title: Three-year follow-up of a randomised clinical trial of intravenous versus oral iron for anaemia in pregnancy.
abstract: BACKGROUND
  To date, there are no data available concerning the impact of iron therapy on the long-term well-being and health-related quality of life (HRQoL) in pregnancy.
  
  
  OBJECTIVE
  To assess the long-term effect of iron therapy on HRQoL in pregnancy.
  
  
  METHODS
  This is a follow-up study conducted between January 2010 and January 2011 of an earlier randomised open-label clinical trial of intravenous and oral iron versus oral iron for pregnancy-related iron deficiency anaemia. We used a modified version of the SF-36 questionnaire together with the original prospective HRQoL data collected during and after pregnancy.
  
  
  METHODS
  Of the original evaluable 183 pregnant Caucasian women randomised to receive oral iron or a single intravenous iron polymaltose infusion followed by oral iron maintenance, 126 women completed the follow-up HRQoL study.
  
  
  METHODS
  The participants were followed up 4 weeks after treatment, predelivery and postdelivery for a median period of 32 months (range, 26-42) with a well-being and HRQoL questionnaire using a modified SF-36 QoL-survey and child growth charts as set by the Australasian Paediatric Endocrine Group (APEG).
  
  
  RESULTS
  Patients who received intravenous iron demonstrated significantly higher haemoglobin and serum ferritin levels (p<0.001). There were strong associations between iron status and a number of the HRQoL parameters, with improved general health (p<0.001), improved vitality (physical energy) (p<0.001), less psychological downheartedness (p=0.005), less clinical depression (p=0.003) and overall improved mental health (p<0.001). The duration of breastfeeding was longer (p=0.046) in the intravenous iron group. The babies born in both groups recorded similarly on APEG growth chart assessments.
  
  
  CONCLUSIONS
  Our data suggest that HRQoL is improved until after pregnancy in anaemic pregnant women by repletion of their iron stores during pregnancy. About 80% of the intravenous iron group showed a maintained normal ferritin until delivery with long-term benefits. Further studies to confirm these findings are warranted.
authors.affiliation: Department of Medicine and Clinical Haematology, Launceston General Hospital, Launceston, Tasmania, Australia.
authors.forename: Alhossain A
authors.initials: AA
authors.lastname: Khalafallah
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Dennis
authors.forename: Kath
authors.initials: K
authors.lastname: Ogden
authors.forename: Iain
authors.initials: I
authors.lastname: Robertson
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Charlton
authors.forename: Jackie M
authors.initials: JM
authors.lastname: Bellette
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Shady
authors.forename: Nep
authors.initials: N
authors.lastname: Blesingk
authors.forename: Madeleine
authors.initials: M
authors.lastname: Ball