Thread by @OBsleepmerchant

Prof Marie Pierre Bonnet = @MariePierreBon2 (yay! for #SoMe) and she presents on anemia in #ObAnes at #OAA3dc2022 (photo better than podium ones). Definition of anemia in pregnancy: 110 or greater (11.0g/dL). Worldwide disparities.

Iron deficiency dominates anemia in pregnancy. Iron deficiency is innocuous, right? Perhaps not in pregnancy. Maternal iron deficiency affects more than just Hb. It is associated with adverse outcomes. #OAA3dc2022

@MariePierreBon2 highlights anemia’s impact on maternal mortality (@BJOGTweets @mbrrace): aOR 3.6! Not just mortality, but morbidity burden as well (@Anaes_Journal). The psychological impact of maternal anemia is acknowledged - postpartum depression & cognition #OAA3dc2022

Systematic prevention of anemia in pregnancy is difficult - poor consensus, wide variation. @NICEComms dropped iron supplementation in 2021 update. No consensus from USA: @CDCgov recommends in 1998, lost in 2015, back in @acog recommendations 2021 - low dose iron
#OAA3dc2022

@cochranecollab 2015 found poor evidence for iron supplementation routinely. @NATAforum recommendations 2019 focused on population factors: supplement routinely if high risk, test ferretin if not. @cochranecollab found intermittent iron supplementation viable #OAA3dc2022

Curative treatment - is it possible? Oral or IV? Both have pro’s and con’s. IV iron may be superior, but does it impact on clinical outcomes? #OAA3dc2022

IV iron definitely impacts anemia at delivery more than oral iron, but no difference in birth weight, gestational age or umbilical Hb (@BMJ_Open). IV did improve quality of life at 4 weeks after starting treatment. #OAA3dc2022

As Peri-delivery physicians who may encounter #OBAnes patients during their pregnancy, we should possibly ensure treatment of anemia? @MariePierreBon2 recommends an algorithmic approach. #OAA3dc2022

@threadreaderapp unroll please