Железодефицитная анемия у беременных

Введение. Проблема железодефицитной анемии (ЖДА), особенно у беременных, продолжает оставаться актуальной. Несмотря на достижения в разработке методов диагностики и лечения, число беременных с ЖДА продолжает расти. Так, по данным ВОЗ за 2020 г. распространенность анемии среди женщин репродуктивного возраста варьировала от 9,1 % в Австралии до 69,6 % в Йемене.

Цель работы − определение современного состояния проблемы ЖДА у беременных на основе анализа литературы.

Материалы и методы. Отобраны оригинальные статьи, рандомизированные клинические исследования и мета-анализы. Подбор источников осуществлен в базах данных Scopus, PubMed по поисковым словам: iron, oral, intravenous iron, intravenous iron therapy, pregnancy, anemia, treatment, randomized control trial, anemia in pregnancy, treatment of anemia in pregnancy, intravenous iron in pregnancy; и на платформе eLibrary по поисковым словам: железо, пероральный прием, внутривенное железо, внутривенная терапия железом, беременность, анемия, лечение, рандомизированное контрольное исследование, анемия во время беременности, лечение анемии во время беременности, внутривенное введение железа во время беременности, осложнения ЖДА для матери и плода. Глубина поиска – 5 лет.

Результаты и обсуждение. Имеются разные точки зрения на классификацию и диагностику ЖДА в руководствах профессиональных организаций. По мнению большинства руководств наиболее достоверными для верификации и предикции ЖДА являются определение уровня гемоглобина и ферритина. Несмотря на то, что в настоящее время изучены особенности патогенеза и подходы к лечению ЖДА, ее распространенность среди женщин остается очень высокой. Причины этого кроются в недостаточной диагностике и неполноценной терапии с точки зрения ее продолжительности и выбора препарата. Методы диагностики и лечения ЖДА в настоящее время активно изучаются и совершенствуются в ожидании получения наибольших преимуществ.

Заключение. Осложнениями ЖДА в третьем триместре для новорожденных являются развитие анемии, нарушение развития нервной системы и когнитивные расстройства, что требует активной профилактики во втором триместре с использованием, в том числе, и парентеральных препаратов железа.

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