DRAWING FIRST BLOOD
How Should We Treat
Pregnant Women With
Iron Deficiency?
Iron deficiency is prevalent among pregnant women, as mater-
nal iron is used to supply the needs of the fetus and placenta,
and additional iron is required to replace iron lost due to bleed-
ing at delivery. This condition is associated
with increased risks for adverse outcomes for
the mother and baby, like preterm birth and
low birth weight. Standard treatment of iron
deficiency and iron-deficiency anemia relies on
iron supplementation, but questions remain
about the optimal delivery route.
Michael Auerbach, MD
There are five intravenous (IV) iron
products available in the U.S., but few
clinical-trials data to guide their use in
pregnant women with iron deficiency. Here,
ASH Clinical News invited Michael Auerbach,
MD, and Ralph V. Boccia, MD, to discuss
the optimal approach for delivering IV iron
Ralph V. Boccia, MD
in pregnant women with iron deficiency. Dr.
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Focus on Classical Hematology
Auerbach is a practicing hematologist at Auerbach Hematology
and Oncology in Baltimore and a clinical professor of medicine
at Georgetown University School of Medicine in Washington,
DC. Dr. Boccia is a clinical associate professor of medicine at
Georgetown University School of Medicine in Washington, DC,
and founder and medical director of the Center for Cancer and
Blood Disorder in Maryland.
Michael Auerbach, MD: In the U.S., the standard treatment
for pregnant women with is oral iron, administered daily as
two to three 325-mg tablets containing approximately 50 to
65 mg elemental iron. 1 While oral iron is inexpensive and
readily available, more than 70 percent of women experience
significant gastrointestinal symptoms, including metallic taste,
gastric irritation, and worsening of constipation that is already
present due to high progesterone levels; for pregnant women
who already experience other gastrointestinal symptoms, this
is a heavy burden.