蔗糖铁注射液治疗产后贫血的疗效观察[J].中国妇幼保健，2013，28（10）：1677-1679.
|
| [2] |
李爱国，杨连华，蔡治英.静脉铁剂治疗严重产后贫血优于注输红细胞[J].基因组学与应用生物学，2018，37（8）：3569-3574.
|
| [3] |
葛玉纯，裘佳敏，应豪，等.蔗糖铁注射液治疗产后贫血的多中心平行随机对照临床试验[J].现代妇产科进展，2008，17（12）：937-939.
|
| [4] |
Mhra V，Roy P，Gandhi K，et al.Safety and Efficacy of Intravenous Ferric Carboxy Maltose in Iron Deficiency Anaemia During Post-partum Period[J].J Nepal Health Res Counc，2018，15（3）：208-211.
|
| [5] |
Nguyen PH，Young M，Gonzalez-Casanova I，et al.Impact of Preconception Micronutrient Supplementation on Anemia and Iron Status during Pregnancy and Postpartum：A Randomized Controlled Trial in Rural Vietnam[J].PLoS One，2016，11（12）：e0167416.
|
| [9] |
Bhandal N，Russell R.Intravenous versus oral iron therapy for postpartum anaemia[J].BJOG，2006，113（11）：1248-1252.
|
| [12] |
王丽梅，王心，肖英，等.蔗糖铁治疗产后缺铁性贫血疗效观察[J].人民军医，2010，53（4）：275-276.
|
| [6] |
Westad S，Backe B，Salvesen KA，et al.A 12-week randomised study comparing intravenous iron sucrose versus oral ferrous sulphate for treatment of postpartum anemia[J].Acta Obstet Gynecol Scand，2008，87（9）：916-923.
|
| [7] |
Dede A，Uygur D，Yilmaz B，et al.Intravenous iron sucrose complex vs.oral ferrous sulfate for postpartum iron deficiency anemia[J].Int J Gynaecol Obstet，2005，90（3）：238-239.
|
| [8] |
Breymann C，Gliga F，Bejenariu C，et al.Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia[J].Int J Gynaecol Obstet，2008，101（1）：67-73.
|
| [10] |
El Khouly NI.Comparison of intravenous ferrous sucrose and oral ferrous sulphate in treatment of postpartum iron deficiency anemia[J].J Matern Fetal Neonatal Med，2017，30（8）：967-971.
|
| [11] |
Van Wyck DB，Martens MG，Seid MH，et al.Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anemia：a randomized controlled trial[J].Obstet Gynecol，2007，110（2 Pt 1）：267-278.
|
| [13] |
Khalafallah AA，Dennis AE.Iron deficiency anaemia in pregnancy and postpartum：pathophysiology and effect of oral versus intravenous iron therapy[J].J Pregnancy，2012，2012：630 519.
|
| [14] |
Seid MH，Derman RJ，Baker JB，et al.Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia：a randomized controlled clinical trial[J].Am J Obstet Gynecol，2008，199（4）：435.e1-7.
|
| [15] |
Damineni SC，Thunga S.ⅣFerric Carboxymaltose Vs Oral Iron in the Treatment of Post-partum Iron Deficiency Anaemia[J].J Clin Diagn Res，2016，10（11）：QC08-QC10.
|
| [16] |
Roy NBA，Pavord S.The management of anaemia and haematinic deficiencies in pregnancy and post-partum[J].Transfus Med，2018，28（2）：107-116.
|
| [17] |
Barroso F，Allard S，Kahan BC，et al.Prevalence of maternal anaemia and its predictors：a multi-centre study[J].Eur J Obstet Gynecol Reprod Biol，2011，159（1）：99-105.
|
| [18] |
Haider BA，Olofin I，Wang M，et al.Anaemia，prenatal iron use，and risk of adverse pregnancy outcomes：systematic review and meta-analysis[J].BMJ，2013，346：f3443.
|
| [19] |
中华医学会围产医学分会.妊娠期铁缺乏和缺铁性贫血诊治指南[J].中国实用内科杂志，2014，35（7）：451-454.
|
| [20] |
吕荣君，刘馨，刘巍，等.多糖铁胶囊治疗妊娠合并缺铁性贫血的临床疗效及不良反应观察[J].中国妇幼保健，2014，29（2）：183-184.
|
| [21] |
Naqash A，Ara R，Bader GN，et al.Effectiveness and Safety of Ferric Carboxymaltose Compared to Iron Sucrose in Women With Iron Deficiency Anemia：Phase ⅣClinical Trials[J].BMC Womens Health，2018，18（1）：6.
|
| [22] |
Neogi SB，Devasenapathy N，Singh R，et al.Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate-to-severe anaemia in India：a multicentre，open-label，phase 3，randomised，controlled trial[J].Lancet Glob Health，2019，7（12）：e1706-e1716.
|
| [23] |
Gurevitch J，Koricheva J，Nakagawa S，et al.Meta-analysis and the science of research synthesis[J].Nature，2018，555（7695）：175-182.
|
| [24] |
李秀霞，韩雪梅，杨克虎.循证卫生政策的发展与展望[J].图书与情报，2018，（3）：43-49.
|
| [25] |
杨克虎，李秀霞，拜争刚.循证社会科学研究方法：系统评价与Meta 分析[M].兰州：兰州大学出版社，2018.
|
| [26] |
杨克虎.循证社会科学的产生、发展与未来[J].图书与情报，2018，（3）：1-10
|
| [27] |
柳春艳，李秀霞，杨克虎.发展中的循证教育学：多元特征与研究前景[J].图书与情报，2018，（3）：35-42.
|
|
|
|
