Assessing Treatment Effects Using Quality of Life Questionnaires in Pregnant Women with Iron Deficiency Anaemia [26H]

INTRODUCTION: There is considerable overlap between symptoms related to iron deficiency anaemia (IDA) and a normally advancing gestation, posing challenges to the use of quality of life (QoL) tools to measure treatment effects. Our aim was to determine how best to use two existing QoL tools; short-form 36 (SF36) – a general questionnaire covering eight domains and the multidimensional fatigue symptom inventory: short form (MFSI-SF) – a fatigue-specific questionnaire to assess treatment effect in pregnant women with IDA. METHODS: We recruited consecutive women with IDA attending the Obstetric Day Unit at Mount Sinai Hospital, Toronto, for intravenous iron infusions over six months. Consenting participants completed SF36 and MFSI-SF questionnaires at each visit and upon completion of treatment. Scores for the entire questionnaire and individual domains were summed and plotted graphically over time. RESULTS: 29 women consented and completed at least one SF36 and MFSI-SF questionnaire, while 24 completed two, 12 completed three and four women completed four. The mean maternal age was 34 (24-46) years and the mean gestational age 29 (25-38) weeks. These women represented different ethnic groups and socio-economic strata. Although there was no consistent pattern in scores for 6/8 SF36 domains, there was a significant improvement between visits in the energy/fatigue (37.6 vs 42.8, p=0.044), and emotional wellness (62.7 vs 77.3, p<0.001) domains and in MFSI-SF scores (17.1 vs 12.2, p=0.025). CONCLUSION: When assessing treatment effects in pregnant women with IDA, consideration should be given to using QoL tools specifically designed to measure fatigue, such as MFSI-SF or the energy/fatigue domain in SF36.