Iron Deficiency Anemia in Pregnancy and Treatment Options

INTRODUCTION: As many as 17% of Canadian women suffer from iron deficiency anemia (IDA) in pregnancy. Treatment options include oral ferrous salts, haem iron, intravenous (IV) iron and blood transfusions. Trade-offs pregnant women are willing to make to alleviate symptoms of IDA have not been determined. This study elicits preferences of pregnant women for health-states arising from IDA and the use of various treatment options. METHODS: A cross-sectional study was conducted on pregnant women with and without IDA. Participants were presented with five vignettes representing maternal health-states arising from IDA in pregnancy. They were asked to rank these states and assign them values on a visual analogue scale, by the standard gamble, and by time trade-off methods. Utility values (preferences) of women with and without IDA, obtained from these methods were presented on a scale of 0-100 where 0 represented death and 100 represented perfect health. RESULTS: 60 pregnant women (30 with IDA and 30 without) completed the interviews. With all three methods, utility values were lowest for blood transfusion and highest for oral iron. Regardless of the evaluation method, there was no difference in utility values for treatment with oral ferrous salts vs. haem iron or between women with or without IDA. CONCLUSION: Women acknowledge that symptoms of IDA in pregnancy reduce quality of life. Despite side effects and frequency of administration, oral iron is preferred over IV iron and blood transfusion. Confirmation of these findings in larger studies would directly inform clinical practice and research.